Getting Prepared as a Caregiver: What’s Next?

It can be scary to learn that someone you love has been diagnosed with bipolar disorder. You may be overwhelmed by the challenges of the condition and all there is to learn about how to support your family member or friend.

Bipolar disorder is a common mental health condition that many people have managed before you. Their experiences can help you prepare for what’s next in your journey as a caregiver.

How bipolar disorder affects loved ones

The highs and lows of bipolar disorder can be disruptive not just to the person with the condition but their family and friends, too. The moods and behavior that erupt during mania may involve explosive outbursts, outrageous demands, and reckless or dangerous acts. Then, you may have to manage the fallout from these manic behaviors.^1,2

Episodes of depression bring different challenges. You may have to shoulder all the household chores and childcare for someone who is unable to help. You will have to be on alert for signs that they are having thoughts of self-harm or suicide.^1,2

During mania or depression, your loved one may find it impossible to work or go to school. This can result in unemployment and loss of income, or problems achieving enough education to get a good job in adulthood. Both situations have long-term consequences for the family.¹

Supporting someone with bipolar disorder

The good news is that bipolar disorder can be managed with proper treatment and supportive family and friends. Proper treatment includes prescription drugs, therapy, and self-management techniques. How you support a loved one in these 3 areas depends on that person’s individual needs.¹

First, learn as much as you can about bipolar disorder. Knowledge will help you be patient with the life-long process of managing this condition.¹

Also, become familiar with the early and advanced symptoms of mania and depression. The more you understand about the condition, the better you will be able to offer support and encourage the person to get help when it is needed.¹

Caregiving tasks

People with bipolar disorder recover more quickly and have fewer and milder episodes when they have support from family and friends. Empowering the person to manage their own health is key, but most people still need extra support at least sometimes.^1,2

Caregiving tasks that may be needed to support someone with bipolar disorder include the following.^1-3

• Encourage routines for sleep, meals, and exercise.
• Track whether prescription drugs are taken as directed.
• Prepare healthy, easy-to-eat meals.
• Participate in family therapy.
• Avoid stimulation and loud sounds as much as possible.
• Help find doctors, therapists, and support groups.
• Attend doctor’s appointments if appropriate.
• Help the person track their moods, and identify and avoid triggers.
• Help them learn ways to build resilience to stress.
• Offer transportation to doctor and therapy appointments.
• Help them manage their insurance or disability benefits.
• Provide financial support or help them find financial support.
• Watch for early signs of relapse and drug side effects.

Since people may not remember some or all of what they said and did during a manic episode, friends and family may have to report what happened to their doctors. Finally, perhaps the most important role for a caregiver is to advocate for their loved one in the healthcare system, at school, or at work.^1-3

Dealing with stigma

People with bipolar disorder and their families may feel judged, ridiculed, or excluded by others. They may even direct these feelings inward on themselves. This is called stigma, and it hurts people physically as much as mentally. People who feel stigma are more likely to avoid treatment, try to conceal their illness, and withdraw from life.⁴

Addressing stigma head-on is critical to helping both yourself and your loved one. Some things you can say to a person experiencing stigma include:¹

• Bipolar disorder is a real illness, just like heart disease or diabetes.
• You did not cause your condition – it is not your fault.
• You can do this. You are capable and smart, and you can make changes to your life that will keep you healthy.
• You are not alone in this. I am here, and you matter to me.

Making a crisis plan

Planning ahead for what to do in a crisis can help you act quickly when it occurs. A crisis plan is basically a list of:^1,4

• Emergency contacts for your loved one’s doctors and therapist
• Health insurance information
• Address and telephone number for the hospital where you will take your loved one if needed
• Interventions that have been helpful in the past
• Interventions that should be avoided as they were not helpful or may have made things worse

If an episode of mania or depression is moderate to severe, you may need to:¹

• Take away their car keys
• Remove any guns from the house
• Take away credit and debit cards
• Revoke access to bank accounts

If you become worried that your loved one may hurt themselves or someone else, call 911. If they are having thoughts of suicide, do not leave them alone. Call 988, the national suicide hotline, for support while you wait for an ambulance to arrive.¹

Taking care of yourself

Recurring episodes are a natural part of bipolar disorder. That can get discouraging or overwhelming. That’s why finding help for the helper is so important. There are many strategies to cope with the stresses of caregiving.

First, learning what to expect from others who have been there can help. Several national organizations offer support groups that specialize in helping caregivers of people with bipolar disorder. Support groups can offer needed advice and understanding.⁴

Some support groups are led by mental health professionals, and others offer peer-to-peer support. The groups may meet in person or online. They may be targeted to caregivers of children, teens, adults, or the newly diagnosed.⁴

When you are caring for someone with bipolar disorder, it is important to care for yourself too. This means accepting your loved one’s limits and your own. Be realistic about how much you can do on your own, and set boundaries for others and yourself.¹

Remember, you can help a person with bipolar disorder. But ultimately, they have to care for themselves. You cannot force them to do what it takes to find balance.¹