Bipolar disorder is a complex mental health disorder that used to be referred to as manic-depressive disorder. People diagnosed with bipolar disorder go through distinct mood episodes. These may range from energetic and elevated (manic or hypomanic) to deeply sad and lethargic (depressive). Hypomania is an elevated mood state and increased energy that is less severe than mania, but can still cause impairment in daily life.
Bipolar disorder can easily interfere with daily life. Sleep disturbances, stress, substance use, and some medications can trigger mood episodes. Identifying and managing triggers is a crucial part of managing the condition. It can feel overwhelming to someone working to live a healthy life with bipolar disorder.
To support someone with bipolar disorder, it’s important to have patience, understanding, and a commitment to learning about the disorder. It’s essential to understand the nature of the disorder to be able to provide effective support.
What is Bipolar Disorder?
Bipolar disorder is characterized by extreme shifts in energy, mood, and activity levels. There are three different types of bipolar disorder: bipolar I, bipolar II, and cyclothymic disorder. Each type is defined by the rate and severity of manic and depressive episodes the person experiences. It’s important to distinguish if the person is suffering from bipolar disorder or another condition, such as a depression disorder.
People with bipolar disorder cycle between periods of depression and elevated mood (mania or hypomania). These shifts can seriously affect daily life. If the person isn’t formally diagnosed as bipolar, they may attribute the shits to having a moody or chaotic personality.
Mania or Hypomania Symptoms
- Elevated mood: Feeling unusually elated, happy, or irritable
- Higher energy: Feeling jumpy, wired, or more energetic than usual
- Racing thoughts: Rapid thoughts and speech, memory problems, and difficulty concentrating
- Less need to sleep: The person may feel rested with little sleep
- Increased activity: Taking part in more activities than usual
- Grandiosity: Having an exaggerated feeling or self-importance
- Talking excessively: Talking more rapidly and excessively
- High-risk activities: Taking part in reckless and risky behaviors without thinking about the consequences
Depression Symptoms
- Constant sadness: Empty feeling, sadness, uncontrollable crying, or hopelessness for extended periods
- Loss of interest: People may lose interest or pleasure in previously enjoyed activities
- Sleep changes: Insomnia, excessive sleep, or changes in sleep patterns
- Appetite changes: This can lead to significant weight loss or gain due to changes in appetite
- Fatigue: Lacking energy and constantly feeling tired
- Problems concentrating: Having trouble concentrating, memory issues, and making decisions
- Thoughts of suicide or death
Mixed Episodes
A mixed episode includes both mania/hypomania and depressive symptoms simultaneously. This may be displayed as depression combined with agitation, irritability, anxiety, distractibility, insomnia, and racing thoughts. Mixed episodes can be especially dangerous because of the high suicide risk.
Tips to Support Someone with Bipolar Disorder
There is no outright “cure” for bipolar disorder, and healthy living with the condition requires work and effort. But people with bipolar disorder are capable of leading happy and productive lives.
If you love someone with bipolar disorder, you may not be able to empathize with everything they experience. But you can still be a helpful and supportive presence as they live with this disorder.
Prioritize Effective Communication
Active listening
Pay attention to what they’re saying and how they’re feeling without showing judgment. Validate their feelings.
Choose words carefully
Don’t use blaming language or minimize their experiences. Never say “It’s all in your head.”
Educate yourself
Learn as much as you can about bipolar disorder. This can help you understand your loved one’s experiences and know when it’s appropriate to seek help.
Be patient
The mood swings of bipolar disorder can be unpredictable, so be prepared for fluctuations. Remember that these are caused by the illness, not the person.
Encourage professional help
Encourage your loved one to work with mental health professionals. Offer to help them find help, drive them to appointments, or even go with them to appointments.
Don’t argue during episodes
During depressive or manic episodes, it can be difficult to reason with someone with bipolar disorder. Concentrate on stability and safety, and discuss serious concerns with them when they’re in a stable frame of mind
Offer Practical Support
Help them stick to their treatment
Encourage your loved one to take their medication as prescribed and stay consistent with any additional treatment they may require. You can offer gentle reminders or practical help, like helping them organize their medication into daily doses.
Watch for warning signs
Learn to recognize early signs of a depressive or manic episode. Discuss a plan for what to do if these signs appear
Support a healthy lifestyle
Encourage them to get regular sleep, engage in consistent exercise, and maintain a balanced diet. These can play a substantial role in mood stability.
Help them manage stress
Stress is a major trigger for mood episodes. Help your loved one to recognize their stressors and find healthy coping methods.
Plan for crises
Work with your loved one to create a crisis plan with steps to take if their mental health deteriorates significantly. This plan can include contact information for their therapist, doctor, and emergency assistance.
Provide practical help
During their difficult episodes, offer to help your loved one with daily tasks, such as cleaning, cooking, or running errands.
Practice Self-Care
Set boundaries
Recognize your limits and express them clearly. If you feel overwhelmed, it’s okay to say “no” to providing additional help. Supporting someone with bipolar disorder can be physically and emotionally taxing. It’s important to prioritize your care.
Get support for yourself
Connect with family, friends, or support groups for loved ones of people with bipolar disorder. A mental health professional can provide guidance and a safe space for you to explore and manage your feelings.
Maintain your interests and hobbies
Don’t let supporting your loved one’s condition take over your life. Continue the activities that bring you joy.
Know your limitations
You can’t cure bipolar disorder, nor can you maintain another person’s treatment. Your role is to be supportive, not to take sole responsibility for their recovery
How Bipolar Disorder Can Interact with Addiction
Bipolar disorder is one of the most challenging mental health conditions to evaluate and treat. One key challenge is the high rates of co-occurring addiction experienced by people with BD.
Substance use disorders (SUDs) are highly prevalent among people with bipolar disorder.
It’s not clear why individuals with bipolar disorder have a higher risk for addictive disorders. But individuals with bipolar disorder tend to “self-medicate” with drugs or alcohol to relieve mood episodes. This increases the risk of addiction.
Both bipolar disorder and substance use disorders involve common brain changes and genetic likelihood. The deregulation of neurotransmitters, such as those that play a part in mood regulation and reward pathways, can be involved in both disorders. Manic episodes of bipolar disorder can lead to impulsive and risky behaviors, including increased substance use.
The Value of Dual Diagnosis Treatment
The presence of a co-occurring mental health disorder and substance use disorder is called a dual diagnosis. Effective treatment of a dual diagnosis requires an integrated approach that treats both disorders simultaneously. This approach is especially valuable for people with co-occurring bipolar disorder and addiction, where the two conditions often feed into each other (and can even aggravate symptoms). It can create a challenging cycle that becomes difficult to break over time.
Dual diagnosis treatment recognizes that addiction and mental disorders are interconnected. By treating them at the same time, people can learn healthy coping mechanisms and reduce the likelihood of self-medication. It makes it more possible to sustain sobriety and recover from the effects of addiction.
Receive Help for Mental Health and Addiction at First Steps Recovery
At First Steps Recovery, we offer comprehensive treatment programs to address the needs of people facing addiction. We also offer support to people dealing with the effects of mental health disorders, including bipolar disorder. Our compassionate therapists are trained and experienced in evidence-based therapies, such as cognitive behavioral therapy (CBT) and trauma-informed therapy. Experiential therapies like equine therapy, yoga therapy, and mindfulness round out our offerings to facilitate healing of the whole person.
Remember that support for your loved one is an ongoing process. With patience, understanding, and self-care, you can be a valuable source of support for someone living with bipolar disorder. Contact us today to learn how we at First Steps Recovery can help in that journey.
Dr. Curl is the Medical Director and primary on-site provider for First Steps Recovery. He is a Board Certified Internist and Addiction Medicine Specialist having attended the David Geffen School of Medicine at UCLA and completing his residency at Mount Auburn Hospital with Harvard Medical School. Following several years work as an internist and physiatrist (physical medicine and rehabilitation). Dr. Curl completed the Addiction Medicine Fellowship at Howard University in Washington DC and participated as a RAM Scholar (Research in Addiction Medicine). While part of the fellowship, Dr. Curl pursued research investigating the barriers to expanding and improving medication for opioid use disorder. Following his fellowship, Dr. Curl spearheaded the Opiate Use Disorder outpatient clinic and worked in the Department of Psychiatry and Behavioral Sciences within the Howard University Hospital. In 2023, Dr. Curl completed his Board Certification in Addiction Medicine.
