How can I understand what my friend/family member is going through? For individuals with bipolar disorder the understanding of family and friends is essential. The behaviours shown by people with bipolar disorder can have a profound effect on those closest to them, who experience consequences from the disorder as well. It is not always easy to offer sympathetic support to someone who may have been behaving erratically, angrily, recklessly or thoughtlessly. It is difficult not to take such behaviour personally and to react to it, particularly when it causes disruption or has negative repercussions. Family and friends often express the opinion that they feel they have been rejected by the individual concerned and are unsure how to respond. The more you understand this illness the more you will be able to empathise and offer useful support.

Does bipolar disorder run in families?
This is a difficult area, both in terms of the concerns it may raise for family members and because our understanding of the genetic component of bipolar disorder is somewhat limited. We can only talk about the issue in a very general way. Children of people who have bipolar disorder appear to have an increased risk of developing bipolar disorder themselves, but this is only in the region of 10-15%. The risk is higher where both parents have a mood disorder diagnosis, but this risk differs depending on circumstances and it is difficult to generalise. The risk that siblings of the person with the diagnosis will themselves have children with bipolar disorder is relatively small.


How bipolar disorder may affect relationships with others
Many people with bipolar disorder stay well most of the time but one of the problems of this disorder is that the quality and nature of relationships with others may change alongside changes in mood during an episode of illness.
Family and friends need to be able to adjust to the various changes that occur during episodes of mania or depression and they need to be able to give control back to the person when they are well and try not to ‘supervise’, however tempting.Sometimes relationships deteriorate so much that family and friends no longer want anything to do with their ill relative – and the person with bipolar disorder may feel betrayed by them.

When a person with bipolar disorder becomes unwell, relationships can get strained because others get frustrated:

• with having their own lives disrupted as well;
• with being constantly visited or phoned;
• with being ignored, or with being verbally or physically abused;
• with having to deal with the consequences of reckless behaviour and lack of judgement (e.g.) spending sprees, reckless driving, promiscuous sexual behaviour;
• because the individual does not control their behaviour or ‘pull themselves together’;
• with lack of communication;
• with the other person’s ongoing negativity, criticism or negative comments;
• because they feel out of control, cannot help or don’t know how to help.

If bipolar disorder affects things at home, it is also going to affect things at work and in other situations. Relationships with workmates will be affected in the same way as with friends and relatives. In addition, some of the characteristics of mania and/or depression (e.g. impaired judgement or decision making, poor concentration, excessive tiredness) may affect the person with bipolar disorder’s ability to do their work properly or safely.

Most people with bipolar disorder continue to lead a normal life when well and the disorder does not actually affect their ability to function on a long-term basis. A small group of people may continue to have difficulties with their social relationships and ability to work over a longer period of time.

Many books (see reference list) describe the lives of both famous and ordinary people who have had this disorder but have made outstanding contributions
to society.

[Material in this section has been adapted from the Manic Depression Fellowship information for family and friends (2003)]