How to Address Behaviors of a Friend or Loved One with Bipolar Disorder

How to Address Behaviors of a Spouse with Bipolar Disorder - CassandraStout.com

Trigger Warning: This post contains a brief mention of suicidal ideation. If you are suffering from suicidal thoughts, please talk with someone from the Suicide Prevention LifeLine at 1-800-273-8255 or www.suicidepreventionlifeline.org.

Confronting a loved one about their recent behaviors due to their mental illness can be dicey, especially if the disease is something like bipolar disorder.

If you find yourself needing to confront a friend or loved one about, say, their manic spending spree, approach the person with compassion and empathy. Try to put yourself in their shoes.

Above all, try to separate the person from their mental illness. Attempt to recognize that their unpleasant behaviors are part of the disorder and not a part of them. Most of the time, they don’t want to act out of control.

Here are some tips to help you address the behaviors of a friend or loved one with bipolar disorder.

When They’ve Been Manic

If your friend or loved one is manic and is acting out, do not hesitate in getting them the help they need. Ask them if you can call their psychiatrist or therapist. Ride the wave of their mania, but try not to contribute to their episode by agreeing to help them with wild, obsessive projects.

As tempting as it is to address their behaviors in the moment, they won’t understand you or be able to respond appropriately. The time to confront them is after the manic episode is under control and they’ve become stable again.

If your loved one has been cheating on you due to a hypersexual manic episode, explain to them how you feel about that. You may feel betrayed and unwilling to trust them. You may feel sad, as if you were not enough to satisfy their urges. You may feel a plethora of negative emotions, many of them directed at your partner and not their mental illness.

Again, try to separate your friend or loved one from their illness. It may be difficult to do at first, but do make an attempt. Unless your relationship was already failing, your partner didn’t mean to hurt you.

Dealing with hypersexual feelings can be extremely difficult, especially in the heat of the moment. People on a manic high tend to be pleasure seekers. They’re always looking for the next good feeling. Flirting and sex is just one way to feel great about yourself.

When the manic episode is over, then the remorse sets in. People coming off of a manic high usually feel terrible; the crash of depression often follows manic episodes, and for good reason. They wonder how they ever could have hurt their spouses or loved ones, and wonder how they’ll be able to make it up to them.

Usually, people suffering from bipolar disorder don’t have the tools to help them rebuild trust.

Explain to your loved one how you feel, and also tell them what they can do to help put your mind at ease. Maybe you need them to check in with you at night so you know where they are and what they’re doing. Maybe you need space to figure your feelings out. Try to set parameters that you both are comfortable with.

Similarly, if your loved one has gone on a manic spending spree and blown through their financial cushion or your joint bank account, explain how that behavior made you feel.

Manic spending sprees come from the same place that other forms of infidelity come from: the inability for the bipolar person to see the consequences to their actions when in the throes of a manic episode.

Tell them that you can’t trust them with money anymore when they’re manic, and that you will be keeping a close eye on your shared finances. If you need to carry the charge card rather than your spouse while they’re manic, then do so.

When They’ve Been Depressed

Confronting someone about the things they’ve done when they’re depressed is a difficult prospect. You want to be careful to blame the disease and not the person for their behaviors, as that might set off a wave of remorse and trigger another depressive episode.

Unlike dealing with a person in the midst of a manic episode, you can tell a person suffering from a depressive episode how you feel, but do be careful to separate your feelings about the disease from your feelings about the person.

Fortunately, depression is usually less harmful to spouses than mania. But there are still behaviors that people suffering from depression do that can be difficult to handle.

For example, people who are depressed may engage in self-harm or suicidal behaviors. You may have felt scared and helpless. Explain to your loved one that you would miss them terribly if they died, and that you felt scared for them.

This is the extreme example. Not all people who face depression hurt themselves. But depression is a very selfish disease. People who suffer from a constant barrage of negative emotions, ranging from guilt to anxiety to hopelessness–and even anger–tend to withdraw into themselves and think only of themselves.

Tell your friend or partner that you love them, if you do, but that it’s hard to love someone who doesn’t love themselves. Not that they are hard to love, but that the disease is.

Explain to your partner exactly what you need. Perhaps you need them to ask you how you’re feeling more often, and geniunely listen. Maybe you need a weekend off from their complaining about their anxieties. Perhaps you need to take some time to yourself.

Whatever you need, don’t be afraid to tell the depressed person that you need it, but be compassionate.

But do recognize that even a simple request for space might end up with your spouse feeling rejected. Reassure them that it’s not about them, but your inability to handle the disease for extended periods of time.

Final Thoughts

Telling your friend or loved one how you feel is crucial to maintaining a healthy relationship. Communicating with them how you’ve been impacted by their behaviors is the first step towards their acknowledgement that they’ve hurt you. Often times, we need that acknowledgement to forgive them.

Confronting someone in the middle of a manic episode about their behaviors is generally a bad idea, as you will often be rebuffed. Similarly, confronting someone in the middle of a depressive episode may be a bad idea because it might send them on downward spiral of guilt and shame.

So try to address the undesirable behaviors after the person is back to what you consider to be normal–a stable mindset. Tell your friend or loved one how their behaviors made you feel. But do separate the person from the disease.

Communication is one of the most difficult parts of a relationship, but it is crucial for the mental health of both partners. You can support your spouse while making your feelings heard. You can forgive them, and address the disease as a team.

You can do this.

How to Address Behaviors of Friends and Loved Ones with Bipolar Disorder - CassandraStout.com

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How to Support a Friend or Loved One Staying in a Psychiatric Hospital

hospital.jpg
A white man reclining in a hospital bed. Credit to flickr.com user JD Harvill. Used with permission under a Creative Commons license.

Sometimes, people just need a little help. There may come a time in your life where a friend or loved one is committed to a mental hospital. When I suffered a postpartum breakdown after the birth of my first child, I committed myself. I was fortunate enough to have the support of a loving, devoted husband, who cared for our newborn and for me while I was struggling with a psychotic manic episode. If you have a friend or loved one spending time in a psychiatric ward, here are some tips on how to best support him or her. If you have a loved one staying in the mental hospital and have other people ready to support him or her but don’t know how, then feel free to print this article out and hand it to them.

The “DON’Ts” of Visiting a Friend or Loved One in a Mental Hospital

  1. Don’t show up unannounced. Make sure you call ahead of time before visiting your friend or loved one in a mental hospitlal. I am sure he or she would love visitors, but being hospitalized is exhausting, and sometimes your friend might not be up for a long visit, or even one at all that day. Also be sure to check when visiting hours actually are.
  2. Don’t be afraid. Mental hospitals may seem like scary places, and it might feel natural to be afraid while you’re there. Patients talk to themselves, are in pain, and are sometimes unpredictable. But your fear contributes to stigma. These patients are normal people who are struggling with mental and/or physical illnesses. The nurses can manage the patients, who are unlikely to be violent. Conquer your fear and don’t worry about visiting your loved one.
  3. Don’t act like you’re going to catch mental illnesses. When I was committed, a fellow patient introduced me to her family. They were very reluctant to shake hands with me, and leaned back from me, presumably so I wouldn’t breathe on them. Their behavior, where they acted as if I were contagious, was insulting and demeaning. You cannot catch crazy. Do not even act as if people in pain are contagious.
  4. Don’t pity the patients. Sympathy is good, empathy is even better, but pity is terrible for anyone suffering from a mental illness. Pity contributes to feelings of low self-worth and depression, and just feels bad. Try to empathize with your friend or loved one stuck in the hospital, but don’t pity or blame him or her for being there.
  5. Don’t abandon your friend as soon as the hospital stay is over. After the hospital stay has concluded, check in with your friend and see if there’s anything he or she needs, be it a cup of coffee or help cleaning the house. Just like a physical illness, mental illnesses take a long time to recover from, especially when a hospital stay is required. Your friend will need you more than ever when they leave the hospital. Continue being a good friend and supporting him or her.

The “DOs” of Visiting a Friend or Loved One in the Mental Hospital

  1. Do visit. One of the best ways to support a friend or loved one who is staying in a psych ward is to show up and be there for them. If you can leave your judgments at the door and offer a compassionate listening ear, you can help buoy him or her and even aid in his or her recovery. Visit as often as you can and the hospital allows.
  2. Do bring something to do or talk about. One of the surprising aspects of the hospital is how boring a stay can be. Patients have very little to do other than color and read old copies of Reader’s Digest, or whatever the hospital has on hand from prior donations. A person staying in the mental ward may face crushing boredom; do your best to alleviate that.
  3. Do write and call. If you can’t visit, dropping your loved one a note or calling him or her up will be very much appreciated. Knowing that people on the outside haven’t forgotten him or her is extremely helpful to a person staying in the psychiatric hospital.
  4. Do offer your loved ones the same respect you give them when they are well. The best way my husband was able to support me was to treat me as if I were the same person he’d always known, and play with me as if I weren’t in a hospital setting. Treat your loved ones with respect; even when psychotic, I was able to tell when other people were mistreating me.
  5. Do acknowledge your loved one’s pain. Validation is one of the most powerful tools you have at your disposal to relate to your loved one. Rather than responding with something like, “You’ll get over it,” or even “Hang in there,” to their depression, acknowledge that he or she is hurting. Even saying, “That sounds really difficult,” will put your loved one at ease.
  6. Do advocate for your friend or loved one. Ask the person you’re visiting whether they think their treatment team is treating them properly, and keep your eyes open for any problems. The likelihood of your loved one being abused is low, but he or she still might not be able or willing to speak up for himself or herself, even for something as simple as asking for an extra blanket or a clean set of sheets. Keep in mind that your loved one may not be the most reliable narrator; anger at the nurses is common in a mental ward, especially at the beginning of one’s stay, so your loved one might take the chance to rail against their “tormentors.” But don’t hesitate to bring up your loved one’s concerns with the nurses. If the mistreatment is real, you will need to advocate for your loved one and ensure he or she gets proper care.
  7. Do establish boundaries. If you are overwhelmed by your loved one’s negativity, change the subject. Try not to cut the visit short unless he or she becomes too agitated to speak or becomes violent, as some patients might think you’re abandoning them. But healthy boundaries are important when visiting a friend in the mental ward. Take care of yourself and make sure to do something relaxing for yourself as soon as the visit concludes.

Final Thoughts

There are several dos and don’ts when supporting a friend or loved one staying in a mental hospital. Having gone through the experience of committing myself, I can strongly suggest that you visit as often as you can and the patient allows, as that will aid in his or her recovery. The feeling of being forgotten while staying in a psych ward is very real, and is crippling. Try to be in tune with your friend’s needs, and don’t abandon them after the hospital stay is over.

I wish you well.

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