Nearly six million Americans have bipolar disorder (BPD) and more than half of them are not receiving treatment for this serious mental illness. Many people with BPD are misdiagnosed with major depression, schizophrenia, or borderline personality disorder because signs of BPD
While in a manic phase, people with BPD may engage in delusional or irrational thinking and extreme behaviors leading to criminal activity or involvement in dangerous situations. Alternately, the “down” stage of a bipolar episode can make a person feel extremely depressed and suicidal.
How Can You Be Sure You are Living with Someone Who is Bipolar?
The difference between occasional moodiness and bipolar disorder is the severity of symptoms. For example, if your significant other or roommate feels especially happy or especially sad about something, they’ll likely want to talk about their emotions. Most people cope with “the blues” by binging on their favorite shows, eating “comfort” food, or just being by themselves for awhile to think about things.
Individuals with bipolar disorder cannot cope with out-of-control thoughts and emotions. Genetics, environmental factors, and an imbalance of neurotransmitters are all thought to be causes of BPD. Too much or too little dopamine, serotonin and norepinephrine in the brain disrupts thought processes and a person’s ability to regulate emotions. Unless those with BPD receive pharmocological and psychological treatment, symptoms will continue to worsen.
Signs of someone experiencing a manic episode can last as long as a week. Individuals in manic phases talk constantly, sometimes incoherently, about random subjects. They will have grandiose, irrational ideas, an inflated sense of their self-importance and sleep only a few hours a day, if any.
As the manic phase deepens, they will become even more agitated, wired and hyperactive, possibly engaging in activity that later causes major problems for them–maxing out credit cards, spending days at gambling casinos, starting numerous projects involving questionable types (loan sharks, scammers), or even endangering the lives of others with risk-taking behavior. Some individuals with bipolar disorder experience “hypomania,” which is a milder form of mania.
The term “bipolar” refers to the swing that occurs between this pole (mania/hypomania) and very severe depression. This swing can be sudden and glaringly obvious. One minute, the person you are living with is giddy, euphoric, and excitedly talking nonstop about a dozen different topics. The next minute, they are curled up in a corner, feeling guilty and worthless about the consequences of their actions and possibly talking about suicide.
How Does a Bipolar Treatment Center Help?
Psychiatrists and psychologists can accurately diagnose BPD by performing a detailed intake assessment and evaluation of the person’s symptoms. The patient’s cognitive abilities, physical health, and history of mood swings are also noted during the assessment. In some cases, a doctor may order blood work to determine if an underlying physiological condition is causing mania/hypomania and/or depression.
Residential centers offering treatment for bipolar disorder also provide post-treatment support and assistance for patients completing treatment.
Living with a Spouse or Significant Other Who Has Bipolar
Living with someone who has untreated bipolar disorder demands immediate intervention. However, be aware that trying to talk someone into getting help for BPD requires a commitment to yourself to resist that person’s attempts to justify or downplay their actions.
Additionally, many bipolar individuals may not remember everything they did during a manic phase. Before sitting down with spouse or roommate to discuss their getting help, have the receipts to show them that you are not exaggerating or falsifying their manic behavior.
Be prepared to discuss their bipolar disorder by doing the following:
- List everything the person has done during a manic episode that resulted in negative consequences (job loss, bankruptcy due to wild spending sprees, arrest for criminal activity, health problems due to substance abuse, divorce, etc)
- List all the ways in which the person’s behavior has impacted you and their family’s lives. (An example would be parents removing money from retirement accounts to pay for a son’s overspending during manic phases)
- Explain gently but firmly if the person refuses to seek BPD treatment that you can’t support them anymore because your own wellbeing is suffering. If they are a spouse, they may need to be told that until they agree to enter treatment, you will need a period of separation from them.
Probably the quickest way individuals can receive treatment involuntarily is when they attempt suicide. Unfortunately, people in the grip of mania only receive involuntary treatment if they are actively delusional or hallucinating while committing acts that endanger themselves or others. (When someone’s beliefs are sufficiently divergent from reality, a diagnosis of delusion disorder may be appropriate.)
What Treatments are Available for People with Bipolar Disorder?
Mood stabilizers like lithium, Depakene, Depakote and Lamictal help reduce the severity of hypomania/mania cycling by preventing dopamine from flooding the brain. Mood stabilizers also act similar to antidepressants by increasing serotonin levels in the brain. Bipolar individuals taking mood stabilizers for the first time often need doses readjusted several times before they find a specific dosage that works best for them.
When someone is more affected by the depression stage than the manic stage, their doctor may prescribe an antidepressant to treat severe depression and suicidal ideation. Celexa, Zoloft and Effexor are commonly prescribed to relieve symptoms of bipolar depression. Some research suggests antidepressants also help decrease rapidly cycling episodes of mania and depression.
New antipsychotic medications like Seroquel, Abilify and Risperdal control delusional thinking and hallucinations in bipolar adults experiencing severe manic phases. These medications do not cause the side effects associated with older antipsychotics and can also help diminish disorganized thinking, impulsive behavior, and insomnia.
Once medications have stabilized their moods and reduced cycling, individuals with bipolar disorder can benefit significantly from CBT. A subtype of psychoanalysis, CBT examines the direct correlation between your thoughts, your emotions and your behaviors. Cognitive behavioral therapists essentially show patients how to restructure their thinking patterns to avoid negative thinking and improve their ability to deal with stress productively.
What Can You Do to Support Someone with Bipolar Disorder?
Learning more about bipolar disorder and understanding that it is a chronic brain disease requiring lifelong treatment can be a good place to start in helping a loved one with BPD. Being a great listener without being judgemental or critical can also give bipolar individuals the unconditional support they need to cope. Pay attention to what the person is saying and remain calm if they seem to want to start an argument. Remember, no one chooses to be bipolar, just like nobody chooses to be an addict. While medications and CBT can help manage BPD, they cannot cure this brain disease.
If you are living with someone who has bipolar disorder and want more information about helping them cope successfully with BPD, call FHE today to speak to a member of our support staff. If you know someone who you think has bipolar disorder and needs help immediately, please contact FHE for information about getting help for your family member or friend.