- Encourage the person to access treatment.
- Consider suicide risk.
- Keep the depression in mind when communicating with the person.
- Encourage the person to do something small.
- Encourage as much routine as possible.
- Provide a bit of perspective.
- Offer kindness, patience and attention even if this is not reciprocated or does not seem to help.
- Remember to take care of yourself too.
Encourage the person to access treatment
If the person has not seen their clinician, encourage or offer to assist them to access treatment.
Consider suicide risk
Although not all people with bipolar disorder become suicidal, bipolar depression is a high risk time for suicide. There may be things you can do to help prevent suicide .
Keep the depression in mind when communicating with the person
The person may not respond or relate to you as they do when they are well.
- What comforts one person who has symptoms of bipolar depression might not comfort another ( e.g. while some people like to be reminded that they will feel better in time, others cannot relate to this).
- Let the person know you care, but not to the extent that it makes the person feel overwhelmed and helpless.
- Don’t force the person to talk. When a person is depressed they may not be able to tell you what they are feeling or what help they need.
- Avoid telling the person to “pull themselves together” or “snap out of it”.
- Don’t always mention the illness when encouraging the person to do something. For example, lethargy and lack of energy can make it hard for people with depression to do things. Encourage the person to do a bit of physical activity by saying something like “Please help me bring the groceries in from the car” .
- Sometimes, just being there without telling the person what to do can be comforting for them.
Encourage the person to do something small
Don’t try to get the person to do something they find very stressful or overwhelming. Consider encouraging them to do something more manageable, especially something that might give them a slight sense of achievement or pleasure.
Divide the task into even smaller steps (e.g. if they are very depressed, first invite them to sit outside in the sun with you before you ask them to go for a walk) if they have difficulty. If they do things very slowly, don’t take over and do everything for them. However, if they are very depressed and unable to do certain tasks, consider temporarily doing these tasks yourself or delegating them.
Encourage as much routine as possible
Bipolar moods can disrupt a person’s routines and sleep patterns. However, this disruption can also make moods worse. Sleeping in the day can make it much harder to sleep at night. Going to bed and getting up at regularly times may help. Having something in particular to do in the morning helps some people with bipolar depression to get up at a regular time.
Provide a bit of perspective
Assisting the person to acknowledge their achievements, (no matter how small) can have a positive effect on mood. Also consider mentioning positive events and experiences if they occur (e.g. acknowledge some good news the person receives).
If the person worries excessively and is preoccupied with a particular problem consider the following options:
- Tell the person that problems seem bigger than they are because they are unwell, and suggest that they postpone trying to sort out the problem until they feel a bit better.
- Invite the person to do something that will distract them from their worries.
- If the person is not too ill, discuss solutions to the problem with them, and assist them to do something small towards these solutions.
Offer the person kindness, patience and attention even if this is not reciprocated or does not seem to help
It is not always easy to help with bipolar depression. You may feel frustrated if your support does not appear to help, and that is understandable. Bipolar depression can be persistent. Don’t stop supporting them because they don’t seem to change or to appreciate or reciprocate your efforts. While they are depressed it may be hard for them to appreciate anything.
Sometimes when a person is very depressed, they may be uncomfortable with lots of suggestions about managing their depression as they feel unable to act on them. However, they may still need your patience and care.
It is vital to take care of yourself when the person you care for is depressed as caregivers can become exhausted and depressed too.
For more about what to do if the person has early symptoms, warning signs or a few mild depressive symptoms see:
- If the person has warning signs or early symptoms of bipolar depression
- If the person has mild ongoing symptoms