Your questions answered: Supporting someone with bipolar

We know summer can be challenging time of year for people living with bipolar, and their family members, partners and friends. Changes to routines, sleep patterns and mood can leave loved ones wondering how best to help, or where to turn for advice.

Recently, we asked our Instagram community to send in their questions about supporting someone with bipolar. The questions were answered by researchers from the Partners of Parents with Bipolar (PPB) Study, led by Professor Steven Jones at Lancaster University, who shared practical, evidence-based guidance for loved ones.

1. What if they don't know what support they need or would want from me?

If the person with bipolar does not know what they want or need from their loved ones that is understandable. Family approaches to bipolar such as a Family Focused Therapy can be very helpful in facilitating constructive conversations between the person with bipolar and family, as well as addressing any communication issues. This space can allow the person with bipolar to think through what they need in a supportive environment.

Bipolar UK's support groups, including the Family and Friends support group, may also be useful here as speaking with people with similar experiences can help us in thinking about our own needs and ways to address them.

2. What’s the best way to support a young son?

Young people with bipolar aged 17 or under should be offered support clinically from a child and adolescent mental health service (CAMHS). Young adults should have access to specialist bipolar professionals in the local mental health services, accessed via GP, self-referral, or both.

The carer team should also provide family with information about bipolar and facilitate shared conversations about how they can help and also about their own support needs.

Self-help and peer support can also be important for young people. YoungMinds would be good place to start. 16-17 year olds are also welcome at Bipolar UK support groups if accompanied by a parent or legal guardian.

3. What is the best way to calm someone down in a manic state?

As a loved one, there is only so much you can do if someone is experiencing mania. The most important thing is to help them access the right support.

Clinical guidance from the National Institute for Health and Care Excellence (NICE) is that they should have access to a calm environment that is not additionally stimulating. You can also encourage them to avoid making any major decisions or taking risks until their mood has stabilised.

If you are concerned about their safety or feel they need urgent help, you can support them to access urgent mental health care or crisis support.

Once the acute episode has stabilised, psychological therapy may help them make sense of what they have experienced, manage ongoing mood difficulties and avoid risky behaviours. Peer support such as that offered by Bipolar UK can also be really helpful here.

4. How can I identify early warning signs (sometimes called prodromal symptoms)?

There is a lot of research evidence that monitoring mood can be helpful for people living with bipolar, as it can give an early indication of mood changes. If you know someone well, you may be able to pick up on changes in their mood or behaviour.

You can encourage them to keep track of their mood themselves to spot patterns. Bipolar UK offers a free Mood Diary or Mood Tracker app that are worth looking at.

It can also be helpful for them to briefly record how they are spending each day and any key events as well as mood. Over time, this can help build up a picture of things that might trigger changes in mood, such as work stress, family disagreements or lack of sleep.

If you notice changes yourself, you can gently raise these with them and let them know you are there to support them if they find themselves becoming very high or low.

Bipolar UK also runs self-management courses that cover mood monitoring and developing early warning signs plans. You could encourage the person you support to explore these if they would find them helpful.

NICE also recommends that people living with bipolar in England are offered structured psychological care to help prevent future relapse and manage ongoing mood symptoms.

5. I don’t really recognise my loved one right now. Will I get them back?

It can be hard to see the people we love during a manic or severely depressed episode. Bipolar is a serious and complex mental health condition but, with the right combination of treatment and self-management, people can get well and stay well for decades.

For many people, this means working with their clinical team to get the right balance of care that works for them, combining psychological therapy and appropriate medication as indicated by NICE guidance.

NICE also highlights the importance of not overmedicating people and having open discussions with the individual about their experience and preferences with care including medication.

Help shape support for families affected by bipolar

Researchers at Lancaster University are looking for partners of parents with bipolar to take part in a study exploring their support needs.

If you live in the UK with a partner who has bipolar and a child aged under 18, you may be eligible to take part. Participation involves a 30-minute online survey, with optional interviews or workshops. Participants will receive vouchers as a thank you for their time.

To find out more and register your interest, visit the PPB study website.