Bipolar and Communication
Having bipolar disorder has an impact on how you communicate with those around you; the fluctuating moods that are part of your disorder can lead to various communication issues.
However, with some thought and effort, you can work towards being a better communicator.
How Communication Can Suffer
There are several ways you might find communication breaks down if you have bipolar.
Hypomanic or full manic episodes can lead to an inflated sense of self esteem and ego. This can lead to difficulty communicating as you may be unwilling to listen. You may feel you know best, or that you don’t need to listen due to your heightened skills or abilities.
If you are experiencing psychotic symptoms these are likely to have a huge impact on communication. For example, if you are paranoid and having delusions that you are being followed you likely won't believe those around you have your best interests at heart, causing you to withdraw.
Depression and feelings of shame can also cause you to withdraw. You may feel you can't talk to those around you about how you are feeling out of embarrassment, or a depressive episode may cause you to keep everything inside due to feelings of guilt and worthlessness.
Psychotic symptoms such as auditory hallucinations may also break down communication. If you are hearing what's called a ‘command’ voice you may be instructed not to tell anyone about what you are thinking or feeling. You may feel as though you have to act on that instruction due to the abusive or threatening nature of the voice.
Physical symptoms may also present challenges in communication and understanding. For example, those in a heightened manic episode may talk extremely quickly and be very difficult to understand, something called pressured speech.
What Can I Do About It?
These issues may seem overwhelming at first, but it's important to note that there are many ways you can help yourself.
Compromising is important in all relationships, and is arguably even more important in helping keep a bipolar friendship or romantic relationship stable. Try to reach a middle ground when you come to a breakdown in communication.
Certain kinds of bipolar medication can have an impact on memory, so try not get frustrated when you forget things or have to ask someone to repeat something. Try writing important things down to serve as a visual reminder, such as a task list at work.
Making lists during periods of recovery and wellness can be extremely helpful in strengthening your communication skills. For example, an ‘early warning signs’ table or list of how mania might begin can assist you both in spotting things before they get bad, and being more open about your condition.
Everyone makes mistakes, and this is no different during a bipolar episode — you may have behaved out of turn, or done something to upset someone. Apologize as soon as you can and make it sincere. The other person may find it hard to accept at first, but be patient and most (if not all) bridges can be mended.
Tips for Loved Ones
If you are a caregiver and having issues communicating with someone during an episode it can be useful to keep your points direct, clear, and short. Don’t overcomplicate things, and cover one point at a time.
If you are dealing with someone at the very top or bottom of an episode then you may find yourself getting quite annoyed — this is a normal feeling. Try to take a few deep breaths, and keep your tone pleasant but firm.
Try to keep stimulation levels low if possible, especially during a hypomanic or manic episode. Don't promote excitable behaviour but rather aim for calm conversations that are direct and to the point.
Coping in a Crisis
As with any other medical condition bipolar will affect each person differently, so not all of these tips will be useful for everyone. The most important thing to bear in mind, both as someone diagnosed with bipolar and as a caregiver, is how vital it is to step in during a crisis.
This might lead to a complete breakdown in communication and trust, but if someone is a danger to themselves or others then they must be treated immediately. It is always better to err on the side of caution, so it could be useful to carry the numbers and names of the relevant medical professionals with you at all times. If a crisis occurs out of hours then please visit your local hospital.