59 First Person: How to Talk to a Loved One with Bipolar Disorder

BY REBECCA JAMES

Talking to someone with bipolar disorder can be confusing and overwhelming, particularly if the person is in crisis. Here are some key words to use to connect with your loved one.

Tell me.

• Tell me what you’re feeling. This gentle command can be powerful. It shows interest and investment and gives us an opportunity to be open.
• Tell me how I can help you/what you need. Sometimes, we don’t know the answer. But other times, we know exactly what we need and just have to know that someone cares enough to give it.
• Tell me what this state is like. Recognizing states and symptoms is important for you and for us. You may be better able to organize symptoms and identify states or episodes.

Let me.

• Let me help you. Ultimately, you can’t help us unless we let you. You’re acknowledging this gives us a small sense of control when we often feel out of control.
• Let me call your doctor. Again, you’re giving us a sense of agency makes us want to cooperate and be allies.
• Let me hold you/hold your hand/hug you. Physical affection can be powerfully grounding, but some states make it overwhelming. You’re asking permission lets us keep that sense of control while getting the comfort we need.

Help me.

• Help me understand. Your asking for help lets us feel some control and agency. This tends to cut through the sludge of depressive thoughts or the frenzy of manic thoughts.
• Help me make a plan to keep you safe. Involve us, especially when we’re stable. Exchange insights about our illness. We’re more likely to accept something we helped to create.
• Help me pack a bag just in case you need to go to the hospital. This kind of preparation is good, and our having had some choice in it can be a comfort later, even if it’s just the color of T-shirts.

Your illness is telling you that.

• Your illness is telling you that you’re a bad father. The bipolar brain lies. Identify those lies. This can be a powerful reminder.
• Your illness is telling you that you need to buy a new car. It’s okay to identify potentially harmful bipolar impulses.
• Your illness is telling you that I don’t love you. Bipolar disorder can make us doubt everything. Be aware of this. Rather than simply telling us we’re wrong, tell us what is really going on: the illness is lying.

It is not your fault.

• It is not your fault that you can’t stop talking. Some symptoms can be embarrassing. When it’s not our fault, acknowledge that.
• It is not your fault that you forgot to take your medication this morning. Sometimes, we choose not to take our medication. But sometimes, we simply forget, and we can feel ashamed. Help us.
• It is not your fault that you are sick. Bipolar disorder can come with much shame and guilt. Your acknowledging that we didn’t choose this illness is a relief.

I’m here.

• I’m here to help you. Do you think we should know this? Tell us anyway.
• I’m here, and I’m on your side. Knowing you are on our team is powerful.
• I’m here the moment you need me. Even when we’re stable, we need to know that someone is ready to help us when the situation changes.

I’m proud of you.

• I’m proud of your efforts to be well. Acknowledge trips to the doctor and therapist, attempts to exercise, and other displays of commitment to wellness.
• I’m proud of you for taking your medication. We can have trouble remembering to take or remembering that we need to take medication, and side effects can be harsh. Your support builds us up.
• I’m proud of you for getting ready/cleaning the kitchen/doing the laundry. Summoning the energy or calming the frenzy to accomplish these tasks can be nearly impossible during depression or mania. You’re acknowledging that effort means a great deal.

I love you.

• I love you no matter what. If this is true, say it.
• I love you manic, depressed, and everything in between. Sometimes, we believe that people only love us stable or, perhaps, only love us manic. We need you to love us in all our states.
• I love you exactly as you are. You can want and expect better for us, but show us that you love us right where we are.

The best part of easy scripts like this is that, if they are sincere, they can work again and again. Learn what works for your loved one.