Coping Strategies for Families of Patients with Bipolar Disorder

Q: Coping Strategies for Families of Patients with Bipolar Disorder

Hello： If it is confirmed that your sister is in a manic phase, due to poor insight, she may believe that she does not need treatment and wish to be discharged. <br>Since she is currently under involuntary hospitalization, the focus should be on treatment for now, and the physici

How to approach patients with bipolar disorder?

Hello, Doctor.
My sister has not been in a good mental state recently; she is experiencing symptoms such as paranoia, grandiosity, and aggression.
She is currently being involuntarily hospitalized for treatment, and her diagnosis is bipolar disorder, currently in the manic phase.
Today is the third day, and her mood is still unstable; she has also been aggressive towards others in the hospital.
The nurse mentioned that the medication effects may take some time, around a week.
Every time she is allowed to make phone calls, she calls me asking me to pick her up, threatening to commit suicide if I don’t come, saying that if I don’t come soon, she will be gone.
How should I respond to her? I am afraid that my response might trigger her further.
What should I do? I feel sad and helpless as a family member.

Ms. Zhang, 30~39 year old female. Ask Date: 2016/06/29

Dr. Qiu Junda reply Psychiatry

Hello: If it is confirmed that your sister is in a manic phase, due to poor insight, she may believe that she does not need treatment and wish to be discharged.
Since she is currently under involuntary hospitalization, the focus should be on treatment for now, and the physician will assess when she should be discharged.
As a family member, you can cooperate with the medical care.
If your sister calls, you may choose not to answer.
If that is not convenient, you can discuss with the healthcare staff how to respond, such as: "Since this is an involuntary hospitalization, discharge can only be permitted by the physician's assessment.
Please be patient and accept treatment for now," to facilitate your sister's recovery.

Reply Date: 2016/06/29

More Info

Coping with a family member diagnosed with bipolar disorder, especially during a manic episode, can be incredibly challenging and emotionally taxing. Your sister's current state, characterized by delusions, grandiosity, and aggressive behavior, indicates that she is experiencing a manic phase of bipolar disorder. It is crucial to approach this situation with empathy, understanding, and a well-informed strategy.

Firstly, it is important to recognize that during a manic episode, individuals may not have a clear grasp of reality. They might express feelings of paranoia or make threats of self-harm as a way to communicate their distress. When your sister calls and expresses a desire for you to take her home or threatens self-harm, it is essential to respond in a calm and supportive manner. Here are some strategies you can employ:
1. Listen Actively: When your sister calls, let her express her feelings without interruption. Acknowledge her feelings by saying something like, "I hear that you're feeling really upset and scared right now." This validation can help her feel understood.

2. Stay Calm and Reassuring: It’s crucial to maintain a calm demeanor. Reassure her that she is in a safe place and that the hospital staff is there to help her. You might say, "I know you want to come home, but the doctors are working hard to help you feel better."
3. Set Boundaries: While it’s important to be supportive, it’s equally important to set boundaries. If she becomes aggressive or threatening, it’s okay to say, "I can’t talk to you when you’re yelling. I want to help, but I need you to calm down first."
4. Educate Yourself: Understanding bipolar disorder can empower you to respond more effectively. Learn about the symptoms, treatment options, and the nature of manic episodes. This knowledge can help you anticipate her needs and reactions.

5. Encourage Treatment Compliance: If she expresses frustration about her treatment, gently remind her that the medication may take time to work and that it’s important for her to stay in the hospital until she is stable. You might say, "I know it’s hard to wait, but the doctors want to make sure you’re feeling better before you come home."
6. Seek Support for Yourself: Caring for someone with bipolar disorder can be overwhelming. Consider joining a support group for families of individuals with mental health disorders. This can provide you with emotional support and practical coping strategies.

7. Communicate with Healthcare Providers: Stay in touch with her healthcare team. They can provide you with updates on her condition and guidance on how to best support her during this time. Ask them about the expected timeline for her treatment and what signs to look for that indicate improvement.

8. Plan for the Future: Once your sister stabilizes, discuss with her and her healthcare team about long-term management strategies for her bipolar disorder. This may include medication management, therapy, and lifestyle changes that can help prevent future episodes.

9. Emergency Plan: Have a plan in place for emergencies. Know who to contact if she threatens self-harm or if her behavior escalates. This may include contacting her psychiatrist, a crisis hotline, or emergency services.

In conclusion, dealing with a family member's bipolar disorder requires patience, understanding, and a proactive approach. By providing emotional support, setting boundaries, and educating yourself about the disorder, you can help your sister navigate this difficult time while also taking care of your own mental health. Remember, it’s okay to seek help for yourself as you support her through her treatment journey.

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