Any tips on dealing with someone who is bipolar?

Are you talking about people who have actually been diagnosed with BP or you suspect they have it because of the symptoms you see?

Diagnosed

Patience.
and lots of it.

Your question provides very little information in relation to what the problem is. Is the person experiencing a high/low period at the moment?
Do you live with him/her? Are you fearing for their safety? It’d be helpful if you could be more specific.

Try to find patterns of things that sets the person off…then, you can slowly re-introduce them by way of addressing the problem.

Treat us with respect. We’re real people. We don’t want to be condescended to. We don’t believe you know better than we do—except when we know we are having some kind of episode. But don’t 302 us. We may never trust you after that. Even if we think we trust you, there’s a part of us that may try to make things hard on you by just letting it go the next time, forcing you to deal with it again. So don’t baby us.

The people I’ve seen who remain sick the longest are those whose caretakers believe they have to do everything for us. We want to be responsible for ourselves and we can be, but if you take over, it kind of backfires.

You should provide support, but not be a nanny. Sometimes that can seem like a subtle difference, but the key is to always make sure we are on board with what you think we should be doing. We want to get better, but we don’t want to be forced to get better.

I got sick about three years ago, and I did a lot of things as part of my process of healing that hurt my wife. The process seemed, at many times, like it was more destructive than constructive. I pushed my wife away. I wanted her to hate me because it would confirm my own view of myself. I acted out sexually which threatened her, of course.

But I also always loved her and wanted to fix things between us. My acting out was a symptom, not a real desire for divorce, although it was not always clear to me that was the case. I was not, however, the person I had been before I was sick, nor the person I became as a result of being sick.

The sick me—wow. I don’t know what to say. I was so different. I was upside down and backwards in my thinking. Pushing my wife away to see if she loved me. Pushing everyone away to see how they really felt. Feeling bad about myself because I wasn’t getting better no matter what I did. Feeling less human because the meds were the only thing between me and death. The meds changed the way I thought (and still do), and it makes me feel powerless.

I’ve written a lot about this on fluther and elsewhere. Check out my blog if you want more detail (there’s a link from my profile here). It’s pretty sordid—just a warning. Search on my name and the term “bipolar” and you should come up with stuff. You also might search on my old name, “daloon” (the loon).

I got better. One day at a time (wundayatta time). I remain well the same way. I do not take for granted that I can remain well, but for today, I can.

Encourage your person to get therapy and do group therapy and to take meds and make all the arrangements for him or her. But let us choose whether to go or not. If you pressure us, it probably won’t work.

Above all, tell us you love us. Over and over. We don’t believe we are lovable. Not when we’re sick, anyway. All we really want is to feel like a person—lovable, cared for, like we matter. When you don’t matter, you often just want to get it over and die. It hurts so much you can not possibly understand without being there. We just want the pain to end and sometimes it seems endless. Only death seems like a salve. But we don’t want to die. We just want the pain to end. That’s all. And love, too.

Patience and read up on bipolar so you know what you will be dealing with. My sister in law was diagnosed with it 20 years ago. The whole family had its ups and downs, but it is no different than having any other illness. Make sure they meet regularly with the doctor and take their meds and everyting will be okay

Wow, I believe @wundayatta said all that needs to be heared, I would only add: Acceptance.
Hardest is when you believe the other person should not be as they are, should not have a fit over this or that and so… Accept that other person as he/she is, and don’t try to change them, accept their behaviour as their real self, if you can deal with that – great, if not – you can even cause damage.

Lithium works wonders.

@troubleinharlem Oh my gosh, how true. My ex. was/is bipolar and when she went through menopause life was not easy. Patience is actually an understatement.

Being supportive is one thing, accepting abuse is entirely another.

If you cannot be in relationship with this person without them dragging you down with them and inflicting abuse, then you must employ a no contact rule.

Some people can’t be helped, and often, they don’t want to be helped.

One should never sacrifice themselves at the alter of a seriously unwell person.

Only you can decide what you can and can’t live with.

Good luck.

@wundayatta Were you willing to accept help or how did that happen? I suspect that a family member is bi-polar, all the symptoms fit. But, they won’t see their doctor about it. How in the world should this be handled?

@wundayatta I forgot to add that I appreciate what it took for you to share the above…thank you.

I am bipolar, and I tell very few people in my real life that fact, because 99% of them leave when I do. I am not exagerrating. The only friends I have now are other disabled people, and the people who don’t know.

I take my medication daily as prescribed. I’m stable. I am active in my community, but I have to keep this part a secret. It’s an overwhelming burden to carry.

I haven’t met a single bipolar person who wants to be sick. I’ve met some who don’t take their medication as prescribed, but that’s part of the disease.

I was diagnosed 9 years ago, and they have been full of highs and lows even on medication. Mental illness is little understood. The person may appear normal on the outside, but an adept caregiver will see past that and help the sufferer with the pains of the disease that are happening on the inside.

To address the question, I would suggest visiting bipolar.com and educating yourself about the disease through the internet and books. I suggest looking for a support group for friends and family of those with mental illness. It helps to know that you’re not alone. If support groups aren’t available in your area, then try individual counselling for yourself for a while.

If you loved the person before the diagnosis, try to hold on to that. The person needs your support and understanding.

@hawaii_jake has given you some excellent advice. Support groups play an important role not just for those of us with the disorder, but for those who love us. In my group. caregivers are totally welcome. We can learn a lot from each other.

@MissA I had been engaging in a lot of behaviors I didn’t understand for almost six months. I got involved in a series of relationships online. These relationships might last a month, and they would go to extraordinary highs to devastating lows in weeks. I did this over and over, constantly looking for someone who would fix me and who I could fix in return.

I wrote about this a lot—well, not always so directly, but everyone on Askville who read me very much could tell something was wrong.

Eventually, I told my wife what I was doing, and that I wasn’t at all sure I wanted to be with her any more (although I said that she shouldn’t want to be with me). I felt awful about myself for what I had been doing, and even though I had been trying to feel better, it only had made me feel worse. And worse. And suicidal.

My wife, shocked as she was, was more concerned about my health. I, too was concerned about my health because none of this was any fun any more, and the pain was becoming unendurable, or so it seemed. Things would get worse.

Anyway, my wife had me make an appointment with a psychiatrist, and when I couldn’t be seen for two months, she talked to a therapist friend who managed to get someone to see me after the weekend. Over the weekend, I researched myself, and I saw that the pattern of behavior for bipolar people was pretty similar to mine—and so I was pretty sure that when I told my story to the shrink, that would be the diagnosis.

When I got my prescription, I was more relieved than anything else. I wanted to get well because I was close to killing myself. Not as close as some, but closer than I wanted to be. I didn’t want to die, but living was too hellish to endure.

I have never missed a med on purpose. I have done all my changes with the supervision of my shrink. I have always been a good patient and I have tried to do everything people suggested. Some of it didn’t work, but some did. That’s about par for the course.

I was lucky in that the side effects of my meds weren’t that bad. Bad side effects are the major reason why people stop taking meds. The problem is that treating bipolar is more an art than a science. That is, we know there are a lot of meds that can help, but we don’t know which ones will help any one individual. I have friends who have been through a dozen meds and still don’t have something that works that they can tolerate.

The same is true for therapists and groups. Sometimes you have to try several therapists or groups before you find one that works for you. I was lucky. My meds all helped (although he had to add two more to the first before we got an effective combination. I got the right therapist the first time, and the right group the first time. That’s unusual.

It helped me that I was 51 when I was diagnosed. That’s unusual. Very unusual. But it meant that I had a lot of knowledge and understanding that most people don’t have at the age of 16 or 20 or whenever most people get diagnosed. I had a lot of skills that helped me manage my illness, and I had a wife who provided an enormous amount of assistance. It was one of the major things that made me realize she did love me, after all.

Other friends helped me, too, but they were all new friends. None of my friends from before was there for me. They all thought I wanted to be away from them and not a one called to check on me. Weird. I am trying to get back together with them now, but it’s hard because I’m different and it’s hard to get that across to them when they weren’t traveling this road with me.

So I wanted help. It was easy to accept some help, although it was harder to accept my wife’s help because I didn’t deserve it. And that’s not just low self-esteem talking. I did things to her no one should have done to them. It’s amazing that she wanted to stick with me, even so. Although she is not blameless in this, either.

The thing is that we are all imperfect beings and no one ever has all the right on their side. If we are able to believe this and be a bit more forgiving, well, more reconciliation is possible. This disorder damages more than the person who has it. It takes loving and forgiving people to be willing to work through that damage. Not everyone can do it. Not everyone should do it. But from the point of view of someone who has been sick, I wish everyone would stick it out for all of us who are sick. It really means so much.

@wundayatta How do you think it would have worked out for you if you had not agreed to see a doctor/psychologist? And, I am so happy for you that all of the hard work of going through this has paid off.

@MissA Hmmmm. That’s really hard for me to say. I think that when I’m bad, my self-destructive impulses grow stronger and stronger. Yet, underneath it all, I don’t want to die. I just want to be able to feel the love I can’t recognize is there. So if I refused to get diagnosed, it would have been because I was much deeper down than I was. It would be because I had already decided to die.

I’m not sure I could actually do that. I’ve always felt I could never kill myself, and even when I wanted to, I didn’t want to, if that makes any sense. But if I had gone beyond that place where I could hold on, then I wouldn’t have gone because I would have known it didn’t make a difference.

But I had hope even though I was hopeless. Don’t ask me how that works, because I don’t know. I do, however, believe that that hope is inside all of us even when we have given up hope. Deep inside all of us, I think, is a part that not only wants to get well, but believes it is possible. We usually hide that place from ourselves, not just from other people, but I think it is there, and often it helps us save ourselves.

Sometimes, of course, it’s not enough. Well, it’s rarely enough without help, although some people do manage to heal on their own. But usually help is necessary.

It’s also necessary that one get help from people who have been there. Others—maybe they do understand—but to us it is hard to imagine they really understand. We know that people like us understand once we’ve spoken to someone else for five minutes. But so often we are isolated and we think we are the only one, and that makes getting well (or even better) so much more impossible-seeming.

Yes, I am glad the work is paying off. But I am also aware that that work will never stop. I feel like I am always in danger of sliding down that slope again. It makes me crazy when I see myself doing things that I know could be dangerous, and my natural tendency is to fight it, but that has never worked for me. There’s something in me still that I don’t understand, and it allows me to play close to the edge. I need to accept that, but it is hard because I think I should fight. This probably doesn’t make much sense because I am not giving you the details, but there are limits to what I will share. I just want to point out that it’s a constant battle—and a complex battle, because in order to fight it, I have to not fight it. What a mess.

@wundayatta I wish so much that the person i’m writing about could somehow take the medicine without his knowledge because he’d never take it on his own. He’s inclined to think that the doctors are not to be trusted. But, if he could feel the difference, it might change his mind a little.

Is that it? Blanket statement? Doctors can’t be trusted?

Does he admit he has bipolar disorder? Has he been diagnosed?

If he won’t take meds, is he trying to do other things to help? Meds really help (or can), but you can also do it on your own. It’s a lot harder that way.

Did he ever take any meds? How many? Did he try one or two, have a bad experience and quit? That happens more than people would like it to.

Sometimes people don’t know that it is normal to have to go through many drugs before you find one that works. Sometimes people feel powerless—like the medical establishment doesn’t listen to them. These are both reasons I’ve heard why people won’t take meds.

Doctors and psychiatrists can be pretty obnoxious and high-handed. The thing to know is that not all psychiatrists are the same and you can shop around for a better one—one you can work with; one who will treat you like an intelligent person. The other thing to know is that finding the right meds is a crap shoot. No doctor knows what any drug will do to any individual patient. They are just guessing about which ones will work.

Sometimes the patient has to take charge and say they won’t take this drug. Instead we want that one. I had to do that. Or rather, my wife did. We knew that I was depressed and we knew that Lamictal had worked very well for two of my relatives (one of whom just passed away—moment of sadness—she saw me through the first days of my diagnosis).

My psychiatrist didn’t want to give us Lamictal—he’s worried about the side-effect that kills one in two thousand people who take it—it’s a bad rash. So he started with Lithium, which helped somewhat, but left me depressed. He added Welbutrin, which raised my mood a bit, but still left me unacceptably depressed. Finally, after much lobbying by my wife, we tried Lamictal, and it helped banish my depression—together with therapy. All this took about two years.

After I felt well, I tried to get off the Lithium, but I soon started getting manic again, so I had to go back on it. Bummer. But I’ve been on ever since.

It is tempting to be manic, because it does feel good to be confident about myself. I seem to be a very attractive person when I’m manic. And it’s not all that wild a mania. They call it a hypomania because it is very mild. But now that I’ve been healthy for a while, I don’t mind so much about not being attractive. I got into trouble being attractive—trouble I don’t need any more.