What family and friends can do to help
The most important factor is to have the illness recognized as an illness, rather than trying to explain it away as being moody or trying to explain away the repeated changes in mood as the result of external events . If you know the person well, then you will know quite clearly that their highs and lows are different to their normal personality.
It is best for the person affected if someone can go with them to a doctor, explain to the doctor what is happening, and specifically ask the doctor whether or not this could be bipolar illness , for which prevention is possible to stop future episodes.
It is very useful if you can convince the person involved that they have a simple chemical problem, very much like diabetes. The control of bipolar illness, just like the control of diabetes, is far better using a combination of medication and the person's own efforts, rather than either one alone. While we all know a person with diabetes will not get adequate control of their illness without medical involvement, it is difficult to persuade someone with bipolar illness that they too need some appropriate degree of medication to control their chemistry, in addition to their own efforts. Nobody likes having to take medication for any long-term condition, but pretending the condition does not exist is only going to make the final result much worse. Bipolar disorder gets progressively more unstable and frequent if left untreated, as the brain learns bad habits in effect, a mechanism similar to epilepsy which is called “kindling”.
When the person is depressed , it is very useful simply to ensure the person is given as much company as they can cope with, but without expecting the person to actually make a great deal of conversation, or involve themselves in a great deal of activity. Preventing loneliness is very useful in minimizing the impact of depression. It is also very useful to let them know that you understand depression is very painful, but they will recover .
When the person is high , trying to keep the stimulation around them to a minimum is the best, and trying to encourage them to relax or sleep properly may help. This is however difficult, if one remembers that being high is like being in high speed overdrive. Giving the person access to a way to burn up their energy such as going on long walks or going to gym, may be very useful. It is also very important to try to restrict the person's access to cars and to money . Ideally, the person involved should not drive when they are high, due to the risk that they will drive very dangerously, without being able to understand the danger to themselves and others from their new-found super-confidence! Similarly, it is often very useful to ask the person involved to put their credit cards in a sealed and signed envelope, and to restrict their general access to money, to deter them from spending money in a way they are likely to regret when they recover. And no major decisions should be made during highs (when people are sure nothing can go wrong) or during depressions (when people are sure everything is wrong).
It is also very useful to encourage people with bipolar disorder to drink only small amounts of alcohol, or preferably no alcohol when they are unwell, as their inhibitions are already undermined, and the alcohol will intensify this loss of normal inhibitions. Illegal drugs should certainly not be used at this time particularly.
