Help is on the Way
How you
can support someone with bipolar disorder.
by Wes Burgess, M.D., Ph.D.
TWEENS & TEENS News December
2007
Mary is in my office, crying. Tomorrow is her
first day in a new school, and she is afraid
that the other students will not understand
her. She is afraid that the other students will
not want to be her friend. Mary has bipolar
disorder.
Through the Internet, the media or your personal
experience, you have probably known of adults
who have an illness called bipolar disorder.
However, you may not realize that more than
30 percent of the time, bipolar disorder starts
between the ages of 10 and 18. A study by
the Child and Adolescent Bipolar Foundation
estimated that 750,000 tweens and teens suffer
from bipolar disorder— and I believe
the number is much higher. You are highly
likely to meet someone your age who has bipolar
disorder, and you may have the unique opportunity
to be that person’s friend.
Having a friend who is bipolar can be a special
and rewarding experience for both you and
your friend. You will be able to see firsthand
how an adolescent meets the challenges of
living with a serious medical condition. At
the same time, your bipolar friend will expose
you to new thoughts, viewpoints and new approaches
to life borne out of his or her experience
with the bipolar condition. You will have
the opportunity to help another person, and
your bipolar friend will benefit from your
support. If you have a friend with bipolar
disorder, now or in the future, it’s
a good idea to find out what the condition
is all about and how specifically you can
help.
What is Bipolar Disorder?
Bipolar disorder, or manic depression, as
it used to be called, is a physical illness
that affects the body, brain and emotions.
Left unchecked, bipolar disorder can interfere
with normal teenage life and keep tweens and
teens from achieving their dreams. Untreated
bipolar disorder can cause agitation, impulsivity,
irritability, mood swings, obsessive thinking,
poor attention, procrastination, sleep problems
and weight problems.
Bipolar adolescents usually have a mixture
of slowed-down (depressed) and sped-up (manic)
symptoms. Depressed symptoms include difficulty
waking in the morning, fatigue, easily hurt
feelings, low motivation, social avoidance
and weight gain. Manic symptoms include distractibility,
hyperactivity, insomnia, inability to maintain
weight, poor judgment, an overly optimistic
mood and an inflated self-image.
To find out if someone has bipolar disorder,
the person in question needs to see a doctor
for an evaluation. Psychiatrists are medical
doctors trained in the physical, mental and
emotional aspects of bipolar disorder, including
how to treat it. If a doctor makes a diagnosis
of bipolar disorder, he or she will probably
prescribe a mood stabilizer, which is a medication
tailored to treat bipolar disorder. After
the disorder has been brought under control
with a mood stabilizer medication, the tween
or teen will feel more like his or herself,
and will be better able to face the challenges
of the bipolar illness.
Situations Challenging Bipolar Tweens
and Teens, and How You Can Help
Schoolwork is often challenging for adolescents
with bipolar disorder. Even though bipolar
students may be intelligent and creative,
bipolar distractibility makes it hard for
them to sit through classes and take notes.
Bipolar disorder can make it especially difficult
to succeed in classes that rely heavily on
linear thinking, such as algebra, precalculus,
foreign languages and composition. At home,
it may be difficult for bipolar students to
start homework assignments or to study for
tests, and these responsibilities often get
put off until the last minute.
You can help your bipolar friend by offering
to do homework with that person or suggesting
to study together for quizzes and tests. Your
presence will help him or her to stay on task.
In addition, you may find you get more of
your own studying done while helping your
friend than you would have if you had studied
solo.
Mood swings, anger, sadness, shame and jealousy
plague many tweens and teens who have bipolar
disorder. They spend a lot of time suffering
from negative emotions and they may release
their frustration inappropriately— perhaps
at you. Try to be understanding if your bipolar
friend unintentionally says or does things
that make you uncomfortable, such as teasing,
criticizing and telling secrets. As anger
outbursts often disappear within hours or
a day, be prepared to wait. If your friend
is sad, encourage him or her to pursue happy
and rewarding activities. This helps chase
away the blues.
Bipolar disorder can make individuals sensitive
to certain medications and drugs. Drugstore
cough medicines, cold remedies and prescription
pain medicines can worsen bipolar symptoms.
Antidepressants are not designed for bipolar
depression, and they can irreversibly worsen
the course of bipolar disorder. Recent cases
where adolescents have become violent after
being given antidepressants may represent
a bipolar drug reaction. This drug sensitivity
makes it imperative that bipolar tweens and
teens avoid alcohol, marijuana, cocaine, speed
and other illicit drugs. Encourage your friend
to understand that using these drugs can worsen
bipolar disorder and leave lives in shambles.
You may be surprised if your friend’s
bipolar disorder increases his or her sex
drive. Your bipolar friend may be just as
surprised, especially if the person is not
ready or does not want these feelings. Bipolar
disorder can cause your friend to think obsessively
about sex or get into dangerous sexual situations.
Severe consequences related to impulsivity
and poor judgment in sexual matters may include
sexually transmitted diseases and unwanted
pregnancies. In these situations, your consistent
and levelheaded advice may help save your
bipolar friend from making mistakes he or
she will regret for years.
The worst problem you may face is learning
that your friend is so depressed or angry
that he or she is thinking of committing suicide.
If your friend does not seek help or you are
worried about your friend’s safety,
then this situation has already gone beyond
your control. You are not a doctor or a therapist,
and you cannot take responsibility for your
friend’s life. Instead, you must discuss
your friend’s possibility of attempting
suicide with your parents and ask them to
handle the situation. They will probably call
your friend’s parents to help ensure
your friend gets help.
Take Advantage of Available Bipolar
Information and Support
Take this opportunity to learn more about
bipolar disorder. There are some great books
available for you to read. The Internet offers
a wealth of informative sites, support groups,
chats and blogs for bipolar sufferers and
their friends. You and your bipolar friend
are not alone.
•American Psychiatric Association, www.psych.org
•APA Patient Alliance, www.apaalliance.org
•Bipolar World: A Bipolar Family, www.bipolarworld.net
•Dr. Wes Burgess’s Web site, www.wesburgess.yourmd.com
•Cbel.com Mental Health Index, www.cbel.com/mood_disorders
•Child and Adolescent Bipolar Foundation,
www.bpkids.org
•Depression and Bipolar Support Alliance,
www.dbsalliance.org
•Harbor of Refuge, Inc., www.harbor-of-refuge.org
•A Silver Lining, www.a-silver-lining.org
•Support 4 Hope, www.support4hope.com/bipolar_disorder/index.htm
Set an Example
The single best way you can help your bipolar
friend is by setting a good example. Eat healthy
food, exercise, and avoid alcohol and drugs.
Do your schoolwork. Get out of the house and
find things to do that are new, exciting and
fun. Show your friend how to maintain a good
social support system, how to make new friends
and how to be a good friend. When your bipolar
friend sees that you have a healthy, happy
life, he or she will want to follow your example.
Wes Burgess, M.D., Ph.D., is a clinical
psychiatrist specializing in the treatment
of bipolar disorder in adolescents and adults.
His private practice is in Los Angeles, and
his first book, The Bipolar Handbook (Avery/Penguin),
is available in bookstores and over the Internet.
His next book from Avery, a member of Penguin
Publishing Group (USA) Inc., addresses bipolar
disorder in kids and teens.
