How Can My Friend Help Her Bipolar, Manic Depressive Sister?

I have a friend whose sister lives with her since leaving a bad relationship. The sister has no job, or very little means for making money. And she has some bipolar, manic depressive episodes. What can she do to find help when she has no insurance? My friend needs help dealing with her sister! Thanks. - Concerned
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Dear Concerned,

Thank you for asking this important question. Dealing with episodes like mania and depression can be very challenging and quite upsetting. It does sound like your friend’s sister would benefit from professional help—as well as your friend herself. There are a couple of possibilities worth considering. There are free or low-cost public services available in most communities throughout the United States. If your friend and her sister live near a major metropolitan area, there should be several programs and services available. A good place to start is an online search with keywords such as “community mental health services in (location),” or “programs or services for people with bipolar disorder (or depression).” Another possibility is to contact therapists in your community—you can search for local therapists at, for example. Send e-mails asking local therapists if they ever provide free or low-cost services, and ask them what local programs or services they know of. Your friend may want to contact the nearest local Mental Health Association. These are the local affiliates of the national Mental Health Association and are nonprofit advocacy and resource centers. They should have listings of free or low-cost services available in your area.

Your friend may need some support or guidance herself. She may want to consider seeing a therapist who is familiar with her sister’s disorder. There are a few very helpful guidelines to keep in mind when you live with someone who has bipolar disorder (and other kinds of severe emotional disorders such as major depression). It’s important to understand that the symptoms—mood, behavior, and disturbing things that are said—are indeed part of a real biological, psychological, and emotional disorder, or illness. Those who live with people who struggle with these disorders often are affected in ways that are totally normal and even expected. These “caregivers” often become angry or depressed themselves, and they often experience feelings of guilt, helplessness, and frustration. Your friend needs to know that these feelings are predictable and understandable and that she did not cause the problem or disorder—nor can she cure it. She can be emotionally supportive, make sure her sister is safe (if there are any suicidal statements she must take her sister to the hospital or contact the proper authorities), and suggest help from local programs or therapists. She should also practice self-care, everything from setting boundaries (saying no to her sister when necessary) to taking care of her own needs. These are important guidelines for all of us who care for people with significant psychological problems.

Kind regards,

Richard Loebl
Richard Loebl, MSW, LCSW, BCD, is a board-certified psychotherapist, consultant, and educator with over 25 years of experience in the fields of mental health and chemical dependency. Although his primary specialties include men's issues, couples counseling, mood issues, and addictions, Richard has special interests in attachment issues, emotionally focused therapy (EFT), and in the use of mindfulness, meditation, and mind-body approaches.
  • Leave a Comment
  • BOYD

    November 23rd, 2012 at 12:36 PM

    Seems like multiple issues all together for the person’s friend.Sister has bipolar disorder and the need to find a low cost health facility.That in itself can be enough to put someone in stress and I’m happy to see the therapist responding here has stressed on how even the writer’s friend herself should seek help.

    It can be quite overwhelming when situations like these pop up in one’s life. Having knowledge of the right outlets at the right time by itself can be a big advantage that will reflect later on.Kudos to the good advice.

  • Celeste

    November 23rd, 2012 at 4:01 PM

    Isn’t it sad that one of the first things that we think about when considering helping someone who is ill, seriously ill, is whether or not they have any health insurance.
    If that isn’t evidence of a system that is fundamentally broken then I’m not sure what is.

  • Royce

    November 4th, 2014 at 10:44 AM



    November 23rd, 2012 at 5:27 PM

    There are so many program out there that can help her. I think most are covered in the answer here anyway but yes it is necessary that the same is addressed as soon as possible.Stay strong,my wishes are with you and your friend.

  • Brent

    November 24th, 2012 at 5:29 AM

    This is a question that many people face when living with someone who has mental illness. You want to help and do all that you can to help them become a success, but by the same token it’s hard when you don’t have the means or the resources to do everything for them that they really need to get the best help available.
    I would encourage your friend to start with some community groups who may have some leads on how to get the sister the help that she needs, because at least this is a good start.

  • joaquina

    November 24th, 2012 at 2:35 PM

    never too easy to decide you need help just because the one you are taking care of needs help it always recommended that the caregivers receive help themselves or does it come down to some parameters?because I have seen both the situations playing out for different people in not so different circumstances.just how important is it for the caregiver to receive help too?

  • Leon

    November 25th, 2012 at 4:36 PM

    Firstly your friend needs to have a lot of patience…I think what she also requires is to remain calm and to know that there is help out there.She wouldn’t want to overwhelm herself with the situation and then have further problems…There are many outlets that can offer a helping hand and there definitely is hope..She must hold on to hope and believe she can tide over this with her sister…Anxiety and confusion are definitely not going to help the situation.

  • Owen

    November 25th, 2012 at 8:19 PM

    Living with someone with a condition like bipolar needs a lot of understanding and patience.Not only do you need to learn of the disorder and its affects but also cope with the mental drain that comes with it.Its not easy but gaining knowledge of the issue,interacting with others in a similar situation,and a good group of friends can definitely help someone tide over such a situation.

  • liZZie

    November 26th, 2012 at 4:05 AM

    I have been in a situation like this one before, not with my own sibling but one of a friend. There is not that much you can do but be there when they need some guidance and support, but basically it’s not like you can get this person help or anything because you are not their guardian or their family.

    Your friend, I know feels a whole lot of responsibility for her sister, but there comes a time when you have to let that go too. She is not the mother, and until the sister comes down and is rational for a moment and understands that she needs help and has to seek that out, there is not that much that can truthfully be done.

  • Grace

    November 27th, 2012 at 12:30 PM

    I am 34 years old, I was diagnosed with bi-polar disorder when I was was 25. I have been married for over 15 years.
    Your friend needes to do some research on by-polar disorder, this will help her understand a lot. By-polar mood swings are set off by what we call trigers. This meaning your friend will need to help her sister keep a diary of situations that set off triggers. For instance money issues, relationships. And loud places. Can all triger stress, which create a mood swing. When her sister identities these she should first avoid these things or get help with them. Then write them in her diary and take it to her Dr. As for your friend, she has to be understanding, yes but that doesn’t mean her sister get to treat her like crap and get away with. When her sister has an episode she should help calm her, after things are calm she has the right to say I know you are going through a lot buy this is what you said or did that hurt me, and that she still loves her. It will help her sister to know when she crossed a line. Good luck!

  • bree

    November 27th, 2012 at 4:36 PM

    The best way that she can take care of her sister is to start by remembering to take care of herself.

    How many times have you heard about familiy members literally draining their personal wells dry because they are always trying to help someone else in their family?> I find it so sweet and admirable when someone really steps up to the plate like this when they have to but they shouldn’t try to do it alone, and they can’t ignore their own needs either.

    There is probably a long road ahead of that whole family as they try to find the right mix of options that will help this sister. Until then they all have to remember that it is critical to not allow yourself to become rundown too. Take just a moment everyday to do something that still means something to you, something that completes you, and gets you away from the otherwise dismal issues that you may have going on.

  • Royce

    November 4th, 2014 at 10:38 AM


  • Billie A

    September 22nd, 2015 at 10:46 AM

    I am dealing with my 25 year old adopted daughter that is bi-polar. She has recently started taking things from our home and bonding them for money as well as taking my credit cards. I do not know how to deal with this. I am currently seeking therapy for myself. She refuses to stay on her medicine.

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