5. Call the police whenever necessary.
“If there’s a physical threat to anyone in the household, or if your loved one is actively threatening suicide, the police need to be involved,” Miklowitz said. When it comes to suicide, “more often what families deal with is vague suicidal ideation, which doesn’t involve the police,” he said.
Instead, it’s important for loved ones to listen and be supportive and compassionate. What also may help is doing “something that interferes with the negative spiral of thinking,” which includes helping the person re-engage with the world.
Of course, “this is the time when meeting with a trusted therapist may be most helpful, although it may also be the time when your loved one is least likely to want to do it.”
(Learn more about how to help someone who’s suicidal here.)
6. Don’t assume medication is a cure-all.
Families and friends tend to overvalue the effectiveness of medication, seeing it “as the answer to everything,” Miklowitz said. But don’t forget about the importance of therapy and positive life events or interactions with close friends or family members.
“Some people with bipolar disorder benefit from behavioral activation exercises that encourage them, in step-by-step fashion, to gradually increase rewarding activities available in their immediate environment.”
7. Attend support groups.
Support groups often play a pivotal role in helping families and friends cope. Because they experience similar struggles, members are able to share tips and insights and truly empathize with each other.
Your loved one also can benefit greatly from participating in support groups. According to Miklowitz, “some support groups are moving toward an AA model with having a sponsor.” This buddy system may be helpful for spotting changes in your loved one’s symptoms and preventing impulsive behavior.
8. Know your limits.
Supporting a loved one with bipolar disorder can be exhausting, and many people feel like failures when things go wrong. And for some families, especially aging parents, caregiving can become almost impossible, Miklowitz said. Close friends and family members, such as siblings and cousins, might be able to take over in some cases.
Taking care of a person with bipolar disorder takes a major toll on a family’s mental health. Many family members develop depression and anxiety as a result of their loved one’s illness, he said. Spouses may decide that they can’t handle the symptoms anymore and want out of their marriage.
At the same time, it’s also important for loved ones to remember that bipolar disorder is a “biologically-based brain and behavior disorder,” so to an extent, the person doesn’t have full control over their actions. Still, as someone told Miklowitz, “If a bus runs you over, it doesn’t help to know that the person had vision problems.” Your loved one’s actions, such as extramarital affairs, arguments, legal problems and monetary misdeeds, may be too much to take.
Additional Treatment Tips for Bipolar Disorder
It can be hard to find a psychiatrist who specializes in bipolar disorder. This tends to be even trickier in rural areas. Miklowitz suggested seeking a one-time consult with a specialist. That practitioner can evaluate your loved one and create a report with the medications they’ll need, which you can then bring to your general practitioner.
Participating in research studies is another way to gain access to treatments that you wouldn’t otherwise, he said. Even if participants are placed in the placebo or “minimal treatment” condition, they still have the opportunity to attend a specialized clinic and get careful oversight.
Collaborating with your loved one’s treatment team is important. But it’s not always possible if they refuse to sign release forms to facilitate communication. If that’s the case, you can get tips and insight into bipolar disorder by reading books on the topic (such as Miklowitz’s publications above) or from newsletters (he recommended Muffy Walker’s “My Support” newsletter, but you might also try Psych Central’s own bipolar newsletter as well) or websites (he also suggested McMan’s Depression and Bipolar website, but you might also try Psych Central’s Bipolar resources section).
Also, even if you can’t obtain information about your loved one from their doctor, you can provide them with information, especially during emergencies. So if your loved one’s symptoms are worsening, tell their doctor immediately.