Caring for someone with bipolar disorder can be enormously difficult. The spouses, parents, children, and friends of people with bipolar disorder are often its forgotten victims. It can wreak havoc on their marriages, careers, friendships, finances, and emotions.

If you're helping someone through bipolar disorder, you face a difficult balancing act. On one hand, you have to be supportive and sympathetic; you can't blame a person for the effects of an illness. But on the other, you can't sacrifice all of your own needs to care for another person.

There's no easy solution. But here are some tips that might help you cope.

• Learn. The first step is to read about bipolar disorder. Go to the bookstore or the library. Get information from reputable web sites. Find out about the symptoms and treatments.
• Listen. Pay attention to what your loved one has to say. Don't assume that you know what he or she is going through. Don't treat your loved one's emotions and feelings as if they are all signs of an illness. Just because someone has bipolar disorder doesn't mean his or her point of view isn't valid.
• Ask how you can help. During bad periods, everyday things can be overwhelming to people with bipolar disorder. Reducing stress at home helps. Offering a ride to a doctor's appointment, or help with laundry or child care, can mean a lot.
• Keep track of symptoms. In many cases, you may notice emotional changes in your loved one before he or she does. So think about keeping records. Catching changes in mood early -- and getting treatment for them -- can make a big difference. However, you walk a fine line. If you're too intrusive, your loved one might feel like you're spying.
• Encourage your loved one to stick with treatment. It's key that your loved one stay on his or her bipolar medication and get regular checkups. Your loved one may also need encouragement to eat well, get enough sleep, and stay away from alcohol and drugs.
• Do things together. People who are depressed often pull away from the world. So encourage your friend or loved one to get out and do things he or she enjoys. Ask him or her to join you for a walk or a dinner out. If he or she resists, don't force the issue. Instead, just gently ask again a few days later.
• Make an explicit plan. Because bipolar disorder is an unpredictable illness, you should plan for bad times. Be explicit. Agree on what to do if symptoms get worse. Have a plan for emergencies. If you both know what to do and what to expect of each other, you'll feel more confident about the future.
• Express your own concerns. Since your loved one's behavior can have a huge effect on you, you have the right to talk about it. However, don't blame the other person. Don't list all of his or her mistakes. Instead, focus on how your loved one's actions make you feel and how they affect you. Since this can be a very difficult subject, you might find it easiest to discuss it together with a therapist.
• Accept your limits. Supporting your loved one can be key to his or her recovery. But you have to remember that you can't single-handedly make your loved one better. You can't take care of him or her every second of the day. So get other people involved. Ask for the help of other family members or friends. Don't bear the burden on your own.
• Take care of yourself. It's easy to lose sight of your own needs when you're taking care of someone else. But you have to stay healthy emotionally and physically. If you push yourself too far, you'll just burn out -- and that's no good for anyone.

So take time off regularly. Ask other friends or family members to help out so you can get away. Do things that relax you. Consider seeing a therapist on your own or joining a support group for loved ones of people with bipolar disorder.

Next: Convincing a Loved One to See a Doctor

View the full table of contents of the Bipolar Disorder Guide.

Reviewed by the doctors at The Cleveland Clinic Department of Psychiatry and Psychology.

The information provided by The Cleveland Clinic is not intended to replace the medical advice of your doctor or health-care provider. Please consult your health-care provider for advice about a specific medical condition. For additional health information, please contact the Health Information Center at The Cleveland Clinic, (216) 444-3771 or toll-free (800) 223-2273, Ext. 43771.

Edited by David Fram, MD, October 2006.

SOURCES: Diagnostic and Statistical Manual of Mental Disorders, Fourth edition, Text Revision. Washington, D. C.: American Psychiatric Association, 2000. The Nations Voice on Mental Illness. Depression and Bipolar Support Alliance (DBSA). American Psychiatric Association. National Institute of Mental Health. Practice Guideline for the Treatment of Patients with Bipolar Disorder, 2002. WebMD Medical Reference in collaboration with The Cleveland Clinic: Bipolar Disorder. Muller-Oerlinghausen, B. The Lancet, Jan. 19, 2002; vol 359: pp 241-247. Kaufman, K. Annals of Clinical Psychiatry. June, 2003; vol 15: pp 81-83. Compton, M. Depression and Bipolar Disorder, ACP Medicine.

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