The effects of a person's bipolar illness on the family may vary from mild to devastating. As a family member, here's what you need to know.
Effect of Bipolar Disorder on Family is Far Reaching
Depending on the nature of an individual's manic-depressive illness (aka bipolar disorder), the family will be affected in many ways. Where mood swings are mild, the family will experience many forms of distress but, over time, may adapt well enough to the demands of the illness. If episodes are more severe, the family may need to work through extreme difficulties in several ways:
- emotional effects of the illness
- social effects
- changes within family members
- changes within family structure
- ways of reducing stress
- coping with the threat of suicide
- ways of establishing good communication lines with family members and with outside resources
If symptoms are related to an individual's aggression or inability to fulfill responsibilities, family members may well become angry with the individual. They may experience anger if they see the individual as malingering or manipulative. Anger can also be directed at the "helping" professionals who are unsuccessful in curing the illness "once and for all". Anger may be directed at other family members, friends or God.
Typically, these same family members experience feelings of extreme guilt (read Bipolar Guilt) after the individual has been diagnosed. They are concerned about having had angry or hateful thoughts and may wonder whether they somehow caused the illness by being unsupportive or short-tempered (read about causes of bipolar disorder). Moreover, much literature and other media of the past few decades have largely supported (erroneously) a common notion that parents are somehow always responsible for producing mental illness in children. And so, parents and to a lesser degree, other family members may find that feelings of guilt and the wish to compensate for any wrongdoings prevent them from effectively setting limits and developing realistic expectations.
If the individual's illness creates an ongoing burden for the family because of such things as decreased income or continual disruptions in family routines, it is not uncommon for family members to find themselves in a cyclic pattern of alternating feelings of anger and guilt.
Equally painful is the sense of loss that is associated with the growing awareness that, in severe cases of recurrent manic-depressive illness, an individual may never be quite the same person the family knew before the illness. There is grieving over lost hopes and dreams. The mourning process is usually marked with periods of resignation and acceptance and intermittent periods of renewed grief stimulated perhaps, by the accomplishment of a peer, a family celebration or some other seemingly minor event. Eventually, as with any other loss, whether the end of a marriage, the death of a loved one, or the loss of ability through illness or accident, what is needed is a careful re-evaluation of goals and an adjustment of expectations.
Related here, may be some feelings of shame associated with unfulfilled expectations and with the stigma of mental illness. It may be interesting for family members to realize that one of the reasons that mental illness carries with it such a stigma is that mental illness is often associated with decreased productivity. The value of productivity and the notion of "the bigger the better," have long formed a mainstay of North American culture. The family may have to grapple with whether they want to place such emphasis on these values. Shifting emphasis on to values related to family, spirituality or other focus may help to diminish any unnecessary suffering due to feelings of shame.
Finally, anxiety may be ever present as family members grow to continually anticipate a change of mood, a return of bipolar symptoms. Families may find planning events fraught with worries of whether the ill relative will present any problems at the event. There may be fear that unprovoked conflicts will arise at any time, that other family members may suffer. Children may fear that they will inherit the illness, they fear that they may have to manage the care of their ill relative as well as manage their own lives when the primary caretakers can no longer do the job. To cope with such consuming anxiety, some family members learn to distance themselves (both physically and emotionally) from the family, while others may put their personal goals on hold in anticipation of the next crisis. In any event, families need support to learn to manage anxiety and to lead as fulfilling lives as possible. Attending bipolar family support groups can help to relieve the pressure experienced by families caught in their stressful situations.
In severe cases of manic-depressive illness, families typically find that their social network starts shrinking in size for several reasons. The family is often embarrassed by the varied symptoms of an ill relative whether these symptoms have to do with poor self-care skills or belligerent behavior. Visitors may feel awkward about what to say or how to help the family. Usually they say nothing at all and soon both family and friends find themselves participating in a conspiracy of silence. Eventually, it becomes easier to avoid each other.
Going to a bipolar disorder support group is one way to help reduce the sense of isolation a family often faces. Through the practice of self-disclosure and the development of a vocabulary to use and the self-confidence to use it, a family can gradually learn how to communicate with extended family members and friends.