Bipolar Disorder in Family: Questions and Support Strategies

Q: Bipolar Disorder in Family: Questions and Support Strategies

Hello： Regarding your questions, here are the answers： 1. If mild mania is already affecting normal life, it is advisable to seek medication treatment to avoid adverse consequences. 2. Mild mania does not necessarily lead to depression. If your family memb

I would like to ask questions regarding family members with bipolar disorder!

Doctor: Hello! My family member (married) lives in a different county and experienced a major depressive episode 10 years ago.
After taking medication and shifting life goals, they gradually stabilized.
Early last year, due to work stress, they experienced another major depressive episode.
Since my spouse had to work and could not provide personal care, we decided on hospitalization for treatment.
After discharge, they returned to work before fully recovering, as they could no longer take leave.
About 9-10 months later, at the beginning of this year, they transitioned to a hypomanic state: feeling good about themselves, talking more, making exaggerated investments, and being more mentally active.
This has continued for over three months now.
I would like to ask the doctor the following questions:
1.
Does my family member's hypomanic state necessarily require medication? They have agreed not to engage in uncontrolled investments after my sister's advice, but I am unsure if this is due to my sister's authority or if they truly understood.
Additionally, no adverse situations have been observed so far.
2.
Is it inevitable that hypomania will lead to depression? Is this a certain outcome?
3.
How can I assist my family member? They respond confidently to many of my suggestions, seeming to believe everything is under control.
For example, I encouraged them to use their energy for exercise, but they declined because they need to prepare for exams and may consider running a marathon in the future.
4.
If my family member offers many suggestions and we follow them, could this lead to a worsening of their condition? During their depressive episode, my sister and I continuously discussed the management of depression, and there is a wealth of information available online.
However, there seems to be limited information on hypomania, and their behavior exceeds our understanding, leaving us unsure of how to support them.
Lastly, a question about myself! I am single and particularly care about family ties.
I am also quite sensitive, and my family member's depression has significantly affected me.
Without my sister's advice to take care of myself, I might have fallen into depression as well.
I have a notion that seems hard to shake: if my family member is suffering, I cannot be happy, as happiness feels like a sin.
During my family member's depressive episode, I experienced several panic attacks.
How can I correct this? Thank you for your response!

Zhongnian, 40~49 year old female. Ask Date: 2021/05/08

Dr. Lin Mianzhang reply Psychiatry

Hello: Regarding your questions, here are the answers:
1.
If mild mania is already affecting normal life, it is advisable to seek medication treatment to avoid adverse consequences.

2.
Mild mania does not necessarily lead to depression.
If your family member has Type I Bipolar Disorder, it is more likely that mild mania will transition into full-blown mania.
If they have Type II Bipolar Disorder, there is a higher chance that mild mania will turn into depression, but this is not guaranteed.

3.
Is your family member currently on medication? If not, it is recommended that you encourage them to see a doctor for an evaluation of their condition.
Family members can support by encouraging them to seek medical help and assisting in monitoring their condition, taking them for treatment if necessary.
If they refuse to seek help, you can consult their original treating physician with other family members, as the doctor may have a better understanding of their situation and can discuss potential interventions.

4.
You do not need to comply with your family member's suggestions just to meet their needs; your judgment should take precedence.
Whether or not to follow their suggestions is not directly related to the changes in their condition.
However, if your family member becomes verbally or physically confrontational due to your noncompliance, you can call the police to take them for medical treatment.

You have been working hard! It seems you are a responsible person, and this sense of guilt is not something that can be easily changed, as there are likely deeper reasons behind it.
It is advisable for you to seek help from a psychiatrist to discuss the causes of your guilt and how to live more comfortably and happily.
Wishing you peace and health!

Reply Date: 2021/05/08

More Info

Dealing with a family member who has bipolar disorder can be incredibly challenging, both emotionally and practically. Your concerns reflect a deep understanding of the complexities involved in supporting someone with this condition. Here, I will address your questions and provide some strategies for support, while also emphasizing the importance of self-care for you and your family.

1. Does mild mania (hypomania) always require medication?
Hypomania does not always necessitate medication, especially if the individual is functioning well and not engaging in harmful behaviors. However, it is crucial to monitor the situation closely. If your family member is exhibiting impulsive behaviors, such as uncontrolled spending or risky investments, it may be wise to consider medication or therapy to help manage these symptoms. The fact that your sister was able to influence him positively is a good sign, but it’s essential to remain vigilant. Encourage open communication about his feelings and behaviors, and consider involving a mental health professional for guidance.

2. Does hypomania inevitably lead to depression?
While many individuals with bipolar disorder experience cycles of mania and depression, it is not a certainty that hypomania will lead to a depressive episode. However, it is common for individuals to experience mood fluctuations. Maintaining a stable routine, managing stress, and adhering to treatment plans can help mitigate the risk of transitioning into a depressive state. Encourage your family member to engage in healthy activities and maintain a balanced lifestyle.

3. How can I assist my family member?
Supporting someone in a hypomanic state can be tricky, as they may feel overly confident and dismissive of advice. It’s important to approach the situation with empathy and understanding. Encourage physical activity, as exercise can help regulate mood, but be mindful of his current focus on studying for exams. Suggesting activities that align with his interests, such as running or other forms of exercise, can be beneficial. It’s also vital to establish boundaries; while you want to support him, you should not feel responsible for his decisions.

4. Will following his suggestions worsen his condition?
If you and your sister choose to follow his suggestions, it’s essential to do so with caution. While it’s important to respect his autonomy, you should also prioritize your well-being and the overall family dynamic. If his suggestions seem unrealistic or potentially harmful, it’s okay to express your concerns. Open dialogue about the impact of his suggestions on the family can help him understand your perspective without feeling attacked.

5. Taking care of yourself during this time
Your feelings of guilt and anxiety are understandable, especially when a loved one is struggling. It’s crucial to recognize that your well-being is just as important as that of your family member. Engaging in self-care practices, such as exercise, hobbies, or spending time with friends, can help alleviate feelings of guilt. Consider seeking support from a therapist or support group for caregivers, where you can share your experiences and learn coping strategies. Remember, it’s not selfish to prioritize your mental health; doing so enables you to be a more effective support for your family member.

In conclusion, navigating the complexities of bipolar disorder within a family setting requires patience, understanding, and a commitment to self-care. Encourage your family member to seek professional help and maintain open lines of communication. At the same time, prioritize your mental health and well-being to ensure you can provide the support your family needs. Remember, you are not alone in this journey, and seeking help for yourself is a vital step in managing the emotional toll of caregiving.

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