The tricky thing about bipolar disorder is that there is no one state to get used to. As the name implies, there are two somewhat opposite extremes of behavior: the manic and the depressive. They have very distinguishing characteristics, both of which can be damaging for loved ones.

Some of the symptoms of bipolar mania and hypomania include:

• Impulsive behavior
• Self-confidence verging into arrogance
• Endless energy and euphoria
• Nervousness
• Irritability
• Feelings of indestructibility

It’s easy to see how this can be damaging to any kind of relationship. It can be impossible to get a word in edgewise, much less talk someone out of a bad idea when they are in a manic state. They can turn on you quickly for not being in sync with them. And while it is a symptom of a disorder, that doesn’t make it any less frustrating. In extreme cases, mania can be outright dangerous.

Then there is the depressive side. Some of those symptoms include:

• Loss of motivation for activities big and small
• Feelings of emptiness, guilt, hopelessness, and despair
• Inability to enjoy even favorite activities and hobbies
• Daytime sleep and nighttime insomnia
• Eating disorders
• Suicidal thoughts

This end of the spectrum can also be scary and frustrating and dangerous. The feeling of emptiness and obsession with sadness and guilt is, upsettingly, almost a form of narcissism. A person in a depressive state has trouble seeing outside themselves. They know they are hurting people, adding to guilt, but often unable to do anything about it except feel even worse. That is isolating, and shuts out even those who care the most.

Both extremes can cause serious emotional strains and make it hard to form or maintain genuine connections. And the effects of untreated bipolar disorder don’t stop there.

Having bipolar disorder can make it very difficult for someone to keep a job. If they are a parent or spouse, that income might be needed. That loss of income, combined with other healthcare costs, can put severe strain on a family. The stress of worrying about money is as real as it gets.

There are many ways bipolar disorder affects family members. Luckily, there is a very good way to treat it.

THE IMPORTANCE OF THERAPY WHEN BIPOLAR DISORDER AFFECTS FAMILY MEMBERS

It is extremely important to get a proper diagnosis of bipolar disorder. For complicated reasons, bipolar disorder is initially misdiagnosed as much 70% of the time, if not more. Most manic episodes go unreported, and the sufferer is diagnosed with depression. While depression is serious and needs to be treated, it is a different beast than bipolar disorder.

So we encourage families to also be on the lookout for signs of mania or hypomania. A proper diagnosis is absolutely the key to helping everyone. Loved ones getting involved is another key.

Family involvement in therapy is extremely important, especially to someone who believes they are letting everyone down. They aren’t. They need to know that, and they need to know they are surrounded by love. It’s important for them to see that just as the symptoms of their disorder impact everyone, so does the treatment involve everyone.

At a dedicated long-term facility, family therapy can involve:

• Family therapy sessions every week
• Family weekends twice a month
• Support groups featuring other families going through the same thing
• Tips to communicate in meaningful, supportive, and effective ways
• Methods to support your loved one’s long-term independence

One more thing you will be doing is learning to set boundaries. You’ll be learning to take care of yourself. That’s what happened with Theresa. She loved her husband and was always there for him—but that sometimes that also meant being there for herself. She had to maintain her own identity, and her own health, in order for them both to be well.

In the end, the therapy Theresa and Demián went through together helped Theresa stay strong, stay independent, and avoid the guilt and stress and unwitting angry feelings she’d had before they sought appropriate treatment for his disorder. She and her husband were no longer under the sway of his bipolar disorder. Instead, they were truly, finally, getting through it and moving forward—together.