How Bipolar Disorder Affects Families
Anyone whose loved one struggles with mental illness knows that mental illness affects more than just the individual diagnosed. The far-reaching effects of mental illness stretch across families, impacting everything from finances to physical health.
Bipolar disorder is a form of mental illness that can take an especially hard toll on families. Watching a loved one cope with a disorder that sends them from the lowest of lows one minute to the highest of highs the next can be difficult, to say the least.
Supporting someone you care about who has bipolar disorder requires patience, education, and understanding — but learning how to manage this takes time. As you navigate the complicated road of mental illness, you may find your family experiencing its own unique set of challenges.
Read on to learn more about the effects of bipolar disorder on families as well as how you can navigate these difficulties as a unit to better support your loved one through their mental illness.
What is Bipolar Disorder?
So, what is bipolar disorder? You might know that your loved one has bipolar disorder, but you may not understand what challenges they experience on a daily basis.
Bipolar disorder is considered a mood disorder. You might think this means that it only affects a patient’s mood, but its symptoms extend to many areas of life.
In order to receive a diagnosis of bipolar disorder, a patient must experience alternating episodes of depression and mania. During a depressive episode, which must last at least two weeks, patients can experience low mood, suicidal thoughts, fatigue, loss of appetite, and more.
A manic episode is the opposite, consisting of abnormally elevated mood, rapid thoughts, fast speech, and extreme risk-taking behavior. During a manic episode, someone with bipolar disorder may say or do things they would not otherwise. They may get into debt, get in trouble with the law, or get into fights that can have serious consequences on their finances, their career, and their relationships with others.
You may know that there are two types of bipolar disorder. Your loved one may have been diagnosed with either bipolar I or bipolar II. These disorders categorize patients based on the severity of their manic episodes. People with bipolar I disorder experience full mania, while people with bipolar II experience hypomania, a less severe type of manic episode.
It’s important to remember that while bipolar I and bipolar II are defined differently based on their severity, they can both have equally devastating effects on patients and their families. Having bipolar II does not necessarily make the disorder easier to cope with than having bipolar I.
Bipolar Disorder and Families
Bipolar disorder is not easy for patients to cope with, but it can also have negative effects on their loved ones. Mental illness does not exist in a silo, and it affects everyone it touches. In other words, families also feel the effects of bipolar disorder. Here are some of the ways that bipolar disorder can affect patients’ families, beyond the symptoms affecting the patient.
Bipolar disorder places a financial strain on patients as well as their families. These costs include the cost of medical treatment for bipolar disorder itself, as well as costs indirectly associated with the disorder, such as legal fees or gambling debts incurred during an episode of mania.
Compared with other families, families of a patient with bipolar disorder spend 213% more on mental healthcare and more than 7% more on physical healthcare. This included more money spent on outpatient visits to the doctor’s office, visits to the hospital, and prescription medications — 90% of which went toward treating a condition other than their family member’s bipolar disorder.
Financial losses due to bipolar disorder also include the costs of missed work. Six months after hospitalization, only 50% of patients diagnosed with bipolar disorder were found to be employed. Patients age 18 and older with bipolar disorder are estimated to lose more than 49 days of work per year due to their mental illness. This does not include the number of days of work that may be lost by family members who are caring for a loved one with bipolar disorder.
Excessive spending can be a symptom of mania that affects both patients and families of someone with bipolar disorder. Patients with bipolar disorder report spending thousands of dollars on things like expensive Italian furniture, weekend trips around the world, and expensive graduate programs they didn’t need as a result of a manic episode. This can lead to crippling debt and the loss of financial security, which can negatively impact spouses, children, and other family members in addition to the person suffering from bipolar disorder.
The act of caregiving — or being responsible for taking care of another adult — is associated with significant emotional side effects for the people involved. Caregivers for those with bipolar disorder represent no exception. Informal caretakers for someone with bipolar disorder report feelings like confusion, uncertainty, overwhelm, guilt, and dissatisfaction with their loved one’s treatment or diagnosis as a result of caregiving.
The stress associated with caregiving can result in negative mental health effects for loved ones of people with bipolar disorder. In a study of 500 caregivers for someone with bipolar disorder, researchers found that caregivers who reported a high level of stress associated with caring for someone with bipolar disorder employed less effective coping strategies than those who reported less emotional strain. They found a direct link between the severity of the patient’s “problem behaviors” associated with their bipolar diagnosis and poorer mental health outcomes for caregivers.
Stress among caregivers increases when the patient with bipolar disorder is admitted to a psychiatric facility. Among the 93% of caregivers who reported greater stress upon their loved one’s admission to an inpatient treatment facility for bipolar disorder, 70% continued to report experiencing a high-to-moderate burden six months later.
The burden of caregiving is associated with poorer outcomes for patients with bipolar disorder. The more stressed their caregiver, the longer the person with bipolar disorder remained ill, and the more lifetime episodes of depression and/or mania reported by the patient. When the caregiver is less stressed and receives adequate social support, however, patients are more compliant with their medication and recover more quickly from bipolar disorder. As a result, it’s important to emphasize the importance of self-care and stress relief practices among family caregivers dealing with bipolar disorder.
As we mentioned previously, families of people with bipolar disorder utilize the medical system much more heavily than controls. Of this greater number of outpatient appointments, hospital visits, and prescription medications, however, just 10% are related to the patient’s bipolar disorder. Most result from non-bipolar health conditions, some associated with the stress of caring for someone with bipolar disorder.
The more stress experienced by a caregiver, the more likely they are to exhibit symptoms of depression, poor sleep habits, higher use of medical services, and overall bad health practices. Researchers found a direct link between the age of the caregiver and the health effects of caregiving; older caregivers are more likely to experience adverse physical health consequences, meaning, for example, that parents of adult children with bipolar disorder might be at especially high risk.
Caregiving even changes our body chemistry and impacts the inner workings of our immune system. Compared with people who are not caregivers, caregivers have elevated levels of cortisol, the body’s primary stress hormone. Over time, extended exposure to chronic stress can suppress the body’s immune system, making caregivers more likely to get ill. Research findings support this; caregivers have been found to have lower levels of certain antibodies in their immune system.
How to Help a Loved One with Bipolar Disorder
Caregiving takes a toll on loved ones of people with bipolar disorder. Still, it is important for people with bipolar disorder to have strong social support, as greater social support improves outcomes for patients with bipolar disorder. So, how can you take care of a loved one with bipolar disorder without neglecting your own needs?
Educate Yourself About Bipolar Disorder
The most important thing you can do to help a loved one with bipolar disorder is to learn all you can about their diagnosis. Mental health stigma often results from a lack of understanding. Digging deeper into your loved one’s diagnosis of bipolar disorder can help you better support them without encouraging shame or guilt. Learn what strategies are most effective (and ineffective) for helping someone with bipolar disorder.
Practice Empathy and Forgiveness
When someone is suffering from bipolar disorder, they may say or do things they would not do otherwise. It’s important to understand that if a person with bipolar disorder does or says something hurtful to you while they are in a depressed or manic state, it is their bipolar disorder talking, not them. When recovering from bipolar disorder, patients are often aware that their behavior may be harmful or damaging but may feel powerless to stop it. Practice empathy and make sure to communicate your complete forgiveness to them. Knowing that they have been forgiven for their actions allows a person with bipolar disorder to shed the guilt associated with their diagnosis.
Take Note of Unusual Behavior or Mood Swings
You know your loved one better than most, and likely spend a lot of time around them — so you will probably be one of the first people to notice if they are becoming manic or depressed. Take note of potential triggers, such as stressful situations at work or home, and watch out for warning signs like needing more or less sleep, becoming more or less social than usual, or making riskier decisions than usual. If you do notice a change in your loved one’s mood or behavior, check in with them and ask them how they are feeling, without attaching judgment or assumptions to the question.
Create an Action Plan for Your Loved One
Everyone in the family has a role to play in helping a loved one recover from bipolar disorder. However, it can feel overwhelming to help coordinate your loved one’s care between several family members. Creating an action plan to help address a particular problem associated with your loved one’s bipolar disorder can allow you to divide responsibilities among family members, ensuring that all of the tasks that need to be completed don’t fall completely on one person’s shoulders. Families for Depression Awareness has a helpful printable you can use to create an action plan for your loved one.
Make Time for Self-Care
While taking care of your loved one, it’s important that you don’t forget to take care of yourself. As we mentioned previously, caregiver stress is associated with worse outcomes for patients with bipolar disorder — not to mention that chronic stress can make us angry or irritable with our loved ones, which only makes matters worse. If you want to help your loved one recover quickly and effectively from bipolar disorder, taking time for self-care is one of the most essential things you can do to help. Make sure you are eating right, drinking water, exercising, and making time to be social and practice your favorite hobbies. Helping a loved one with bipolar disorder is important, but you do not need to completely lose yourself in the process.
Finding Help for a Loved One with Bipolar Disorder
Bipolar disorder is a challenging mental illness — and is often more than one person, or one family, can handle on its own. You don’t need to take on responsibility for your loved one’s problems, but you can play a role in helping them recover by showing them where to find professional help. Encourage your loved one to seek treatment for their bipolar disorder and, when they are ready, be there for them throughout the process of finding a qualified therapist. You can start by contacting one of our mental health practitioners who specializes in bipolar disorder to connect your loved one with professional help today.