Bipolar Loved One in Denial

When a family member is suspected of being Bipolar - what is the best way to approach/treat our loved one? Our loved one does not see the signs and symptoms that are so clear to everyone around. Our loved one definitely needs to seek out treatment to recognize and treat this horrible imbalance that is controlling their life and upsetting everyone around them. However, until our loved one accepts there is a problem...there is no opportunity for treatment. We, the ones that love and care so much - don't know what to do when we see all the symptoms of bipolar. How can we approach/direct or even suggest our love one seek treatment in order to control and accept this disorder?

Ben's Answer:

That's an excellent question, and a very hard one to give a good answer to. So much depends on the personality of the person, as well as their pattern of mood episodes. Crying one minute, laughing the next? Manic and grandiose? Agitated and paranoid? Deeply depressed and wasting away in bed? Each one of these states would require a somewhat different approach in terms of the urgency of the situation, and the amount of effort or even manipulation might be called for to try to get them some help.

One option might be to do a sort of intervention with all members of your family and closest friends of your loved one, and present them with your concerns and the options that you are giving them. With some people this would work - especially if there is a lot of depression.

If a person is experiencing paranoia, psychosis/delusional states - then a hard confrontation like this would be absolutely the wrong approach as you would simply be reinforcing the delusion that "everyone is plotting against me."

The most coercive measures should be reserved for a person that is truly, imminently in danger of hurting themselves or someone else - whether by suicide, homicide or oblivious recklessness - like driving dangerously, or severe substance abuse.
In some of those cases, carefully planned intervention by the police (if that's possible) may be the only way to go.

But if symptoms are troublesome but not that severe, there may be little you can do right now. You can't force a person into treatment unless they meet those strict criteria (which differ from state to state in the US), for involuntary psychiatric hospitalization. Danger to self, danger to others, or unable to provide for basic survival needs (are the criteria in California).

It's not a crime to be manic, delusional, psychotic, impulsive, grandiose, raging, or unbearably obnoxious.... you get the idea.

Sometimes the best you can do is to be as loving yet firm as possible -- set clear consistent boundaries, and take the best possible care of yourself. Don't go down with a sinking ship. If you start to lose it, you're not helping anyone. Look for a Bipolar Family Support group in your area. Look for Bipolar or Mental Illness advocacy groups. Read books. (Maybe leave a good Bipolar book lying around the house). Take fish oil and vitamin B-12 daily, and leave that lying around too.

Any other suggestions from my readers with personal experience in this would be most welcome here!

Best wishes, and take care,

Ben