Mood disorders such as depression and bipolar disorder affect millions of people. Their family members and friends are affected, too. If someone you love has a mood disorder, you may be feeling helpless, overwhelmed, confused, and hopeless, or you may feel hurt, angry, frustrated, and resentful. You may also have feelings of guilt, shame and isolation, or feelings of sadness, exhaustion, and fear. All of these feelings are normal.
What You Need to Know
- Your loved one’s illness is not your fault (or your loved one’s fault).
- You can’t make your loved one well, but you can offer support, understanding, and hope.
- Each person experiences a mood disorder differently, with different symptoms.
- The best way to find out what your loved one needs from you is by asking direct questions.
What You Need to Find Out
- Contact information (including emergency numbers) for your loved one’s doctor, therapist, and psychiatrist, your local hospital, and trusted friends and family members who can help in a crisis.
- Whether you have permission to discuss your loved one’s treatment with his or her doctors, and if not, what you need to do to get permission.
- The treatments and medications your loved one is receiving, any special dosage instructions, and any needed changes in diet or activity.
- The most likely warning signs of a worsening manic or depressive episode (words and behaviors) and what you can do to help.
- What kind of day-to-day help you can offer, such as doing housework or grocery shopping.
When talking with your loved one’s health care providers, be patient, polite, and assertive. Ask for clarification of things you do not understand. Write down things you need to remember.
What You Can Say That Helps
- You are not alone in this. I’m here for you.
- I understand you have a real illness and that’s what causes these thoughts and feelings.
- You may not believe it now, but the way you’re feeling will change.
- I may not be able to understand exactly how you feel, but I care about you and want to help.
- When you want to give up, tell yourself you will hold on for just one more day, hour, minute—whatever you can manage.
- You are important to me. Your life is important to me.
- Tell me what I can do now to help you.
- I am here for you. We will get through this together.
What You Should Avoid Saying
- It’s all in your head.
- We all go through times like this.
- You’ll be fine. Stop worrying.
- Look on the bright side.
- You have so much to live for; why do you want to die?
- I can’t do anything about your situation.
- Just snap out of it.
- Stop acting crazy.
- What’s wrong with you?
- Shouldn’t you be better by now?
How should I talk to a person in crisis?
- Stay calm. Talk slowly and use reassuring tones.
- Realize you may have trouble communicating with your loved one. Ask simple questions. Repeat them if necessary, using the same words each time.
- Don’t take your loved one’s actions or hurtful words personally.
- Say, “I’m here. I care. I want to help. How can I help you?”
- Don’t say, “Snap out of it,” “Get over it,” or “Stop acting crazy.”
- Don’t handle the crisis alone. Call family, friends, neighbors, people from your place of worship or people from a local support group to help you.
- Don’t threaten to call 911 unless you intend to. When you call 911, police and/or an ambulance are likely to come to your house. This may make your loved one more upset, so use 911 only when you or someone else is in immediate danger.
Planning for a Crisis
Some people find it helpful to write down mania prevention and suicide prevention plans, and give copies to trusted friends and relatives. These plans should include:
- A list of symptoms that might be signs the person is becoming manic or suicidal.
- Things you or others can do to help when you see these symptoms.
- A list of helpful phone numbers, including health care providers, family members, friends and a suicide crisis line such as 1-800-273-TALK.
- A promise from your friend or family member that he or she will call you, other trusted friends or relatives, one of his or her doctors, a crisis line or a hospital when manic or depressive symptoms become severe.
- Encouraging words such as “My life is valuable and worthwhile, even if it doesn’t feel that way right now.” “Reality checks” such as, “I should not make major life decisions when my thoughts are racing and I’m feeling ‘on top of the world’. I need to stop and take time to discuss these things with others before going through with them.”
How can an advance directive or a medical power of attorney help?
An advance directive and a medical power of attorney are written documents that give others authority to act on a person’s behalf when that person is ill. Your loved one can specify what decisions should be made and when. It is best to consult a qualified attorney to help with an advance directive or a medical power of attorney. These documents work differently in different states. The resources below can give you more information.
- National Association of Protection and Advocacy
- Treatment Advocacy Center
How long will it take before the person feels better?
Some people are able to stabilize quickly after starting treatment; others take longer and need to try several treatments, medications or medication combinations before they feel better. Talk therapy can be helpful for managing symptoms during this time.
If your friend or family member is facing treatment challenges, the person needs your support and patience more than ever. Education can help you both find out all the options that are available and decide whether a second opinion is needed. Help your loved one to take medication as prescribed, and don’t assume the person isn’t following the treatment plan just because he or she isn’t feeling 100% better.
There is hope!
As a friend or family member of someone who is coping with bipolar disorder or depression, your support is an important part of working toward wellness. Don’t give up hope. Treatment for mood disorders does work, and the majority of people with mood disorders can return to stable and productive lives. Keep working with your loved one and his or her health care providers to find treatments that work, and keep reminding your loved one that you are there for support.