The Effects of Bipolar Disorder on Family Members

Disease has a strong impact on the lives of everyone who cares for the person who is sick. The same holds true for those diagnosed with bipolar disorder. Their families, friends and coworkers are pulled into the center of the bipolar storm by sheer force of the emotional whirlwind that builds as episodes elevate and moods change. Bipolar disorder creates a uniquely difficult burden for the individual and the family.

Life with Bipolar Disorder

• The effect of bipolar disorder on family members begins with a background of uncertainty, particularly about when moods might change, how severe a given episode will be or how long it will last. There is also uncertainty about whether the individual with the disease will be aware of their changing mood or capable of implementing coping skills, or if they will mange to cope until balance is regained. Uncertainty about how the family members will protect their own emotional and physical well-being while putting every ounce of energy into helping the one with bipolar disorder also comes into play. Effects on the family can be understood by looking at the behavior of the person with bipolar disorder in each mood phase.

Manic Phase

• During mania, the person with bipolar disorder is unpredictable. Their mood might begin as euphoric and escalate into irritability. Their judgment is impaired so they make reckless decisions with potentially serious consequences. They may go on a spending spree or engage in alcohol or drug abuse. All the while they believe they are on top of the world. They are powerful, creative, unstoppable. They have no thought about consequences. Their intense energy and extreme mania may result in arguments, rages and, potentially, violence.

Depressive Phase

• This part of the picture presents a person who is sad, irritable and has such low energy that they have no interest in their usual activities. They do not participate as a family member. They are unable to concentrate. They can't make the decisions that are required in everyday family life. Sometimes, on top of emotional withdrawal, they are physically ill. They either have a hard time sleeping or they sleep more. Either way, sleep disturbances interfere with fulfilling social, work and family obligations. They "check out," leaving the family to function without them. Their feelings of worthlessness may manifest in suicidal thoughts or actions.

Family Response

• Families go through a range of emotions in response to the unpredictability of the bipolar mood phases. They will sometimes be loving, patient and understanding. They will also be angry that their lives are so severely disrupted. Most families put a lot of energy into keeping the secret---maintaining a positive public face---so no one else knows about the constant turmoil and conflict. This just adds to the mounting pressure. They will struggle with their own bouts of depression and anxiety as a result of the unrelenting stress. Their time is filled with worry about what's going to happen next. They are continuously on call to do damage control. They sometimes feel guilty that they aren't able to help. They are forced to face behaviors and situations that are unfathomable.

Coping with the Effects

• This is a high level of stress that continues for months---extending into years---for as long as the family stays together. They face a struggle that encompasses every aspect of life, from economic burdens to deteriorating relationships with each other and the rest of the world. However, hope and support can help change the picture. There are steps that families can take to survive the worst moments and reclaim some peace and happiness. The individual with the disorder must obtain professional help and get on a medication regimen that will stabilize episodes and help to prevent future mood swings. The family can talk to mental health professionals and participate in therapy that will help them learn about bipolar disorder and give them the skills they need to manage it. Together, they can begin to take power back from the uncertainty of this disease. The person with bipolar disorder can't control this neurological imbalance. The family can't control the results. But they can learn what triggers mood swings and develop a plan for ongoing intervention. Working together the family can focus on each day, sustain each other, and make the most of the support that is available.