Managing Mania: Tips to Help a Loved One Cope with Bipolar

Are you the partner or primary caregiver of someone who has bipolar? Perhaps you are the close friend of an individual who has been diagnosed. If someone in your life has bipolar, you may be somewhat familiar with the mania and depression that often accompany the condition. Those who are in a position to offer support and help to someone they care about may be unsure of what support to offer or helpful actions to take, even when they feel something is not quite right.

People who have bipolar typically experience an intense emotional instability that may include prolonged fluctuations between mania (which can be described as a “high” emotional state) and depression (low emotional state). There are different types of bipolar, and these types may present differently—periods of depression and mania may be shorter, or a person may cycle through these rapidly, for example—but when the condition is left untreated, it can be difficult for people who have bipolar to regulate or manage their emotions in productive or positive ways.

Mania is often misunderstood and given little attention, so it is crucial to fully understand this significant part of bipolar in order to support a loved one who may be struggling.

Early Warning Signs of Mania

The transition into mania can be slow and gradual, and your loved one may not notice when this begins to occur. If you are aware of the symptoms and notice the early warning signs, you may be able to offer support and assist them in getting the help they need return to their baseline.

At the onset of mania, your loved one might feel confident and energized, but since mania can ultimately take away from a person’s goals and interfere with functioning, it’s important to spot red flags and indicators at the onset of mania. By doing so, you may able to help them take steps to keep focused and maintain productivity.

Warning signs may include:

• Talking rapidly, unable to be understood easily
• Irritability and frustration
• Restlessness or fidgety behavior
• Unwillingness or inability to sleep
• Being less mindful of their actions or the actions of others
• Disorganized or easily distracted
• Not keeping commitments or sticking to a schedule
• Having unrealistic ideas or plans
• Taking on more tasks than can be managed
• A euphoric mood that may make others feel overwhelmed
• Impulsivity, lacking judgment in decision-making, or risk-taking behavior

How to Help

It can be difficult to know how to support someone during a period of mania. These tips may help you know where to start.

• Remind your loved one to take any prescribed medications, even if they say they “feel good” and deny the need to resume use. If they don’t want to take their medication, encourage them to meet with their psychiatrist to discuss this before making any decisions about treatment. It can also be helpful to keep an eye on their medication. If it’s running low, you could suggest they refill early so there’s no lapse in their prescription.
• If a manic period seems to be approaching, you might suggest they meet with their therapist or other care provider. Offer to go with them if they want additional support. If possible, consider obtaining permission from your loved one with bipolar to give consent for you, or another positive support person, to collaborate in their treatment. They must provide written consent for this to their doctor/therapist. If you aren’t given consent, you can still call their doctor or therapist and give them your observations of what is happening, which may still be valuable to the treatment process. Though without written consent mental health professionals cannot provide you information, or even confirm if they are treating your loved one, any information you provide may be helpful for them to know.
• At home, create a calm environment. Keeping common living areas as calm and free of disruption as possible can facilitate a peaceful atmosphere and mood. Encouraging your loved one to create an environment in their bedroom that’s conducive to sleep, relaxation, and stability can also be a positive and helpful step to facilitate restful sleep.
• Help them break down their goals into small, attainable tasks. Keeping a daily journal or otherwise tracking plans and goals in a written or online format can often be calming and help facilitate mindfulness.
• Encourage them to maintain habits for good health. A balanced diet that contains nutritious foods and a regular exercise routine can improve overall wellness. If a person is not physically able to exercise, spending time outside each day may also be helpful.
• Model positive behavior. By sticking to a schedule and practicing your own self-care and relaxation techniques on a regular basis, you can show your loved one the benefits of these habits and also help them feel supported.
• Share these tips with your loved one. Write down or print out these tips and give them to the person you care for, or leave them in a place where they can be easily seen and accessed. (A daily reminder may work best for some people, but others may prefer to have tips and suggestions out of sight, but available if they choose to look at them. Ask your loved one what they prefer!)

When you care for or support someone who has bipolar, you may feel frustrated and concerned. Try to remain patient and avoid getting into arguments or shouting. Even though you may become irritated, try to avoid condescension. Take a moment to remind yourself of what they may be going through and try not to take their behaviors personally.

Your loved one may express impulsive, extreme, or grandiose thoughts or plans. Try to remain patient and allow them to express themselves. Remember, you cannot force them to do anything. If they express dangerous or harmful thoughts, you can connect them to their therapist or otherwise help them get the support they need, but beyond that, you cannot make decisions for an adult partner. Even if you believe their choice is a mistake, it is their choice to make. By putting your own healthy boundaries in place, you can let them know the ways you are willing and able to offer support and outline what choices or behaviors on their part might cross a boundary.

Instead of matching their energy level, you may find it more helpful to slow down and try and get your loved one to match your speed. Avoiding excessive caffeine, sugar, and other stimulants may be of benefit to you as well as your loved one. Your loved one may find it easier to keep track of what they are eating and putting into their own bodies, especially when it affects their condition, if they see you doing so—particularly if you reside in the same home. Encourage nutritious food options in the home.

Don’t put your life on hold. Go out with friends, enjoy your hobbies, and practice self-care. After all, we are best able to be positive role models for others when our own needs have been taken care of!

When it comes to bipolar, some up-and-down may be inevitable and even expected. When you notice more extreme changes in mood, though, it may be best to offer additional support. Tell your loved one what you are observing, whether it is rapid speech, impulsivity, reduced sleep, or any other warning sign. Ask them how you can help, and work with your loved one to make these changes while still allowing them to make decisions for themselves. This is most likely to help them become able to manage their symptoms more effectively in the long run.

If you are having a difficult time coping, or find yourself stressed or drained, physically and/or emotionally, you might wish to seek support from a mental health professional for yourself. Your well-being is just as important as that of your loved one. Develop and maintain your own support network of friends and family to enable you and your loved one to live a happy, productive, and fulfilled life.

References: 

1. Newman, C. F. (2005). Bipolar disorder: a cognitive therapy approach. Washington, DC: American Psychological Association.
2. Basco, M. R., & Rush, A. J. (2007). Cognitive-behavioral therapy for bipolar disorder. New York: Guilford Press.
3. Frank, E. (2007). Treating bipolar disorder: A clinician’s guide to interpersonal and social rhythm therapy. New York: Guilford Press.

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