It's not always easy to know how to help someone who is experiencing bipolar disorder, especially when the person is yet to seek professional help. When the person is depressed, he/she may feel like nothing is worth doing, however when the person is experiencing mania, they may not recognise that anything is wrong. This can make it difficult to know what to say or do. The following suggestions may help.

Talk
Taking that first step towards helping a person who appears to be in need requires some thought and care. Choose a mutually convenient time and place. Timing is particularly important with people who have bipolar disorder, as they may not be receptive if they are feeling irritable or 'on edge'. Try talking to the person when they are well and ask what they would like you to do when you notice symptoms of depression or mania.

Listen
It's common for people with bipolar disorder to need time to discuss complex feelings and thoughts. Sometimes, when a family member or friend who has bipolar disorder wants to talk, they're not necessarily seeking advice, but just need to discuss some of their concerns. Listening, rather than talking, is a way of understanding how the person feels. This is called active listening. Save any suggestions, solutions or advice for a later discussion and instead, offer neutral comments such as "I can see how that would bother you.".

Body language
Body language plays an important role in helping people feel more at ease. Maintaining eye contact and sitting in a relaxed position can help create a comfortable atmosphere.

Use open-ended questions
Open-ended questions are a good way to start a conversation. They require more information and can't be answered with a simple "yes" or "no". Some examples are "So tell me about..?'" or "What's troubling you?".

Difficult conversations
Sometimes, if people are experiencing the symptoms of depression or mania, they may find it awkward to discuss their thoughts and emotions openly. They may even get angry with you when you ask if they're OK and in some cases, may not understand that they are unwell.

The following tips may be helpful when having a difficult conversation:

• stay calm
• be firm, fair and consistent
• if you are wrong, admit it
• don't lose control.

Spend time together
Often, just spending time with the person or talking to them shows they are being offered care, support and understanding.

Agree to disagree
When a person with bipolar disorder has symptoms of mania, they may experience psychosis and start experiencing delusions, paranoia and hallucinations. Trying to convince them that their perceptions of reality are wrong, can make the person angry and generally won't help the person see things as they really are. However, pretending that the delusion or hallucination is real doesn't help the person realise that they are unwell and their view of reality is distorted.

If a person with bipolar disorder is experiencing paranoia, delusions or hallucinations, let them know that you understand how difficult it must be, but you don't share their perception of reality. If the person tries to convince you that their way of seeing things is correct, you might like to suggest you agree to disagree and move on to another topic of conversation.

Practical ways to help
Helping someone who isn't ready to recognise they need assistance may be very difficult. People with depression often don't see the point of doing anything and may feel that no one can really help them. People experiencing mania may have difficulties seeing things in a rational light. Often they cannot recognise their own behaviour is of concern and may find it difficult to understand others' feelings or points of view. This is called 'lack of insight'.

Below are some Do's and Don'ts for helping a person with bipolar disorder.

DO - You can help someone by:

• spending time talking about their experiences
• indicating that you've noticed a change in their behaviour
• letting them know you're there to listen without being judgmental
• suggesting they see a doctor or health professional
• recommending and/or assisting them to make an appointment with a doctor or health professional
• going with the person to the doctor or health professional
• asking how their appointment went
• offering to help them find information about bipolar disorder
• talking openly about their feelings
• encouraging them to get enough sleep, exercise and eat well 
• taking them out and keeping in touch - as well as encouraging close friends and family members to do the same 
• helping them create an activities plan for when they feel unwell
• setting reasonable boundaries or rules and sticking to them
• contacting a doctor or crisis team if they become a threat to themselves or others
• learning about their way of coping and asking about the sort of support that they find most useful - it may be either emotional support (encouragement, hugs, etc) or practical support (providing a meal, making a phone call or paying a bill).

DON'T - It's unhelpful to:

• pressure them to "snap out of it", "get their act together" or "act normally" 
• tell them they are "over the top", "lazy" or "a downer"
• stay away or avoid them
• respond aggressively, even if provoked
• pressure them to party more or wipe out how they're feeling with drugs or alcohol
• feel you need to provide them with all the answers or help with their unrealistic plans
• assume the problem will just pass
• take over their projects.

Advice for Carers

At times, caring for a person with bipolar disorder can be very difficult. It's not uncommon for a carer to experience anger, guilt or fear. Below are some practical tips to help carers look after themselves.

Learn about bipolar disorder
Learning about bipolar disorder can help family members and friends understand why a person with the illness behaves in a certain way. This knowledge can help people separate the illness from the person and realise that the person's mood or behaviour may not be directed at anyone specifically.

Ask questions
In talking about depression or mania, it can be helpful to use a casual and open approach. Try asking about what helps the person when they're feeling high or low. This shows you care and are trying to understand.

Take time out
It's important for family members and friends of people with bipolar disorder to look after themselves and make sure they spend time doing things they enjoy.

Talk to someone
Family and friends of people with bipolar disorder sometimes find it helpful to talk about how they are feeling with people who are going through the same thing. Others may find this uncomfortable and prefer to talk privately to a counsellor.

Caring for someone who has bipolar disorder can sometimes make people feel isolated. There are services that provide education and support for carers of people with mental illness. For more information see the bipolar disorder section of our links page.

For more information see beyondblue Fact Sheet 1 - How can you help someone with depression? and beyondblue Fact Sheet 2 - Living with and caring for a person with depression

Getting help if someone is suicidal

If a person is suicidal you should: 

• let a doctor know the person is feeling suicidal (either GP or psychiatrist)
• take the person to a local public hospital
• contact a local Crisis Team
• contact a trusted friend or family member
• telephone a counselling service:
  • Lifeline - 13 11 14
  • Mensline - 1300 789 978 
  • Suicide Helpline - 1300 651 251 (Victoria only - 24 hour counselling)
  • Kids Help Line - 1800 55 1800 (free call).

For more information see beyondblue Information Pack for Carers, Families and Friends of those with Bipolar Disorder.