Suicidal thinking is common in bipolar disorder, particularly during deep depressions and mixed states, when a person is agitated, depressed and energized. Though suicidal ideation can be tough to ascertain, some indicators that an individual is at imminent risk include: being depressed, a history of attempts, talk of harming oneself, putting affairs in order and an active plan, Dr. McInnis said.

If you’re experiencing suicidal thoughts, this means your symptoms are getting worse. Call your doctor, therapist or loved one immediately or go to the ER. It’s important to take such thoughts seriously and to realize that suicide is a permanent solution to a temporary mood.

General Tips

  • Think tasks through. Tasks that seemed simpler in the past might be much tougher now, partly because of bipolar’s strain on information processing. Brondolo’s student patients notice they have more difficulty taking tests, even though previously they had no trouble. She suggests using a scale from 1 to 10 to think through the difficulty of the task. If the task is over a 4, consider what it is about the task that trips you up and anticipate what you need to do to complete it successfully.
  • Become an expert. Educate yourself about bipolar disorder by reading everything you can, looking at valuable Web sites like and Psych Central and attending support groups. You can find many books with excellent tips and tools. The key is to become informed and active, Basco said.
  • Recognize your own courage. “Give yourself credit and respect for managing your illness” and acknowledge your hard work, said Brondolo. She notes the “tremendous courage and strength” it takes to live with bipolar disorder.
  • Focus on your health. Every healthy lifestyle requires regular exercise, a wholesome diet and adequate sleep.
  • Avoid caffeine and cigarettes. Whether it’s an energy drink, cup of coffee or anything with nicotine, stimulants can change your mood and cause sleep loss.

What Loved Ones Can Do

Often, family and friends are eager to help, but they aren’t sure what to do. Basco suggests:

  • Keeping an open mind. Loved ones also can have difficulty accepting the diagnosis. However, keep in mind that an accurate diagnosis leads to effective treatment.
  • Educating yourself. “Become knowledgeable about bipolar disorder so you can understand what the person is going through and how you can help,” Basco said. Even if the person isn’t ready to seek treatment, Basco still suggests learning about the disorder.
  • Becoming an active ally. “Show support in an active way, go to support groups and meet with the therapist (with the patient’s permission),” Basco said. Establishing a relationship with the therapist is tremendously helpful for loved ones, who can ask the therapist what to do in specific situations, she said. You might ask, “When should I take suicidal thoughts seriously?” “Do I force my child out of bed when he’s depressed?”

Other Resources

Our Complete Bipolar Library

Bipolar Screening Quiz

Bipolar Screening Test

National Institute of Mental Health

Depression and Bipolar Support Alliance

National Alliance on Mental Illness