When someone you care about has bipolar, a condition that affects moods, it can be difficult to know how to support and be there for them. People with bipolar disorder (formerly known as manic depression) will experience extreme mood swings, going from depression to mania.
During depressive episodes, they’re likely to feel very unmotivated, very low and lethargic. During manic episodes, this changes to feeling very ‘high’ and overactive. They may make poor decisions and in extreme cases may experience psychosis.
Through psychotherapy and medication, symptoms of bipolar can be managed and many people live well with the condition. Having said this, there can be trials and tribulations, especially if the person in question is avoiding professional support.
As a friend and someone who cares about them, there are several things you can do to help.
Perhaps the first thing you should look to do, if you haven’t already, is to read up about the condition. The more you understand how it can affect people, the better positioned you are to help. Keep in mind however that, like most mental health conditions, bipolar affects everyone differently.
Have an honest conversation with your friend when they’re feeling well about how you can best support them when they’re experiencing a manic episode. Some ideas you could discuss include helping them develop a routine, having fun together doing something creative or suggesting they ask for support if starting a new project so they don’t take too much on themselves.
As mentioned, everyone experiences bipolar disorder differently and this means your friend will have certain warning signs or triggers for you to be mindful of. The best way to find these out is by talking to them. Note any patterns and talk to them in a gentle way about any behaviours you’ve noticed before they have a depressive/manic episode.
Triggers like stress and overwhelm can bring on an episode, so try to look out for anything you think may be triggering and discuss ways of avoiding or managing them.
Working with an experienced therapist can help people with bipolar disorder to better understand the nature of their illness and recognise the triggers of their manic or depressive episodes. Cognitive behavioural therapy (CBT) is a popular approach as it is designed to help individuals change negative thought patterns and learn new coping skills. Family therapy is another approach often used in bipolar treatment as it helps to improve communication between family members and the person living with the condition.
World Bipolar Day (30th March) is a day designed to raise awareness of a condition that affects around one in every 100 adults. As with many mental health conditions, bipolar disorder can often be misunderstood.
Stereotypes and myths can lead people to believe those with bipolar are completely erratic, wildly productive, or even have ‘split personality’.
The idea of having a ‘split personality’ largely comes from a condition that was once called ‘multiple personality disorder’ (now known as dissociative identity disorder) and Hollywood’s misinterpretations.
Bipolar disorder doesn’t affect a person’s identity, instead it causes them to have depressive and manic episodes. When the person is going through a depressive episode, they’re likely to feel very low and unable to cope. When they experience mania, they may feel euphoric, as if they can do anything. Both have their dangers for a person’s mental well-being.
Some people think the mania side of the condition is positive, but many people with the condition would disagree. When someone is experiencing mania, they may not feel like they need sleep, their thoughts can jump quickly from subject to subject and they may struggle to focus.
The episode can make people experience ‘grandiose’ ideas, which affects decision-making abilities. This can lead to risky behaviour (such as leaving their job or getting themselves in high-risk situations).
While bipolar disorder is less common than depression, the World Health Organisation says it’s the 6th leading cause of disability in the world. However, bipolar disorder affects everyone differently. Unlike a typical mood swing, the condition causes people to feel these changes much more deeply. Instead of happy to sad, they can go from euphoric to deeply depressed.
For some people, the swings will be rapid and intense (this is called rapid cycling), while others may feel one extreme, such as depression, much more often than mania (or vice versa).
We all need a bit of help sometimes, but it can be difficult to know when exactly help is needed, who to ask, and how exactly to ask for it.
Life can surprise us. Unexpected things may happen, or perhaps you just have a lot going on. Whatever it is, sometimes things can seem overwhelming. You may feel like you’re the only one struggling to keep your head above water.
Whether you’re having a bad day, or you have a mental health problem, it’s important you don’t try and cope on your own. However strong you are, we all need support. When feeling low, vulnerable and unlike yourself, spending time on your own is unlikely to help. This is the time when you need to talk to someone – someone you trust – who can offer love, an ear to listen and guide you to the other side.
There are many reasons why a person won’t ask for help. You might not like asking for help. You may feel afraid and ashamed. You might not want to burden anyone with your problems. You may be worried what others will say and what they will think. Perhaps you don’t know where, or who to turn to.
The thing is, people do care. Help is available and even if you’re not comfortable speaking to a friend or family member, there are professionals ready to support you. You just have to ask.
Who can you ask for help?
If you have come to a time where you need a helping hand, there are many roads you can follow. If you have a supportive family network and are comfortable speaking to them, consider talking to your family about how you feel. This may be your parents, your siblings, your grandparents or your cousins.
If you’re not ready to speak to your family (and that’s OK!) it’s important you know there are other options. Know that it’s OK to talk to your friends, neighbours or even colleagues. They won’t judge you – they care about you and to be frank, people love to help.
You can also speak to a professional. If you’re worried about your health – emotional or physical – you can speak to your GP or consider talking to a counsellor. Sometimes, the simple act of speaking about your feelings can offer a sense of relief and ease some of the stress.
Asking for help is incredibly daunting, but don’t be afraid. If you need immediate help, you can call the Samaritans for free on 116 123. They’re available 24/7 and all calls are anonymous.
If you’re ready to ask for help but not sure how, here are some ways you can prepare.
Decide who is best to talk to, and who you feel most comfortable speaking to. While many of us can get the support we need from family and friends, others will need to follow a different path. If you’d prefer to speak to a professional or support group, that’s OK.
Choose your time wisely and in a place you feel comfortable. If you like walking while you talk, ask the person to come with you. If you prefer a cafe, or the privacy of your own home, invite them over. Try and choose a location that is relaxed and where you won’t be interrupted.
What do you want from them? Acknowledge what it is you want from speaking to them. Do you simply want someone to listen? Or would you like more support? Go in knowing what it is you want from them, and don’t be afraid to ask.
Make notes and plan ahead if you’re nervous. Asking for help can be very overwhelming, so writing down everything you want to say will help you remember.
How common is mental distress?
According to the mental health charity Mind, one in four people in Britain are affected by or living with a mental health problem. People with mental distress may experience problems that affect the way they think, feel and behave. The term ‘mental distress’ is used to describe a range of mental health issues, from the more common problems such as anxiety and depression, to the less common, such as schizophrenia.
A 2016 Time to Change survey of over 7,000 people living with mental health issues found that 64% were feeling isolated, 61% worthless and 60% ashamed of their condition. They explained they felt this way because of the stigma and discrimination they regularly face.
That said, the results suggest progress has been made in raising awareness and reducing discrimination. Time to Change explained that over half of those involved in the survey said it is easier to talk about their mental distress now than ever before. 60% also said they felt relieved and “like a weight had been lifted” once they talked about their condition. Unfortunately this isn’t always the case and not everybody feels they can speak out.
According to the Mental Health Foundation, the most common mental disorder in Britain is mixed anxiety and depression, with up to 10% of people suffering from depression at some point in their lifetime.
• post-traumatic stress disorder (PTSD).
Common symptoms of depression include low mood, fatigue and loss of interest or excitement in things previously enjoyed. Often, symptoms of depression will impair emotional and physical well-being, as well as the behaviour of the person.
While the number of people affected by mental distress is shocking and appears to have risen over the years, many believe that the increase is a result of more people talking about it and seeking help. We are becoming more aware of the prevalence of mental health across all genders and age groups and slowly, the stigma is starting to change.
One way of managing the effects of a mental health problem is talking about it. Whether you are living with a mental health problem, or know somebody else who is, it is important to talk about your experiences and the stigma associated.
Counselling will provide you with the opportunity to explore and be open about your thoughts and feelings without shame, judgement or discrimination. The counsellor is someone to listen to you and offer support.
There are a number of treatments available for those living with a mental health problem. Talking therapy can help you understand what may have caused the problem and how you can manage it.
Everyone will experience feelings of sadness from time to time, and there isn’t always a reason. People will sometimes say they’re depressed when they’re having a bad day or something hasn’t gone right, but depression is more than that. Depression is a serious mental health condition that can have a big effect on a person’s life.
A key difference between feeling sad and depression is time. Sadness can come and go, usually with relative speed and ease, whereas depression is constant.
There isn’t always a reason why you feel sad, but it is important to try and understand what is causing the sadness. Step back and think about what happened when you started feeling this way – did you receive some bad news, or have a bad experience?
If you don’t know the reason, it can be quite unnerving. While it is normal to experience negative feelings, if these thoughts are preventing you from enjoying life, it may help to speak to someone, like a professional.
Depression is a relatively common mental health condition, with anxiety and depression affecting an estimated 615 million people worldwide. Despite this, not everyone will seek help straight away. This could be down to a number of reasons, such as fear, shame or simply not knowing where to turn. Others may not even know they have the condition, especially if it has developed slowly, over a long period of time. Sometimes it is a friend or family member who notices a change.
It is important to take your mental health and well-being seriously, just as you would a friend. If you’re worried about your mental health, it is better to talk to someone and seek support, than do nothing at all.
Start by talking to your GP. They can help you understand more about the condition and why you may be feeling this way. Together, you can discuss treatment options, such as talking therapies and counselling, or self-help.
There is no one treatment that will work for everyone, so be sure to ask questions. If you are looking to speak to a counsellor, do your research and ask more about the way they work. There are many different approaches and each counsellor will work in their own way.
Heads Together are the 2017 Virgin Money London Marathon Charity of the Year.
Through their work with young people, emergency response, homeless charities, and with veterans, they have seen time and time again that unresolved mental health problems lie at the heart of some of our greatest social challenges.
Too often, people feel afraid to admit that they are struggling with their mental health. This fear of prejudice and judgement stops people from getting help and can destroy families and end lives. The aim of Heads Together is to help people feel much more comfortable with their everyday mental wellbeing and have the practical tools to support their friends and family.
The Duke and Duchess of Cambridge and Prince Harry are spearheading the Heads Together campaign.
There has been huge progress made to tackle stigma surrounding mental health in recent decades, but it still remains a key issue driven by negative associations, experience and language. Through this campaign, Their Royal Highnesses are keen to build on the great work that is already taking place across the country, to ensure that people feel comfortable with their everyday mental wellbeing, feel able to support their friends and families through difficult times, and that stigma no longer prevents people getting help they need.
Worldwide, the number of people who are affected by mental health is rising. In 1990, 416 million people suffered from depression or anxiety, rising to 615 million in 2013 (World Health Organisation, 2016).
People with mental distress may experience problems that affect the way they think, feel and behave. The term ‘mental distress’ is used to describe a range of mental health issues, from the more common problems such as anxiety and depression, to the less common, such as schizophrenia.
The stigma associated with mental distress is starting to change. While more people living with mental illness are starting to feel able to talk about their experiences, there is still a long way to go. Stereotypes and negativity surrounding poor mental health continue to mean that many still feel that they have nobody to talk to.
That said, the results suggest progress has been made in raising awareness and reducing discrimination. Time to Change explained that over half of those involved in the survey said it is easier to talk about their mental distress now than ever before. 60% also said they felt relieved and “like a weight had been lifted” once they talked about their condition.
Unfortunately this isn’t always the case and not everybody feels they can speak out. The 2011 NICE guidelines reported that many of those suffering do not seek treatment; therefore many conditions are going undiagnosed.
In the 2013 Wellbeing Survey, almost one in five people in the UK aged 16 or over showed symptoms of anxiety or depression. This result was higher in women (21.5%) than in men (14.8%).
In a 2009 report, it was found that women were almost twice as likely as men to suffer an anxiety disorder in England. However, the 2014 figures released by the Office for National Statistics show there were 6,122 suicides recorded in the UK. While 24% of these were female, 76% were male.
Mental distress can affect each person differently, while some symptoms can be more manageable, others may need specialised treatment.
HSCIC – Mental Health and Learning Disabilities Statistics Monthly Report. 2016, Key facts.
NICE guidelines – Common mental health problems, Introduction, May 2011.
Mental Health Foundation – Fundamental Facts PDF 2015, (page 19).
ONS – Measuring National Well-being: Life in the UK, 2015 (page 17).
Prevalence, incidence, morbidity and treatment patterns in a cohort of patients diagnosed with anxiety in UK primary care. Family Practice, 27(1), (p.9-16).
Ayers, S. and Shakespeare, J. 2015 – Should perinatal mental health be everyone’s business? Primary Health Care Research and Development (page 323-325).
Paulson JF, Bazemore SD. 2010 – Prenatal and postpartum depression in fathers: a meta-analysis. The Journal of the American Medical Association (page 1961).
A report from Cambridge University says that as well as women, young people under 35 and those with health problems are particularly affected by anxiety.
Published in the journal Brain and Behavior, the global review of 48 studies found that more than 60 million people were affected by anxiety disorders every year in the EU and that women were twice as likely to experience anxiety as men. The author Olivia Remes, from the department of public health and primary care at the University of Cambridge, said anxiety disorders could make life extremely difficult.
Anxiety can be seen as a customary, yet unpleasant part of life that can affect us all in different ways. If you are suffering from anxiety you may feel irritable, tense, nervous, uptight or wound up. Common in all these complaints is the overwhelming effect of the body producing too much adrenaline. This results in physical symptoms that can affect daily life.
The apprehension of anxiety, which causes palpitations and shaking, creates even more adrenaline, resulting in a vicious circle. For some people anxiety is a temporary state that passes when the source of stress subsides. For others it becomes a long-term condition that affects their lives and those of their loved ones.
It is normal and healthy to feel sad or worried about life and its problems and pressures. But when a worry casts a cloud over everyday life, you may be suffering from anxiety, depression or a mixture of the two.
When is the right time to seek help?
Anxiety is a problem that feeds on itself and is often covered up and dealt with in isolation. Help should be sought as soon as possible. If physical symptoms are severe, consult your GP as a first port of call. Anxiety counselling can help you to face your fears and rebuild self-esteem.
• consider the wider context of your relationships and their effects.
Cognitive Behavioural Therapy (CBT) has a structured approach to dealing with anxiety in stages. It allows sufferers to look at their own unhealthy thinking and employs graduated exercises in desensitisation and exposure to help people face their fears and anxieties. Psychoanalytic work can look at the origins of the anxiety and offer new perspectives when the time is right.
Mindfulness exercises for anxiety can help you manage symptoms. The aim of mindfulness is to develop your moment-by-moment awareness to be appreciative, self-compassionate and non-judgemental. You will gain greater clarity on what is happening around you, which should help you recognise your anxiety triggers and deal with them effectively.
I am a member of the British Association of Counselling and Pyschotherapy (BACP) and of the Hampshire Association for Counselling and Pyschotherapy. As a Member of BACP I am bound by its Ethical Framework for Good Practice in Counselling and Psychotherapy, the Ethical Guidelines for Researching Counselling and Psychotherapy (where practitioners undertake research) and subject to the Professional Conduct Procedure for the time being in force. I hold full Professional Liability Insurance and a clear enhanced Criminal Records Bureau check.