Or maybe you’ve already said something well intended that nevertheless clearly upset the other person, and worrying about what to say next can be unsettling. Here, mental health experts share seven common phrases that we should all stop saying to anyone with bipolar disorder — and the thoughtful, helpful things to say instead.
1. ‘Everyone Has Mood Swings Sometimes’
Mood episodes, which are the hallmark symptom of bipolar disorder, are not the same as mood swings. A mood episode is a distinct period during which a person with bipolar disorder experiences an intense emotional state lasting days to weeks at a time, according to the American Psychiatric Association (APA). What’s more, the APA notes, there are three distinct types of mood episodes:
Manic, marked by an abnormally high-spirited, energetic, or irritable mood that lasts at least one week and sometimes requires hospitalizationHypomanic, which is a less severe version of a manic episode that nevertheless lasts at least four daysDepressive, during which a deeply sad, despairing, or empty mood lasts at least two weeks
All people experience mood changes (aka swings) from time to time. The difference is that the mood changes that people with bipolar disorder experience are much more extreme. Typically, they are also very disturbing, not just for them but for their family and friends, too, says neuropsychologist Sanam Hafeez, PsyD , the director of Comprehensive Consultation Psychological Services and a faculty member in Columbia University’s PhD program in clinical psychology in New York City. “It is life-altering. They can go from extreme highs to extreme lows that can even include suicidal ideations,” Dr. Hafeez explains.
What Should You Say Instead?
Try acknowledging that you believe what they told you — they have bipolar disorder — and let them know you’re not going anywhere. For example, you could say:
“It’s okay if you don’t feel okay. I’m here for you.”“I might not understand exactly how you feel, but I want to understand. I want to learn as much as I can about bipolar disorder.”
RELATED: Is It Simply Mood Swings, or Is It Bipolar Disorder?
2. ‘You’re Not That Bad, Are You?’
The truth is that you never really know how severely someone is struggling on the inside. Passing judgment on how well — or not well — they’re doing isn’t helpful. “Some people with bipolar disorder can also become quite adept at hiding the amount of distress they are in,” says Elizabeth Easton, PsyD, who is the national director of psychotherapy at the Pathlight Mood and Anxiety Center based in Denver. “We never truly know what another person’s experience is like, so it’s best to stay curious.”
What Should You Say Instead?
Try asking open-ended questions that let the person with bipolar disorder decide what and how much to share. For example, say:
“If you feel comfortable sharing, how intense do your symptoms get?”“What are some signs that you’re struggling? And if I see them, what can I do to help?”
In reality, most people with bipolar disorder are kind and loving people who just happen to have a mental health condition that makes it difficult for them to regulate their moods, Hafeez says.
What Should You Say Instead?
Start by shutting down any hint of stigma by saying:
“You’re not crazy. This is a medical condition.”“Having bipolar disorder does not affect your intelligence or character. This is an illness that does not define you.”
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4. ‘You’re So Lucky You Get Manic Because You Get So Much Done!’
There’s nothing lucky about experiencing mania. Someone having a manic episode is often not in control of their thoughts and actions. They may act abnormally upbeat, energetic, or irritable, have an exaggerated sense of self-confidence, and a decreased need for sleep, according to the Mayo Clinic. They may also say things that are out of character, act aggressively, abuse drugs or alcohol, spend money recklessly, or risk their safety. Mania can sometimes even cause a person to lose touch with reality and need to be hospitalized.
What Should You Say Instead?
Try using statements that help your friend or loved one feel seen for who they are, even in the midst of their manic episode, suggests Carl Nassar, PhD, a licensed professional counselor in private practice in Fort Collins, Colorad o. For example, you might say:
“You have so much to give, and I’m happy to see you do that more skillfully today.”
5. ‘I Thought You Were on Medication for That’
“It’s best to avoid making statements about the medications people with bipolar disorder are using, as it can spark feelings of shame if they are still struggling with certain symptoms despite taking their medication,” Dr. Easton says. “As much as we would like to believe that medication can fix mental health symptoms, we know that they are part of a larger approach to supporting people with bipolar, not a cure,” Easton adds. Along with medication, other key components of a bipolar disorder treatment plan, per the Mayo Clinic, are:
Psychotherapy, or talk therapy, geared toward mood stabilization and identifying and managing episode triggersEducational programs and support groups to help both people with bipolar disorder and their loved onesCreating a healthy routine, such as sticking to a consistent sleep schedule, exercising regularly, eating a nutritious diet rich in fruits and vegetables, and avoiding drugs and alcohol
What Should You Say Instead?
If they’re comfortable discussing their treatment plan, Easton suggests asking something like:
“Do you feel like you’re getting the support you need from your providers and the treatments they’re giving you?”“Is there anything I can get or do to help you feel better now?”
6. ‘You Can’t Have Bipolar Disorder’
People may say things like, “You can’t possibly have that!” either out of disbelief or as a way of trying to reassure their loved one that they’re okay. “It may be hard to believe that a loved one is struggling with a disorder like bipolar disorder, unless you are with them most moments of each day for long stretches of time to observe the cycling symptoms,” Easton says. “Observing them in isolated moments of time does not give you the whole picture.” People with bipolar disorder don’t experience mood fluctuations 100 percent of the time. In fact, many people with the condition experience periods of neutral mood, too, according to the APA .
What Should You Say Instead?
Let them know what you don’t know by asking about the specific symptoms that they experience, Easton advises. For example, consider asking:
“If it’s okay with you to share, what about bipolar disorder do you identify with? I’d like to hear more so I can know what to look for and how to support you.”
RELATED: 12 Famous People With Bipolar Disorder
7. ‘Bipolar Disorder Doesn’t Give You an Excuse to Check Out From Life’
When someone with bipolar disorder is experiencing a depressive episode and everyday tasks are much more difficult for them to accomplish, it can cause the people around them to feel discouraged or frustrated. Bear in mind, though, that the shame and stigma related to mental illnesses, especially bipolar disorder, can be very cumbersome for anyone experiencing it, Easton says. Because of this, it’s helpful to try to be patient with them, especially on hard days. “It’s best to assume that people with bipolar disorder are all doing the best they can, so if they seem checked out, there is likely a good reason,” she says. “The best way to support someone in this state is through compassionate validation and offering to support.”
What Should You Say Instead?
Focus on being encouraging and supportive by saying something like:
“I’m sure managing bipolar symptoms can be overwhelming at times. I’m here for you. Let me know when you’re in a dark place, and I’ll help you think of ways to reengage in life.”“I care. What can I do to help while you’re going through this?”
RELATED: 5 Ways You Can Help a Loved One With Bipolar Disorder
