Dr. Rakesh Ranjan – Many Faces of Bipolar Disorder: Part 2

What Families and Friends Can Do

Walking on Eggshells

Dean* was sobbing like a child. That morning, Dean’s 18 year old son Brad had found Dean sitting inside a running car in a closed garage. Acting quickly, Brad turned off the car, opened the garage door and called his mother Nancy. Nancy had just moved into her parents’ home with Brad’s 14 year old sister Amber. Nancy suggested Brad take his father to the family doctor immediately. The family doctor requested that I see Dean the same day. And that is where Dean now was, sitting in a chair across from me, sobbing into his hands.

Brad informed me that his mother Nancy had been frightened by Dean’s frequent angry outbursts, some of which ended with Dean damaging the walls or other household property. She warned Dean that she didn’t feel safe with him and would divorce him if things didn’t get better. During some of these conversations Dean would cry, beg Nancy not to leave and promise that he would ‘change his behavior’. But the slightest stress or disagreement would set Dean off, and his anger would build until it was out of control. One night an outraged Dean grabbed Amber by the neck. This was the tipping point for Nancy. She packed a bag and fled to her parents’ home with Amber.

I admitted Dean to a local hospital. When I met with the family, Brad told me his father’s unpredictable moods made him feel like a ‘yo-yo’. Nancy said the entire family walked on eggshells every day, afraid of enraging Dean. She also informed me that Dean had ‘always had a quick temper’ and the family could do nothing to calm him. But when faced with these allegations, Dean was only focused on the fact that Nancy had left him; he couldn’t seem to grasp why his marriage was falling apart.

Subsequently, Dean was diagnosed with and treated for bipolar disorder; but Nancy had ‘had enough’. A year later, Dean and Nancy divorced.

So, what families and friends can do?

The quandary that Dean’s family faced is very common with families and friends of people with bipolar disorder. Although, it is never easy, here is what you can and should do if a family member is diagnosed with bipolar disorder:

• Be wary – If your family member or friend is experiencing inexplicable, exaggerated anger episodes or mood changes, do not brush it off as a ‘quick temper’ or ‘emotional’. This is especially true if this behavior is affecting family, social, or occupational lives.

• Acknowledge and support – Blaming the affected individual about family or social problems is not helpful. Instead acknowledging that person is having problems controlling his/her emotions and assuring that family/friends want to do everything to help the situation is more constructive.

• Do not compromise safety – Often, the first time a person is diagnosed with bipolar disorder or receives proper treatment is when a family member or friend has called relevant authorities regarding concerns about someone’s safety.

• Do not wait for the ‘last straw’ – If somebody has a pattern of behavior like Dean’s, the pattern is unlikely to change on its own. Therefore, professional help should be sought when you first become concerned not when you are at the ‘end of your rope’.

• Learn about bipolar disorder – Once your family member or friend has been diagnosed with bipolar disorder, please learn about it, especially the symptoms, early signs of relapse and treatment options. Again, please utilize reputable websites and books only. The local chapters of NAMI can be very helpful.

• Understand that the person is ill – It is very important to realize that bipolar disorder is a medical illness and symptoms are biologically driven. This understanding should help you address your reactions and emotions towards somebody with bipolar disorder.

• Show respect, concern and love – Imagine your family member or friend came down with multiple sclerosis. Wouldn’t you convey concern and love? You should treat someone with bipolar disorder in the same manner.

• Show you believe in the person – Supporting the affected person and letting him/her know that you still believe he/she can overcome the illness can be very helpful.

• Forgive the person – Many people engage in erratic or irresponsible activities during the manic state of bipolar disorder. Conveying that you have forgiven him/her for such behavior helps both you and the affected person.

• Communicate how you are being affected – Having communication with the person about how his/her behavior affects you is very constructive as well. It not only helps you cope but also gives the affected person some insight into his/her behavior.

• Monitor symptoms – Families and friends can play a crucial role in detecting early signs of relapse and notifying treating professionals.

• Monitor compliance with treatment – Again, families should be very involved not only in choosing treatment options, but also in monitoring adherence to treatment and even side effects of medications

• Join support groups – Support groups for families and friends which are focused on bipolar disorder can be very assuring. This is a great way to not only receive help but offer help to others.

• Seek professional help for yourself – Living with or dating someone with bipolar disorder can be very stressful. You should not wait to seek professional help until you feel ‘on the edge’.

It is very important to realize that every individual’s and family’s situation is unique. Therefore, family and friends should work closely with treating professionals to find the best ways to help their loved ones and themselves.

*The purpose of this article is for educational purposes only. It is not intended to diagnose or treat any medical or psychiatric issue. Dr. Rakesh Ranjan is a practicing psychiatrist and a researcher. He is a recipient of several research awards and has authored several peerreviewed journal articles and book chapters on psychiatric illnesses and their treatments. He is a national speaker for several organizations and serves on the medical advisory board for the NAMI of Greater Cleveland. If you or a loved one is experiencing any symptoms that would lead you to believe that there could be a mental imbalance, please email your questions to Dr. Ranjan at askthedoctor@charakresearch.com. All contact info will be kept confidential.