Learning to Cope
with Bipolar Disorder

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What can families and friends do to help?

If you are a family member or friend of someone with bipolar disorder, become informed about the patient’s illness, its causes, and its treatments. Talk to the patient’s doctor if possible. Learn the particular warning signs for that person which indicate that he or she is becoming manic or depressed. Talk with the person, while he or she is well, about how you should respond when you see symptoms emerging.

• Encourage the patient to stick with treatment, to see the doctor, and to avoid alcohol and drugs. If the patient is not doing well or is having severe side effects, encourage the person to get a second opinion, but not to stop medication without advice.
• If your loved one becomes ill with a mood episode and suddenly views your concern as interference, remember that this is not a rejection of you but rather a symptom of the illness.
• Learn the warning signs of suicide and take any threats the person makes very seriously. If the person is "winding up" his or her affairs, talking about suicide, frequently discussing methods of suicide, or exhibiting increased feelings of despair, step in and seek help from the patient’s doctor or other family members or friends. Privacy is a secondary concern when the person is at risk of committing suicide. Call 911 or a hospital emergency department if the situation becomes desperate.
• With someone prone to manic episodes, take advantage of periods of stable mood to arrange "advance directives" - plans and agreements you make with the person when he or she is stable to try to avoid problems during future episodes of illness. You should discuss when to institute safeguards, such as withholding credit cards, banking privileges, and car keys, and when to go to the hospital.
• Share the responsibility for taking care of the patient with other loved ones. This will help reduce the stressful effects that the illness has on caregivers and prevent you from "burning out" or feeling resentful.
• When patients are recovering from an episode, let them approach life at their own pace, and avoid the extremes of expecting too much or too little. Try to do things with them, rather than forthem, so that they are able to regain their sense of self-confidence. Treat people normally once they have recovered, but be alert for telltale symptoms. If there is a recurrence of the illness, you may notice it before the person does. Indicate the early symptoms in a caring manner and suggest talking with the doctor.
• Both you and the patient need to learn to tell the difference between a good day and hypomania, and between a bad day and depression. Patients with bipolar disorder have good days and bad days just like everyone else. With experience and awareness, you will be able to tell the difference between the two.
• Take advantage of the help available from support groups.

Support Groups: Information, Advocacy and Research

Below, you'll find some advocacy groups — grass-roots organizations founded by patients and families to improve care by providing educational material and support groups, helping with referrals, and working to eliminate stigma and to change laws and policies to benefit individuals with mental illness. The support groups they sponsor provide a forum for mutual acceptance and advice from others who have suffered from severe mood disorders — help that can be invaluable for some individuals. The last 3 organizations, headed by medical researchers, provide education and can help with referrals to programs and clinical studies that provide innovative and state-of-the-art treatment.

• National Depressive and Manic-Depressive Association(NDMDA)
  35,000 members in 250 chapters
  For information: 730 N. Franklin St., Suite 501 Chicago IL, 60610-3526
  800-82-NDMDA (800-826-3632) www.ndmda.org

• National Alliance for the Mentally Ill (NAMI)
  140,000 members in 1,000 chapters
  For information: Colonial Place Three 2107 Wilson Blvd., Suite 300 Arlington, VA 22201-3042
  800-950-NAMI (800-950-6264) www.nami.org

• National Mental Health Association (NMHA)
  300 chapters
  For information: National Mental Health Information Center
  1021 Prince St. Alexandria, VA 22314-2971
  800-969-6642www.nmha.org

• National Foundation for Depressive Illness, Inc.
  (NFDI) PO Box 2257 New York, NY 10116-2257
  800-248-4344

• Madison Institute of Medicine
  Home of the Lithium Information Center and the Stanley Center for the Innovative Treatment of Bipolar Disorder
  Distributes very useful consumer guides to mood stabilizers
  7617 Mineral Point Rd., Suite 300 Madison, WI 53717
  608-827-2470 www.healthtechsys.com/mim.html

• Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD)
  Project that is conducting studies involving 5,000 bipolar patients treated in different centers in the United States. The goal is to improve effectiveness of treatment for bipolar disorder. If you are interested in participating, visit: www.edc.gsph.pitt.edu/stepbd

continue: Psychotherapy can help with bipolar medication compliance.

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