Support in a bipolar episode

Below are some suggestions for ways to support a person when they are experiencing a bipolar episode:

  • Help the person to get treatment
  • Be calm and reassuring
  • Listen and observe to help monitor symptoms
  • Support the positive things the person does to get well

Help the person to get treatment

  • Encourage the person to contact their clinician or mental health team if they have not already done so.
  • Offer to assist them to get treatment (e.g. call the doctor, give them a lift to an appointment).
  • If they are too ill to contact their clinician or mental health team or they are at risk of doing something with damaging or life threatening consequences get help on their behalf (see also dealing with a bipolar crisis and  helping to prevent suicide).
  • Some bipolar episodes are more severe than others. While many people can be treated at home, sometimes they need to go to hospital (see also helping if the person needs to go to hospital).
  • If the person tends to become severely ill, it can help to plan ways to deal with severe episodes.
  • Encourage the person to postpone demands or goals so they can focus on getting well.

Be calm and reassuring

People experiencing a bipolar episode need as much calm and stability around them as possible.

  • Try not to shout or express your concerns in very emotional ways. Keep in mind that the person is ill.
  • Don’t respond impulsively (e.g. if the person is irritable try not to respond in the same way).
  • You don’t have to agree with the person. Instead, let them know you understand their viewpoint (e.g. “I can see you are fed up with your job right now and want to quit but, maybe it is a good idea to wait until you have had time to settle down and think things through.”).
  • Supporting a person with depression differs from supporting a person with mania or hypomania.
  • Being available (within personal limits) and letting the person know you care can be reassuring.
  • Don’t expect the person to be able to do what they usually do when they are ill ( e.g. they may not be able to do things they usually do at home, work or to respond to you or others in the same way). Caregivers often help with practical tasks ( e.g. housework, children, paying bills).
  • Once the person is having treatment and trying to get over an episode, don’t keep telling them what to do.

Help to monitor symptoms

Are the person’s symptoms improving or getting worse? Keep in contact with the person and observe, listen and tactfully enquire about how they are.

There are also formal ways that people use to monitor their mood, sleep and activities to help them get well. If the person wants assistance, you can help them with this monitoring. Some people use these mood diaries when they are well to help keep their mood stable.

Find out more about monitoring on www.manicdepressive.org/moodchart.html or www.pendulum.org/bpcoping.htm

Support the positive things the person does to get well (e.g. taking prescribed medication or cutting down on stimulation when manic).”

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