Bipolar and Friendships
Bipolar disorder is a mental illness, primarily categorized by periods of mood disturbance. If you are bipolar, it is likely you will have experienced depressive episodes, at least one manic episode, and in some cases you may have experienced a mixed episode, that which contains factors of both mania and depression.
There is also a possibility for a psychotic episode or break for some people diagnosed with bipolar disorder, and this could potentially occur at either end of the mood scale.
Maintaining a close relationship when one or both of you has bipolar disorder is difficult, and can be a very challenging time. Through my own experiences in my bipolar journey my relationships have suffered at times, and unfortunately owing mainly to factors linked with my bipolar, people have been lost along the way.
Over the years since my diagnosis though, I've worked hard on building on previously held relationships, strengthening them, and even acquiring new friends on the way!
Learning how to manage a bipolar friendship for both the bipolar person and the friend is a constant process, and may result in some intensive feelings along the way. You may find the following strategies and ideas helpful in maintaining and strengthening your relationships, whether you are the person with the bipolar diagnosis, or the friend who wants to understand more.
Education & Awareness
For the bipolar individual - encourage your friends and loved ones to be knowledgeable in bipolar, and even mental illness as a whole. Direct them to sources you feel are more reliable, and give them your own input. Do be careful not to fall into the trap of being too forceful though - motivate those around you to have a basic understanding, but allow them to research details etc. of their own volition.
For the friend - the most important part of your toolkit in being close to someone with bipolar is being educated about the disorder. Try reading some trusted sources online (e.g. mental health charity websites), see if there are any local events in your area that you could attend, or try reading some personal accounts or memoirs (although please proceed with caution in this instance, as bipolar is at times a very unique disorder with details that can present very differently across those diagnosed).
Preparation - a Frank Discussion
For the bipolar individual - although you may struggle to remember every detail of what happened during periods of illness, you likely are one of the best people to know how you may appear when you begin to display symptoms. Striking a balance is difficult but vital, it's important to make sure the friend knows what could potentially occur, but it is equally important not to make them panic unnecessarily. It could be useful to come up with a checklist of warning signs - you could organize these by which order they might appear, or you may find creating a table with 'traffic light' coding is useful. Your doctor or relevant clinician could give important and useful input into this, as they may notice signs that you may not.
For the friend - learning what might happen should an episode occur may be distressing at first, but it is important for the future. Ask for honesty and clarity from your friend, and see if you can create a document with them to help you recognize any issues arising. Feel free to ask (sensitively worded) questions about what might happen, it's always better than making assumptions.
Forgiveness & Understanding
For the bipolar individual - following on from an episode, you may react with embarrassment, or you may feel as though you should not seek forgiveness from those who you might have hurt, or affected negatively, as this stems from an illness. It is important to try and see things from the other side though, and realize how your behaviour might have impacted someone else. If you feel your friend is not being understanding at all, it is important that you address this and have an honest discussion with them.
For the friend - repairing the damage we've caused after an episode is one of the hardest things to face. Bipolar behaviour (such as hypersexuality, excessive spending, self harm, and grandiose delusions) is something that is hard for both parties to come to terms with, and it is useful for you to try and be as understanding as you can of the embarrassment we may feel afterwards.
Respecting Boundaries
For the bipolar individual - boundaries can seem wobbly, distant, or even invisible to us at times - especially during a manic episode. However it is important to respect the boundaries of your friends; e.g. don't call them multiple times in the middle of the night, don't expect them to think all the brilliant ideas that might suddenly occur to you are necessarily safe or a wise idea, and if you are feeling hypersexual, do not make advances on them, or their partners.
Respecting Boundaries
For the friend - please try and bear with us if we're having a hard time with boundaries - bipolar is almost like having all your inhibitions taken away very quickly, and we may not have the logic to process that what we are doing is not socially acceptable or appropriate. In turn, please also respect our boundaries - try and recognition the difference between a genuine good mood and the onset of mania or hypomania, as we may not like being monitored constantly.
Intervention in Times of Crisis
For the bipolar individual - at the certain points during a period of illness, we may not recognize that we are unwell at all. However this is due to the distortion that a mood disturbance or psychotic symptoms could create, and it is likely that those around you are more likely to recognize when you are heading for a potential crisis. Try and listen to their concerns, and respect that they will be prepared to intervene if they think it is necessary.
For the friend - during an episode we may feel as though we are being babied, and are not allowed to 'do anything fun'. We may also feel as though there is no hope for us, we are a burden, and that the world would be better off without us in it. If you become extremely worried about the bipolar individual, then do not hesitate to intervene. An example of a time where you may need to intervene is if you believe your friend has discontinued medication without their clinician or other mental health worker knowing. Try to obtain the details of the relevant mental health team, or even take them to the nearest hospital. It is always better to err on the side of caution, so have faith in your decision.
The most important factor in a bipolar friendship is understanding, something at the core of all relationships. The bipolar person must try to understand the friend's right to intervention if they feel help is needed, and must try to understand how their behaviour might impact those around them negatively for example. The friend would help by trying to understand as much as they can about the disorder, especially the way in which it would show in their friend, and being understanding of how slowly we might be able to repair the damage post episode.