Family and Friends' Guide

The following is taken from the website of Depression and Bipolar Support Alliance (DBSA) :

Family and Friends' Guide to Recovery From Depression and Bipolar Disorder

When a friend or family member has an episode of depression or bipolar disorder (manic depression), you might be unsure about what you can do to help. You might wonder how you should treat the person. You may be hesitant to talk about the person’s illness, or feel guilty, angry, or confused. All of these things are normal.

There are ways you can help friends or family members throughout their recovery while empowering them to make their own choices.

The Five Stages of Recovery

It can be helpful to view recovery as a process with five stages. People go through these stages at different speeds. Recovery from an illness like depression or bipolar disorder, like the illness itself, has ups and downs. Friends and family who are supportive and dependable can make a big difference in a person’s ability to cope within each of these stages.

1. Handling the Impact of the Illness
Being overwhelmed and confused by the illness.

An episode of mania or depression, especially one that causes major problems with relationships, money, employment or other areas of life, can be devastating for everyone involved. A person who needs to be hospitalized may leave the hospital feeling confused, ashamed, overwhelmed, and unsure about what to do next.

What friends and family can do:

• * Offer emotional support and understanding.
• * Help with health care and other responsibilities.
• * Offer to help them talk with or find health care providers.
• * Keep brief notes of symptoms, treatment, progress, side effects and setbacks in a journal or personal calendar.
• * Be patient and accepting.

Your loved one’s illness is not your fault or theirs. It is a real illness that can be successfully treated. Resist the urge to try to fix everything all at once. Be supportive, but know that your loved one is ultimately responsible for his or her own treatment and lifestyle choices.

2. Feeling Like Life is Limited
Believing life will never be the same.

At this stage, people take a hard look at the ways their illness has affected their lives. They may not believe their lives can ever change or improve. It is important that friends, families, and health care providers instill hope and rebuild a positive self-image.

What friends and family can do:

• * Believe in the person’s ability to get well.
• * Tell them they have the ability to get well with time and patience. Instill hope by focusing on their strengths.
• * Work to separate the symptoms of the illness from the person’s true personality. Help the person rebuild a positive self-image.
• * Recognize when your loved one is having symptoms and realize that communication may be more difficult during these times. Know that symptoms such as social withdrawal come from the illness and are probably not a reaction to you.
• * Do your best not to rush, pressure, hover or nag.

A mood disorder affects a person’s attitude and beliefs. Hopelessness, lack of interest, anger, anxiety, and impatience can all be symptoms of the illness. Treatment helps people recognize and work to correct these types of distorted thoughts and feelings. Your support and acceptance are essential during this stage.

3. Realizing and Believing Change is Possible
Questioning the disabling power of the illness and believing life can be different.

Hope is a powerful motivator in recovery. Plans, goals, and belief in a better future can motivate people to work on day-to-day wellness. At this stage people begin to believe that life can be better and change is possible.

What friends and family can do:

• * Empower your loved on to participate in wellness by taking small steps toward a healthier lifestyle. This may include:
  • - Sticking with the same sleep and wake times
  • - Consistently getting good nutrition
  • - Doing some sort of physical activity or exercise
  • -Avoiding alcohol and substances
  • - Finding a DBSA support group
  • - Keeping health care appointments and staying with treatment
• * Offer reassurance that the future can and will be different and better. Remind them they have the power to change.
• * Help them identify things they want to change and things they want to accomplish.

Symptoms of depression and bipolar disorder may cause a hopeless, “what’s the point?” attitude. This is also a symptom of the illness. With treatment, people can and will improve. To help loved ones move forward in recovery, help them identify negative things they are dissatisfied with and want to change, or positive things they would like to do. Help them work toward achieving these things.

4. Commitment to Change
Exploring possibilities and challenging the disabling power of the illness.

Depression and bipolar disorder are powerful illnesses, but they do not have to keep people from living fulfilling lives. At this stage, people experience a change in attitude. They become more aware of the possibilities in their lives and the choices that are open to them. They work to avoid feeling held back or defined by their illness. They actively work on the strategies they have identified to keep themselves well. It is helpful to focus on their strengths and the skills, resources and support they need.

What friends and family can do:

• * Help people identify:
  • - Things they enjoy or feel passionate about
  • - Ways they can bring those things into their lives
  • - Things they are dissatisfied with and want to change
  • - Ways they can change those things
  • - Skills, strengths and ideas that can help them reach their goals.
  • - Resources that can help build additional skills
• * Help them figure out what keeps them well.
• * Encourage and support their efforts.

The key is to take small steps. Many small steps will add up to big positive changes. Find small ways for them to get involved in things they care about. These can be activities they enjoy, or things they want to change, in their own lives or in the world.

5. Actions for Change
Moving beyond the disabling power of the illness.

At this stage, people turn words into actions by taking steps toward their goals. For some people, this may mean seeking full-time, part-time or volunteer work, for others it may mean changing a living situation or working in mental health advocacy.

What friends and family can do:

• * Help your friends or family members to use the strengths and skills they have.
• * Keep their expectations reachable and realistic without holding them back.
• * Help them find additional resources and supports to help them reach their goals step-by-step.
• * Continue to support them as they set new goals and focus on life beyond their illness.
• * Help them identify and overcome negative or defeatist thinking.
• * Encourage them to take it easy on themselves and enjoy the journey.

People with depression or bipolar disorder have the power to create the lives they want for themselves. When they look beyond their illness, the possibilities are limitless.

What you can say that helps:

• * You are not alone in this. I’m here for you.
• * I understand you have a real illness and that’s what causes these thoughts and feelings.
• * You many not believe it now, but the way you’re feeling will change.
• * I may not be able to understand exactly how you feel but I care about you and want to help.
• * When you want to give up, tell yourself you will hold of for just one more day, hour, minute - whatever you can manage.
• * You are important to me. Your life is important to me.
• * Tell me what I can do now to help you.
• * I am here for you. We will get through this together.

Avoid saying:

• * It’s all in your head.
• * We all go through times like this.
• * You’ll be fine. Stop worrying.
• * Look on the bright side.
• * You have so much to live for why do you want to die?
• * I can’t do anything about your situation.
• * Just snap out of it.
• * Stop acting crazy.
• * What’s wrong with you?
• * Shouldn’t you be better by now?

What to find out:

Contact information (including emergency numbers) for your loved one’s doctor, therapist, and psychiatrist, your local hospital, and trusted friends and family members who can help in a crisis

Whether you have permission to discuss your love one’s treatment with his or her doctors, and if not, what you need to do to get that permission.

The treatments and medications your loved one is receiving, any special dosage instructions and any needed changes in diet or activity.

The most likely warning signs of a worsening manic or depressive episode (words and behaviors) and what you can do to help.

What kind of day-to-day help you can offer, such as doing housework or grocery shopping.

When talking with your love one’s health care providers, be patient, polite and assertive. Ask for clarification of things you do not understand. Write things down that you need to remember.

Helping and getting help

As a friend or family member you can provide the best support when you’re taking care of yourself. It helps to talk to people who know how it feels to be in your situation. Talk with understanding friends or relatives, look for therapy of your own, or find a DBSA support group.

DBSA support groups are run by people, families and friends affected by depression or bipolar disorder. They are safe, confidential, free meetings where people can learn more about depression, bipolar disorder, and how to live with the illnesses.

One father of a daughter with bipolar disorder says, “DBSA support groups help take a lot of stress out of your life. As a family member, you have to be as prepared as possible, and accept that things will still happen that you aren’t totally prepared for. DO all the research you can. Build a long list of dependable resources and support people, so when a situation arises, you know where to turn and how to take the next step. This really helped my family when we needed it.”

A mother of a son with depression says, “When you are in the middle of a situation, it’s hard to see what’s happening, but when you sit in a support group meeting across from someone who is going through the same things, it gives you perspective.”

DBSA has a complete section with information for family and friends to help a loved one on their recovery to wellness.

page created: May 10, 2006

page updated: December 29, 2006