Dating for bipolar

5 Secrets to Dating When You Have Bipolar Disorder

For people with bipolar disorder, piloting the unpredictable waters of dating can mean much more anxiety than normal. Here, five adults with bipolar disorder talk about their dating experiences, and how they navigate both the dating scene and the crucial question of when to disclose their mental health issues. Melanie Greenberg, PhD, a clinical psychologist in Mill Valley, California, and author of the Mindful Self-Express column on Psychology Today, also weighs in.

First Dates: Manage Your Expectations and Have a Getaway Plan

“I’d just remind myself to cool it — it’s just a date,” says freelance writer Laura Dattaro, 28, of New York City. Dattaro was diagnosed with bipolar II disorder right after her 23rd birthday. “It can be easy to get carried away, especially if your mood is on the upswing.” That excitement and good feeling may make the new person seem like your soul mate or new best friend, she says, and when that doesn’t pan out it’s a big bummer.

Dr. Greenberg agrees, noting that in someone with bipolar disorder, that excitement can be heightened. So to those with bipolar who are entering the dating scene, she advises, "since bipolar people can be impulsive, you might want to prepare yourself for taking your time." For example, you might not want to get too sexual prematurely.

Greenberg also says that your anxiety could be heightened. Leah Yegneswaran, 24, of Fredericksburg, Virginia, who was diagnosed with bipolar disorder at the age of 20, agrees. “I worry that I’ll be triggered over the course of the date,” says the University of Mary Washington student.

So Yegneswaran creates a backup plan to accommodate the possibility of an anxiety attack. “I tell friends in the area of the date that I might need a safe space in case something happens and I need to crash somewhere,” she says.

Elspeth Rawlings, 23, a student in Frederick, Maryland, tends to only date people she already knows, which helps minimize anxiety. At age 17, Rawlings was misdiagnosed with major depressive disorder. She was formally diagnosed with bipolar I in early 2015 and is now thriving with the right therapy and medication regimen.

Low-key first dates — like watching movies together — are best for her, Rawlings says. “I don’t really like not having a place to retreat to or get away from crowds if I start to feel bad,” she adds, echoing Yegneswaran.

Ryan Zamo, 26, feels “highly nervous” about dating when he’s in a stable period. “I would be hoping that I don’t start swinging into mania, because then I just get erratic and start spending tons of money that I really shouldn’t be spending,” says the Los Angeles resident. Depressive periods make Zamo not want to go at all: “Nothing’s harder than trying to be interested in someone’s story when you’d rather just not be there.” Zamo, who is CEO of his own organic cosmetics company, says he showed signs of bipolar disorder when he was 18, but was only formally diagnosed at age 22.

Should You Disclose Your Bipolar Disorder?

“Definitely do not tell the person on your first date,” Zamo says emphatically. According to Greenberg, not disclosing right away is okay if doing so would be uncomfortable. But, she adds, “If the relationship is getting more serious, you should reveal it.”

“If you think you might behave in a way that is uncomfortable for the other person,” says Greenberg, that’s another reason to disclose.

Zamo has had that experience. When he discloses that he has bipolar disorder, it’s usually after he’s become “feisty and irritated during a low period.” Later, he’ll feel bad about it, and revealing his bipolar disorder is “the only way to explain being an ass to them,” he says.

Michelle Mallet, 32, of Seattle, describes herself as outspoken and open with friends and coworkers about her mental health. Mallet, who currently works as a chef, was diagnosed with the condition around age 18 or 19. Despite being outspoken about her condition, Mallet doesn’t reveal that she has bipolar disorder on a first date.

RELATED: Why Bipolar Disorder Is Often Misdiagnosed

“I want to know the people I tell this to first,” she says. Dattaro leans that way, too, in a mental balancing act of her own. “I try not to think about it as some scary secret that needs to be revealed,” she says. “It’s more an aspect of my life that’s just a little more personal than regular first-date fodder.”

Rawlings takes a different approach because she has anxiety and panic disorder along with her bipolar. “I disclose as soon as possible just so I don’t scare someone, but also to protect myself from people who aren’t necessarily accepting when it comes to mental health issues,” she says.

The Risks (and Benefits) of Building a Relationship

When you have bipolar disorder, dating can make you feel like you’re not quite in control of your emotions, says Greenberg. You could feel like you’re becoming too angry or being ultra-sensitive, she adds. When it comes to relationship style, research has shown that adults with bipolar disorder display more insecure attachment styles when compared to people without the disorder. Zamo says he’s definitely scared people off, either because he cut off communication during a low spell, or because his manic behaviors were too much for someone else to handle.

The mood state does matter, according to Mallett. She once reached out to someone she was dating while she was in a “depressive, anxious cycle,” requesting that they turn their relationship into something more serious. Mallett’s request was rejected. “That triggered an anxiety spiral, which triggered my depressive cycle to the max, and I spent the next day in a super-duper fog and then drove myself to the hospital and checked in for suicide watch,” she explains. “I was in a serious, depressive state for two months,” she says, and had to take medical leave.

But what about the pluses of dating? Dattaro sees some possibilities. “One positive aspect is that it can show you that people aren’t really all that judgmental about it. If they are [judgmental], find new people!” Dattaro thinks that opening up to someone and seeing that they remain calm about it can “really bring trust into your relationship. ”

Rawlings has found that all of the people she’s dated have had a form a mental illness, and that a good portion of her friends do, too. In fact, there are dating sites that cater specifically to bipolar matchmaking, like BipolarDatingSite. The ability to make jokes and talk about that shared experience can be a coping mechanism, she believes. On the flip side, though, is that you could become a “project” of some well-intended person who wants to help fix you without understanding that it’s not something they can do.

Know Yourself, and Get to Know Your Date, Too

Getting to know the person first makes a big difference. “Take things slowly,” Greenberg says. “Don’t let insecurity drive you, or feel less than [the other person] because you are bipolar.”

Be self-forgiving, too, says Yegneswaran. “Don’t berate yourself for not living up to what you think you ‘should’ be like,” she says. Rawlings agrees: “You should not let anyone tell you that you are broken or not good enough, even if it’s your own brain telling you that. ”

“Don’t let being bipolar stop you!” says Mallett. She didn’t date for years because she was worried that she was too depressed or too manic to be attractive to someone without a mental illness. “But if someone likes and then loves you, they’ll love the whole you, and that includes your messed-up brain.”

Bipolar Relationships: What to Expect

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Ups and downs are natural in any romantic relationship, but when your partner has bipolar disorder it can feel like you’re on an emotional rollercoaster. Not knowing what to expect each day is stressful and tiring. Over time, it wears on the relationship.

Understanding why your partner acts out sometimes or becomes withdrawn is the first supportive step you can take in strengthening your relationship. Learn exactly what a bipolar diagnosis means, how it could affect your partner’s behavior and what you can do to foster a healthy, stable relationship.

What does it mean if your partner is bipolar?

Bipolar disorder is a mental health condition marked by intense mood changes. People with the illness switch back and forth from mania or hypomania (an emotional state of being energetic and gleeful or sometimes aggressive or delusional) to having episodes of depression.

The lifelong condition tends to run in families, although the cause of bipolar disease is unknown. However, it can often be successfully managed through treatment. There are two primary types of bipolar disorder:

Bipolar 1

Bipolar 1 is a more severe form of the illness and is defined by manic episodes that have one of these characteristics:

Hallucinations, delusions or paranoia
Hospitalization required for safety
Impulsive behavior with significant consequences

“When people are manic, they pursue pleasurable activities with great enthusiasm and with no regard for the consequences,” says Jennifer Payne, M.D., psychiatrist and director of the Women’s Mood Disorders Center at Johns Hopkins Medicine. “They may gamble, spend excessive amounts of money, use drugs or become promiscuous. ”

Bipolar 2

People with bipolar 2 experience hypomanic episodes, which still include out-of-character behavior but aren’t as extreme as those with bipolar 1. Hypomanic episodes may include:

Increased energy and drive.
Rapid speech.
Decreased need for sleep.

“During hypomanic episodes, a partner with bipolar 2 may obsessively pursue sex with you or others,” says Payne. “They may stay up all night and have lots of wonderful ideas they want to tell you about at 3 a.m.”

Treatment Challenges

Bipolar disorder is usually treated with a combination of medications and therapy. However, successful treatment can be a challenge since many people miss the euphoria and energy of manic episodes.

Often people with bipolar disorder view these elevated mood states as their best selves — when they’re the most productive or creative — and will stop treatment in order to experience that again. Sometimes those with bipolar disorder will even intentionally trigger a manic episode.

“Lack of sleep is a trigger of manic episodes for a lot of people,” says Payne. “Sometimes patients with bipolar disorder will deliberately skip getting the sleep they need in order to initiate an elevated mood state. For example, a person might want the high energy that comes with a manic episode to get a project done.”

The key to your partner’s successful management of the illness is a commitment to continuing treatment and ongoing communication with their psychiatrist. This can take place at therapy sessions, during regular checkups or whenever necessary to discuss troubling symptoms.

Many people with bipolar 1 do well on lithium, a mood-stabilizing drug. Those with bipolar 2 may not fully respond to medications often used to treat bipolar disorder. If that’s the case for your partner, it’s important for them to continue to work with their psychiatrist to find an effective treatment.

Being in a Relationship with Someone Who Is Bipolar

There are certainly challenges in any romantic relationship, but bipolar disorder can make things especially difficult in various aspects of life:

Intimacy

It’s common for people with bipolar disorder to desire frequent sex during manic or hypomanic phases. Your partner may initiate intimacy much more than normal, or masturbate or use pornography more frequently than usual. Those with bipolar disorder may also engage in risky behaviors such as unprotected sex or extramarital affairs while manic.

During episodes of depression, your partner may avoid sexual contact altogether. This can be confusing or feel like rejection, especially if your partner recently desired lots of sexual activity during a manic or hypomanic period. Many medications for bipolar disorder can also lower sex drive.

Work

Your partner’s ability to perform well at work can be affected by bipolar disorder. Severe mood swings, along with manic symptoms such as poor judgement and impulsivity, or depressive symptoms such as low energy and disinterest make it tough to find and maintain a job. Stressors at work may also trigger or exacerbate your partner’s symptoms. If your partner can’t hold down a job, this could put more pressure on you to provide financial support until their illness is well-managed.

Parenting

Many people consider parenting the most stressful (albeit rewarding) job of their lives. But any kind of stressor — good or bad — has potential to trigger manic or depressive episodes for people with bipolar disorder.

In addition, the erratic behavior associated with bipolar disorder can be confusing and scary to children, who look to parents to provide stability. Helping your partner get and maintain treatment to control symptoms is crucial for providing a safe and secure home for children.

How to Make a Bipolar Relationship Work

It takes effort to keep any relationship strong, but it can be especially challenging when your partner has bipolar disorder. Payne offers these recommendations:

Go to Couples Counseling

Couples counseling is essential for working through upset over a bipolar partner’s actions. It’s common for someone with bipolar disorder to hurt and offend their partner. When someone is first diagnosed, there are often relationship issues that need to be addressed. Couples counseling can help you:

Understand that there’s an illness involved in the hurtful behavior.
Forgive the behavior that happened during an altered mood state.
Set boundaries with a partner about maintaining treatment.

Get Involved with Treatment

Ask if you can be involved with your partner’s treatment, which may include occasionally going to the psychiatrist together. Being a part of your partner’s treatment has multiple benefits, including:

Gaining a better understanding of the illness.
Providing additional insight for the psychiatrist.
Learning to spot signs of impending episodes.
Alerting the psychiatrist about mood changes.

Even if your partner hasn’t signed off on you exchanging information with their psychiatrist, you can still report worrisome signs (the doctor just won’t be able to tell you anything). This gives the doctor a chance to make quick medication changes that may help your partner avoid being hospitalized.

Practice Self-Care

Self-care gets a lot of buzz these days, but nowhere is it more important than when you’re caring for someone with a serious illness such as bipolar disorder. It’s essential to dedicate time to your own physical and mental health, whether that’s going to a support group, talking to a therapist or attending a yoga class.

Being in a healthy relationship with someone with bipolar disorder requires not only careful management of their illness, but also setting aside time to take good care of yourself.

Online dating • sdelano.

media

Ksenia Shulman ,
author of the project

At the end of the second course, we were given the task of making a longread. The topic could be anything, the main thing is to reflect real stories.

Our team had many ideas: to talk about bipolar disorder, about loneliness after thirty, about people who were on the verge of life and death. Some options were discarded due to the fact that the topics seemed uninteresting to a wide audience or to some of us, others because of the deadline: it was necessary to find heroes and assemble a high-quality longread in one month During a brainstorming session in a student cafeteria, we realized that many of our acquaintances at least once looked for a mate on the Internet - and this is how the idea of the project was born.

Project cover

Some people think it's safe to communicate online. It's not like that: you never know who's on the other side of the screen, and it doesn't hurt to be careful. Others treat online dating with disdain.

The goal of the long read is to combat excessively negative or positive perceptions of online dating. Yes, sending a friend request to a girl you like on social networks is not the same as approaching a stranger on the subway, but we live in the 21st century, and online dating is normal. We wanted to show that the Internet is the same place for finding a couple as the subway, university or work. The project has stories with both happy and sad endings, but the same could happen to the characters if they were looking for love in real life.

Web project with pencil illustrations

Alina Petukhova ,
illustrator

Responsibilities in the team were distributed by themselves after the idea appeared: someone had already found a hero, someone was well versed in infographics or editing. But in general, we worked together.

I was in charge of the illustrations. We decided to divide them into two categories: abstract, which symbolize network communication, and more concrete, details and fragments of stories.

There are six illustrations in the project

I made several sketches, and my team and I chose the most successful ones. We agreed on a black and white palette, as it is easier to implement both on paper and in Tilda, and it looks stylish. I drew with a pencil, then outlined with a black gel pen. We scanned the finished works to complete the project.

“We do not ban, but warn”

Ksenia Shulman ,
author of the project

We came up with the structure of the project right away, it almost did not change. First, we tell readers three stories: with a bad, neutral and good ending. Heroes found among friends. I interviewed a friend, Anya Bolotina, my sister's husband. Finding a neutral story was the hardest part: a breakup is a breakup. As a result, an acquaintance of Ani Khmaruk spoke about his experience of relationships on the Internet. He considered him neither happy nor sad.

After readers have studied the stories of the characters, we invite them to learn about the risks of dating on the Internet in a special section - our motto: "Trust, but verify. " In the middle of the project, there is a street talk video (street survey - author's note), where people tell what they would do if they were faced with the mentioned risks.

It was not difficult to shoot street talk — the guys were turned down only twice

Several infographics complete the project. We made it based on data from a survey on social networks about how people from 18 to 30 years old relate to online dating.

While working on the longread, we tried not to forget about humor - dry text is not interesting. We are not psychologists, not teachers, and not experts in virtual relationships. We are friends, we do not prohibit, but warn, and the reader draws his own conclusions.

Student longread cycle

We focused on the rules for working on longreads from the book How New Media Changed Journalism. 2012–2016” (chapter “Multimedia longreads as a new format of online journalism”).

First, we came up with an idea and made a story board: we schematically depicted the future project in order to understand what types of multimedia would be useful to us and how it would look. Then they searched for heroes and equipment, arranged surveys for infographics, and came up with questions for street talk.

The authors made the infographic in Adobe Illustrator and typed it into the project as an image. We have never worked in this constructor, but we figured it out quickly: Tilda has a lot of convenient templates, and the result is always pretty.

Then we subtracted the longread, checked that the letters “ё” and em dashes were everywhere, tested the project on mobile devices and tablets.

The last stage is promotion in social networks. I think if we were working on the project now, we would approach this more responsibly - we shared the longread on dating forums or similar publics on VKontakte, connected counters like Yandex. Metrics. But then the session was approaching, and there was no time for that.

We didn’t spend a single penny on the project: we didn’t pay Alina for drawings, we didn’t pay for interviews with the heroes, we rented cameras for free at the Faculty of Journalism.

Victoria Domanina ,
author of the project

We didn't expect our teacher and classmates to like our longread so much, we didn't disappoint the heroes of the project either. It was nice that the work turned out to be worthy - we did it not only for the sake of credit. People were interested in the project and asked questions. I think the project has achieved its goal.

Tips from the authors:

Be clear about your idea and goals. When choosing a topic, evaluate your strengths. Distribute responsibilities within the group in advance, guided by the strengths of the guys you work with, and do not forget to set deadlines. Do not forget about multimedia: without audio, video and pictures, no one will want to read your text.

People with bipolar disorder tell how to properly support them

March 30th is celebrated as Bipolar Day around the world. With this disease, it is important to monitor mood changes, which can be difficult to do alone. The founder of the Bipolar Association, Masha Pushkina, has collected stories of people who are helped by treatment partners.

At the initiative of public organizations that unite scientists, doctors and activists, every year on March 30, World Bipolar Day is celebrated. The date chosen was the birthday of Vincent van Gogh, an artist who, according to researchers, was the embodiment of a "bipolar genius."

With bipolar disorder, a person lives either in a state of strong emotional uplift and excitement (mania), or in depression. According to world statistics, about 2% of people suffer from bipolar disorder in various forms. This means that in Russia there are at least three million bipolar people - this is about half of St. Petersburg.

In most cases, this condition responds well to medication. But, unfortunately, many do not seek help or do not know how to find it. Without treatment, the disease progresses and ultimately leads to sad consequences: loss of family, job, disability in general, and in almost every seventh case, suicide.

These consequences can be avoided. The peculiarity of bipolar disorder is that the onset of remission depends not only on the doctor and medications, but also on the behavior of the patient himself. Very often, bipolar people provoke seizures "with their own hands." The mood of people with BAD (bipolar affective disorder. - Note ed. ) is very unstable, the balance is fragile, and mania or depression can be “started” in dozens of ways: the psyche is easily shaken by psychoactive substances, alcohol, lack of sleep, too intense work, travel, and even falling in love. So, a short time after the next course of treatment with powerful drugs, the person again ends up in the hospital. And each new attack reduces the chances of a long remission, affects social status, and even more painfully - self-esteem.

The experience of people with mental disorders around the world has proven that you are much more likely to cope with difficulties when you are supported by people who understand your problems and condition, but at the same time do not look at you as a patient. As practice shows, such a person can be not only a partner or close relative. An old friend, and even a person with whom you have never met in person, can help you get through the darkest times. Masha Pushkina, especially for Afisha Daily, spoke with several bipolar people about those in whom they found their support. The result is a story not about illness, but about friendship and trust, which can defeat even madness.

Yana, 31 years old

Housewife, collects books and is fond of confectionery

Purposefully, I didn't find out about the ways of support anywhere, everything turned out quite naturally. I have been sick for 15 years. The first person who looked after me was my best friend, and now it's my husband.

When my hypomania (a mild degree of mania, which is characterized by a constantly high mood. - Approx. ed. ) accelerated into a full-fledged mania (this state is also characterized by a one-sided attraction to some topic, sometimes accompanied by delirium. - Note ed. ), it became clear that I needed to be looked after. A friend began to pay attention to repetitive patterns of behavior in one phase or another, and we decided together to find out what helps in such cases. I think my friend was afraid to take responsibility for my condition, but she turned out to be generous and selfless. When I got married, a friend passed this knowledge on to her husband, and he already supplemented it, based on his own experience. The husband initially knew with whom he connects his life. He says it didn't scare him.

I have obsessions during manic episodes. My husband does not argue with me at this time, but he also does not feed them, trying to redirect my stormy energy in a different direction. You can’t argue, because the result will be the opposite: I will finally get stuck on the idea, I will consider that I must prove it at all costs, even if the whole world is against me, and there are enemies and conspiracies around. If this does not help, the husband agrees to discuss all these things, but at the same time tries to slow down their implementation by offering to draw up a specific and detailed plan. Sometimes it takes me a long time.

For example, I always want to move somewhere. Right now, and why aren't we packing our things yet? My husband tries to make me write down what are the pros and cons of different cities, what attracts us to them. As a result, I sit for hours on different forums, make lists, think about how we will arrange our life, calculate the budget for different countries of the world. There is also a manic passion for travel, but after preparation, we usually implement these plans. And many years ago, in a fit of mania, I bought an apartment - with a mortgage, with hellish payments. Then it took a long time to resolve this situation, but, fortunately, everything worked out well.

My husband began to chart my mood. I also manage it, and we check the results so that they are objective. Quarrels due to the fact that the husband takes on the role of the elder often arise in the manic phase (never in depression). Then I become very suspicious, any attempts at control cause rage. But now the husband has learned from experience, so he does not react to attempts to unleash a conflict. With obvious attacks of rage and auto-aggression, he uses holding therapy (long strong hugs. - Note. ed. ). We have seen this in autistic children, this is how their parents influence them.

When I'm depressed, he doesn't console me because it's pointless, but he tries to make reasonable arguments that this period has always ended and this time will also pass soon. We look at mood charts for the past months, discuss the duration of the attacks: two weeks have already passed and, judging by past experience, it should get better in a couple of weeks.

Such support from her husband helps in many ways. When I was being treated by two doctors, taking all the medicines, I didn’t have such support, everything was very bad. Over time, I stopped disappearing from home in a manic state and inflicting serious injuries on myself. All my super-ideas remain on paper in the form of graphs and tables, I don’t even have time to start putting them into practice, so that later I don’t have to deal with the consequences with the whole family.

Alisa, 27 years old

Biologist

To be honest, I don't always find understanding from my healthy environment, I often faced condemnation, devaluation of problems. But from a person who has a similar experience, you won’t hear “don’t invent”, “you can’t feel so bad”, “take a walk and it will pass”.

It just so happens that my best friend also suffers from bipolar disorder. I did not look for support in specialized communities where patients communicate, we met by chance. My friend is much older, he has much more life experience, and he was able to become a real mentor for me. Not once did his actions worsen my condition - I hope that he can say the same about me.

When I'm on the rise, I feel uncomfortable when he tries to slow me down and reduce my passions. But as soon as this state passes and I again take a sober look at the situation, each time I thank him for trying to stop the revelry and disgrace. My friend himself is currently not being treated, but he never imposed his position on me, and when I turn to doctors, he supports me in this.

I told the doctor about this source of support - he is exclusively for it. Before meeting a friend, I had suicidal attempts, but during the entire time of our communication I never tried to say goodbye to life. When you know that there is a person who will understand everything and share warmth (while even my own family repels me), that there is a place where you can come in any condition and where they will accept me without unnecessary questions and teachings, this is a source of great strength. and hope.

When I was expecting my second child, I was depressed. My husband did not yet fully understand the features of the disease and did not want to admit obvious things - this added problems, and my emotional state became extremely difficult. It seems that only thanks to the participation of my friend, I did not do anything to myself and successfully endured the pregnancy. The child was named after him.

Sergey, 49 years old

Freelancer

At the height of the depression, I was looking for any available support and ended up in an online group of anonymous debtors (people who have taken on large loans). One of the participants drew attention to my condition and said that I urgently need medical help. Despite the fact that she lives in the USA, we began to communicate regularly via Skype. Olga literally brought me to the hospital and helped me prepare for the treatment.

Americans are a pragmatic people, many young and healthy people have folders with wills and instructions in case of their death. They also approach mental difficulties calmly and thoroughly. It is common practice for the patient to draw up detailed instructions in advance. In the United States, there is a practice of issuing Treatment Agreements for people with mental illness (Treatment Contract). This document is needed so that family, friends and doctors recognize the symptoms of deterioration in time and take into account your experience and wishes in the treatment. Typically, such a document contains: a list of trusted people; signs of a normal state; signs of an approaching episode; symptoms of mania and depression; actions that trusted people should take to help a person get better and keep him from destructive acts; plan of action in case of an emergency (for example, a suicide attempt). who and what will be done in case of his hospitalization, so that he can be treated without anxiety for household chores.

In a period of severe depression, there is a struggle inside a person between the craving for death and the desire to live - and many external things can outweigh in one direction or another. Every clue is important to help you get out. It is very difficult for one to cope with all this.

I madly didn’t want to go to the hospital and wouldn’t have made up my mind myself, until the last I hoped that somehow everything would go away on its own. But under the supervision of a friend, I drew up a preparation plan: warn the customer at work, arrange to look after my cats. Reported to her about every step. But then he could no longer simply “escape” [from hospitalization], because he felt obliged to both her and the doctor. During depression, one's own life has no value, but the people dear to me, the promises made to them, do.

At the most difficult moment, Olga became my “outer brain”, which told me what to do when I didn’t understand anything myself. After I was discharged from the hospital, I turned to four friends for support. Usually we call each other once a week, I tell what my condition is. It is important not only to chat online, but also to hear the voice, you can understand a lot from it. Friends immediately pay attention, if I suddenly disappear and stop calling, then something is wrong.

I think it is possible to find such a person if you set such a goal. Take a closer look at people in support groups, religious or other communities - those who understand what compassion and mutual assistance are. This must be an internally mature person, ready to take responsibility for you in a difficult situation. If this person has similar problems, then he will better understand your experiences. For this reason, relatives are far from always suitable: they themselves can panic, seeing how bad you feel, choke you with their anxiety, overprotection.

It is necessary to establish the frequency of communication and observe it. And of course, in no case should you parasitize on someone else's kindness. The support system works when you yourself take responsibility for your life, and do not outweigh it completely on another.

Anna and Valeria, 21 years old

Students

Anna: After a major depressive episode four years ago that almost ended in a suicide attempt, I started looking for information on [support]. I managed to find a guide in English for relatives and friends on how to behave with such a person. I have sent this list to all my friends so that they have an idea of what is happening to me. For the past few years, Lera has been monitoring my emotional state on a daily basis, and if, in her opinion, it goes beyond the norm, she tells me about it. Lera just asks every day how I'm doing, and if she sees that I'm reacting strangely, she wonders if something happened. At first, it was very difficult, because, in principle, I did not like to regularly share personal experiences. But by regularly receiving feedback, I can imagine the dynamics: do the pills help, how long do the side effects last, does the depressive phase go into a moderate and severe degree, do I lose my critical thinking during hypomania.

Valeria: We gradually established a very trusting relationship. Anya studied the topic of bipolar disorder up and down, and I read the articles that she sent me. The diagnosis did not change anything for me, because it remained the same. After that, we already discussed some formalities (for example, who to call in case of an emergency).

Anna: I asked Lera to watch for hypomanic manifestations in which I lose an adequate assessment of my actions: impulsive night walks, alcohol begin.

Valeria: My friend is a very responsible and conscious girl who takes care of herself, her health and her wallet. Before buying something expensive, she asks for my advice - and then we are already sorting out the situation. We can entrust accounts to each other and not worry. I also know where and to whom to run in cases of exacerbation.

Anna: I react badly to prohibitions and reminders of illness. Yes, I periodically have to turn to relatives for help, change treatment or take long breaks, but I expect mutual respect so that they don’t look at me through the prism of the disease.
When the mood is unstable, harsh phrases like “the disease speaks in you”, “these are not your real emotions” cause persistent rejection, even when they are true. The line between accepting a loved one's illness and identifying him with a diagnosis for healthy people is extremely thin. Therefore, those who were able to grope it deserve great respect.

Anna: In the last year, I have been going to see the doctor with my parents. When the doctor notices that I may not be able to do it alone, she duplicates the instructions and advice for them. I, in turn, am a friend. The doctor has repeatedly emphasized that the change of episodes is more noticeable from the outside.

Valeria: We don't have any kind of hierarchy in relationships, so there is no pressure when one makes decisions for another. This is not eating each other's emotional resources, but complementing and supporting.

Anna: The main danger in a relationship with a person with a serious illness is to fall into codependency. This format is equally bad for both the "controller" and the "subordinate". Unfortunately, I have been in such relationships before. It is worth maintaining mutual respect and treating each other as equals. Illness should not dominate a relationship. In difficult episodes, it temporarily comes to the fore, but you should always remember that you are not a disease.

Anna: I have memory problems: I don't remember some episodes. In such cases, I can ask Lera for help. If you remember the last weeks, then these are regular reminders to call the doctor. In mixed episodes, this becomes an acute problem, because I can suddenly change my mind or forget. Against the backdrop of a severe episode, I may develop psychosis, and this is the most dangerous thing in the disease. Thanks to our format, I manage to avoid such exacerbations almost always.

The advantages of observation from a loved one are an early response and the fact that he knows the patient's usual behavior very well and can notice even small changes. The main disadvantage is that normal friendly communication risks turning into constant monitoring of symptoms. Not every mentally healthy person is able to remain within the boundaries of reason.

It is important to agree in advance, before an attack, what is an undoubted sign of a worsening condition (for example, persistent insomnia), and what does not need to be given special attention (for example, loud indignation at something that you do not like). In a difficult situation, often a loved one begins to behave not as an equal, but as a “healthy” and “knowledgeable”. Not all relationships stand this test.

There is also a variant of "buddy" (when two people with mental disorders look after each other. - Note ed. ) - it is good precisely because it is the true request of the patient and more equal relations without mixing roles. But I don't know the buddy support system.

To choose a person you can rely on in a critical situation, take a closer look at your surroundings. Above all, a high level of trust is needed. Your assistant should be open to nonjudgmental and open dialogue and at the same time emotionally stable and resistant to stress.

Support is essential for every person - very often we as mental health professionals need it. And with bipolar disorder, this problem is especially acute. At the initial stages, those closest to you often ignore the presence of the disease, and friends advise you to either "pull yourself together" or, conversely, "relax", sometimes with the help of alcohol. When it becomes obvious to everyone that the “condition” will not go away on its own, urgent hospitalization is already required. The saved patient receives the "stigma".

Psychiatrists then put the responsibility on the uninitiated next of kin (parent or spouse) to monitor any changes in the patient, and they really try to do so. At the level of "laughing out loud - hypomania has begun, upset - depression." As a result, psychiatrists begin to treat quite normal human emotions based on complaints from relatives... and the circle closes.

For this to change, mental health literacy must play a major role. Relatives, in order to be able to help, need to understand well what is happening with a loved one.

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