Trigger Warning: This post contains a brief discussion of suicidal ideation.
Bipolar patients suffering from mood episodes often make no sense. If they are depressed, they may say things like, “I’m a failure. No one loves me. I want to die.” On the flip side, if they’re manic or hypomanic, they might say things like, “I can fly! Let’s deep clean the house at midnight! It’s all so clear now!”
Telling the depressed person that he or she is not a failure and that people love him or her may fall on deaf ears. Similarly, trying to engage with the manic person’s delusions might be futile. So how do you talk to someone suffering from these issues?
Let’s dig in.
How to Talk to a Depressed Person
In order to talk to a depressed person, you need to address the root problem: the illness. You need to offer sympathy, understanding, and possible solutions.
For example, one thing you can say in response to his or her negativity is this: “I hear you. I understand that you’re depressed. This is normal for your bipolar disorder. I know it sucks. I’ve seen you like this before. Maybe you could take a long, hot shower; we know that helps you feel better.” This response addresses the real issue and communicates that you are there for the depressed person.
Depressed people may also suffer suicidal thoughts, which are dangerous. If they express these thoughts, you can say something like, “Thank you for telling me. You mean a lot to me, and I am here for you.” Then suggest that the depressed person call his or her treatment team and let them know that he or she is suffering from these thoughts.
How to Talk to a Manic Person
Similar to talking to someone suffering from depression, when talking to a manic person, you need to respond with patience and understanding. He or she will try to talk over you, and will not be able to stop talking. Be careful about being swept up into the conversation, as it can be overstimulating for everyone.
If the manic person ends up overstimulated, his or her mania or hypomania might worsen and he or she may become agitated. Despite their confidence, people with hypomania or mania are very sensitive in their elevated mood, and may take offense easily. If you are overstimulated, you might not be as effective at helping them remain calm. Make sure that the manic person is in a safe place and walk away for a break.
When you return, answer questions briefly, calmly, and honestly. If the manic person proposes a project or goal, do not agree to participate. You can keep tabs on them during the project and remind them to eat, sleep, and generally take breaks.
In my own experience, I was manic shortly after giving birth. I clapped my hands repeatedly and demanded that we–myself and the woman from church visiting me–clean the house, rather than let me recover. I was focused on getting my projects done, and ended up devastated once my goal was thwarted. Prepare to deal with that devastation–or frustration.
If the manic person tries to argue, remain detached. Talk about neutral topics. If you need to postpone the discussion, say something like, “I see this means a lot to you. We definitely need to discuss this, but let’s do so in the morning after I am no longer upset and tired.” You can also try to redirect his or her behavior, saying something like, “Would you prefer to take a walk or watch a movie?”
Communicating with people suffering from a mood episode, be it mania or depression, can be difficult. They often believe things that aren’t true. So taking care of yourself in the situation is paramount. If the manic or depressive person is critical of you, tell the person that you understand that he or she is ill and upset, but that you will not tolerate being spoken to in that way. Then find a way to exit the conversation and reconvene later. Be firm, but kind.
Above all, as with so many strategies for dealing with bipolar people, be patient. They are suffering from a mental illness that they cannot control. It’s not their fault. If they must deal with the consequences of their actions, try to present those consequences after they come out of the mood episode, when they are back to their rational selves.