I think my girlfriend is bipolar

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Understanding why your partner acts out sometimes or becomes withdrawn is the first supportive step you can take in strengthening your relationship.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.

My girlfriend is bipolar and dependent on me – I feel smothered | Family

I’ve been with my girlfriend for two years. We live with our respective parents. It’s been a very strong relationship but I am worried it could soon fall apart.

I am quite a sociable person but afraid of confrontation and conflict. Too often I cave in to the wishes of others to avoid arguments.

My girlfriend has been bipolar since her mid-teens, which is now under control through medication. She is a shy person, very generous, kind and loving, but very dependent on me. She doesn’t seem to like her own company and gets annoyed if we don’t see each other regularly. So far I have accommodated and pandered to this.

However, I’m starting to feel smothered. I have built up an expectation by giving in to this in the past so now it’s hard to break that pattern and get my own space back.

Because I’m no good at conflict I find it hard to say I need my own space. Her reaction also makes it difficult: she gets offended easily and often overreacts to the simplest of things. She is quick to get angry and shout at me for such things.

I’m also stopped from expressing negative feelings. If I get annoyed or angry at something she has said or done, then the response is for her to get angry at me for being angry. It then all becomes about her and resolving her anger and making her feel better. So I never get to express myself.

I also find she belittles my reaction – if she sees me getting upset she says “you’re being over-sensitive”. It’s as though there is one set of rules for her and another for me.

We are looking to move in together, which I think may resolve things (or at least help).

I know this is a very negative letter but when the relationship is good, it’s full of love and support. I really want it to work, but with my ostrich complex and her angry over-compensation, is there any hope?

I can sense that you are torn, because I was too. Part of me wants to tell you to walk away from this relationship and the other part thinks things can be worked on. Not least, I think you need to resolve your fear of conflict. That said, I kept thinking: what if this letter was sent in by a woman, writing about a man?

There are aspects of your girlfriend’s behaviour that are controlling and that concerns me. Sometimes, people with mental health or psychological issues may try to control the outside world because inside can seem so scary and out of control. Maybe she’s young and needs to grow in confidence. Then I came to the conclusion that you just cannot be in a relationship where you can’t be yourself and express how you feel. Sure, we all need to bite our tongue at times and pick our battles, but you can’t be so utterly compromised as to feel sacrificed.

I showed family psychotherapist Karen Holford (aft.org.uk) your letter. She thinks there are elements of love and affection in your relationship and wonders if you could build on them.

On the conflict and confrontation front, Holford wonders: “When do you talk about conflict well?” She suggests you think about things such as “What do I need to say and how do I say it well?”

Sometimes so much is in how we present things, but that takes practice and, frankly, your girlfriend has to do a bit of work too. There is nothing wrong with starting a conversation honestly with: “I find it really hard to talk about this, but …” Or what about writing down how you feel in a letter to your girlfriend so she has time to digest it and not react immediately?

Holford also wonders who would be there for her if it weren’t for you? Who else comforts her? Can she comfort herself? It seems she may need to learn to do that, alongside you learning to say how you feel, for this to work. What resources are available for her, and her family and what help for her to manage her bipolar disorder?

But Holford also wants you to think about this: “What if this was always how it was going to be. Could you live with that?”

I wonder if you really are like this (scared of conflict) with everyone. If so, then this will likely recur in other relationships. Is there anyone you can really be yourself with? Is it a trait you recognise in your girlfriend that you are programmed to react to? Who else in your family do you react to like this?

Ultimately, your girlfriend needs to own her behaviour and be responsible for it, and you for yours. If you can’t resolve this, you need to walk away. And in the short-term, please think carefully before moving in together.

Contact Annalisa Barbieri, The Guardian, Kings Place, 90 York Way, London N1 9GU or email [email protected]. Annalisa regrets she cannot enter into personal correspondence.

Follow Annalisa on Twitter @AnnalisaB

“My beloved has bipolar disorder”

26,096

When we first met Lena, this bright, confident girl was simply overwhelmed with energy, she carried on a stormy activity - and, it seems, did not get tired at all. She constantly traveled between three cities, and sometimes between several countries, never staying anywhere for a long time. Everywhere she had urgent business: there was a conference, here a research project, here meetings with experts, and more courses, scholarships... study - finish one education, start another.

The breakdown coincided with the moment when we started living together. Suddenly, a lot of difficulties were discovered, which nothing foreshadowed before. Lena suddenly started having bouts of drowsiness, she wanted to sleep more and more often. The energy went somewhere and suddenly several chronic diseases came out at once. She had to leave a new job, where she barely had time to get settled - and this is in the midst of a crisis. Instead of a promising career - constant visits to doctors. Lena seemed to have been replaced - she suddenly stopped wanting anything at all.

It became terribly difficult to get her to any social event she used to love - to a concert, to the movies, just to hang out. Strangers caused only irritation and hostility. I tried very hard to entertain her: I invited friends, arranged parties, but every time everything ended the same way - she went to her room and went to bed. She said that she didn’t feel well, and although she did, it still made me angry, I wanted to communicate, and not whine and sit locked up.

In the end, she demanded that no one be invited to our house, not even to my birthday. This was the cause of one of our first serious quarrels - I could not understand why they wanted to deprive me of all the pleasures. Although in fact I didn’t notice at all that my girlfriend really didn’t want to see anyone, moreover, she had neither the strength nor the desire to maintain communication. What she wanted was to eat, especially sweets, sometimes go out for a walk, but better at night, when there are fewer people and cars, and lie on the couch with a magazine. Not with a book, because a book needs some effort.

I found her antics to be whimsical, lacking discipline. I didn't understand that there might be other reasons

She also dreamed of warmth and the sea. She often repeated a rather strange idea for a 25-year-old girl: I want to go to a sanatorium for a month. So that they would take me to medical procedures, and the sun would shine around and the trees would rustle. But after a trip to the sea, everything started anew: illness, drowsiness, unwillingness to do anything, quarrels. They happened due to the fact that I could not understand in any way where such a striking change came from: I had an affair with a cheerful, energetic girl, from whom suddenly, as if something had been pulled out along with all her desires, enthusiasm and interests. But this is not enough: Lena began to experience fits of extreme irritation and dislike for everything. Absolutely everything pissed her off: the wrong food, bad weather, a bad movie - everything made her want to scream, smash something, slam the door. Sometimes she threw things at me, after which we did not speak for several days.

Everything was strange in bed. She could suddenly stop caresses, turn away from me, wrap herself in a blanket. Or showed rejection and detachment, as if there had just been no tenderness. Sometimes her delight was suddenly replaced by coldness and fatigue, sometimes by irritation bordering on aggression. I sensed that there was something else behind these dramatic mood swings, and I tried to unravel this mystery. Once I came to the conclusion that her mood is really cyclical, and not only in bed. But what it means and why it happens, I had no idea.

Her mood swings made themselves felt at the most unexpected moments. When we sorted out a little with health problems, she got a long-awaited job. And at the end of the first day, she called me to say that absolutely everything did not suit her and she would quit. I got angry. It seemed to me terribly dishonest to shift all the worries onto me, I could not pull all the cases for two. Then her antics seemed to me whims, gouging, lack of discipline. I didn't realize there could be other reasons.

Until recently, I was convinced that every person should make efforts on himself, and the one who does not do this is an idler and lazybones, and all his excuses are just empty excuses. Thanks to Lena, I realized for the first time that each person has his own reserve of strength and strength. This is very important to understand for all those whose partners suffer from mental disorders and chronic diseases in general. It is necessary to realize very clearly what exactly the person who is nearby can and cannot do. And if he doesn't do something, it's likely not because he's a dumbass or bullies you, but because he really can't. You need to learn how to live, taking into account these features, learn to enjoy what you have, and not try to "upgrade" a person with an objective lack of resources.

There is another beautiful side to a partner with bipolar disorder. It can be bright, unusual, unlike others. This is what Lena struck me two hours after we met. Her speech is unusual and figurative, she dresses brightly, boldly, giving preference to those things that she likes. When she does not have severe depression, a powerful core is felt in her speech and thoughts. But then he suddenly seems to fall somewhere, and she seems to be no longer her: she cries, complains, not understanding why something needs to be done.

She is unpredictable not only in words but also in deeds. She did not work in her specialty, but she easily mastered a couple of new professions, then she became interested in charity work. And it never looked like throwing and endless search for yourself. Rather, she set ambitious goals for herself, quickly achieved them and lost interest. She could suddenly leave for a month to work on a project interesting to her God knows where, and then return, completely exhausted.

Living with a person who endlessly comes up with new projects, generates ideas and achieves almost everything, although at the cost of his own balance, is not only very interesting - there is nothing more valuable and inspiring. What did not inspire at all was the quarrels that flared up more and more often and ended with slamming doors, silence for several days. I don’t remember exactly, but I think it was I who first uttered the word “psychotherapist.” We did not count on anything, but it turned out that this was the beginning of the path to diagnosis and treatment. True, this path turned out to be long, several years long. It is important for partners of people with mental disabilities to understand this: a good psychotherapist is definitely needed. Later we found out that a psychiatrist was also needed.

One day, after several months of intense and stressful work, Lena had a severe bout of depression. Everything repeated: she again did not want anything, she even lost interest in food and sex. Trying to somehow cope with the situation, she got into huge debts and went on a trip, where she literally threw money. But the debts that we jointly paid off in less than a year turned out to be much less terrible than the new depression that covered her after her return. She couldn’t do anything else, it was amazing how she could even go to the office and do something.

It is important to create a feeling of a safe rear, a place where you can relax and just be who you are at that very moment

Lena has changed several psychologists, and here is my advice: if talking psychotherapy does not help, look for a specialist with a medical education who knows not only about neuroses, but also about psychoses. So we first heard the diagnosis of "bipolar affective disorder" and received a prescription for mood stabilizers. After that, the scandals, the showdown, the struggle for power and the division of space stopped by themselves. It became obvious to me that you can’t demand or pressure, you can only try to protect yourself from unnecessary stress. From the prescribed medicines, Lena became soft, calm and attentive in just a few months. Gone are the storms, bouts of irritation and discontent. She became relaxed and sensitive, the differences between depression and bouts of inspiration were smoothed out, while creative energy and enthusiasm did not leave her.

She still has a lot of plans, and it became even more interesting with her, because now I know what exactly happens and how she feels in this or that phase of the illness. But finding effective drugs is not an easy task. Doctors have a different vision of diagnoses, and they prescribe different drugs. Sometimes therapy works very well, and then suddenly something changes, and again you have to deal with irritability and depression. Here you need not to despair, but to be patient and wait, realizing that the attack of the disease will go away just as it came. Talk about this to a loved one so that he hears and believes that joy will return to him again, life has not stopped right today, this is just a malfunction in the nervous system, it will be repaired, and everything will definitely work out.

The disease did not deprive Lena of her will to live – on the contrary, she began to treat me and those around her with much greater interest. She still has some mild depressions and agitation, but they are not as devastating. Now I know that for us to love is to create for each other such an environment that would not allow illness to hurt us. The fact that my beloved has become softer and calmer has given me more strength to support her, and this, in turn, gives us the confidence that our home has finally become a safe space. For a person with mental difficulties, it is important to create a sense of a safe rear, a place where you can relax and just be who you are at that very moment. I realized the value of this comfort and safety only after Lena was diagnosed and treated. Then it became clear what was happening and what to do about it. We no longer step on the same rake and run into the same wall. And then, it is important to remember that the person you love has largely become the way you love him, including as a result of illness. Therefore, the disease has something to appreciate, it must be reckoned with and find a way to live with it in such a way that you suffer as little as possible.

This story was published in the book of journalist, bipolar. su portal editor Masha Pushkina “Bipolar People: How People with Bipolar Disorder Live and Dream” (Publishing Solutions, Ridero, 2017). It gathers testimonials from people with bipolar disorder and comments from experts, a psychiatrist and psychologists on how to recognize the illness and learn to live with it and be happy and productive.

Text: Alla Anufrieva Photo Source: Getty Images

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Don't Go Crazy: How Treatment Partners Help People with Bipolar Disorder

March 30 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 bring together 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 high 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 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 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 enjoys 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 comfort me because it's pointless, but he tries to give 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.

Alice, 27 years old

Biologist

To be honest, I do not 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 Valeriya, 21

Students

Anna: After a major depressive episode four years ago that nearly 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 go 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 you do not need to pay special attention to (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, and we, 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".

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