I think an adult I know needs help.

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If you think something is wrong, it probably is.

Family, friends, and co-workers are often the first to notice that someone they care about is struggling with depression or bipolar disorder.

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Intervening isn't always easy.

It can sometimes be difficult to know how to help–and sometimes the desire to help can be mixed with feelings of anger, frustration, or fear.

But you CAN help.

You are in a strong position to help. You know the person. You care about their well-being. Once you learn how to offer support and encourage treatment, you will be ready to approach the person of concern.

Depression symptoms you may notice

You may notice some or all of these symptoms in the person of concern

  • Talking very negatively
  • Acting unreasonably, without concern for others
  • Abusing alcohol or drugs
  • Picking fights, being irritable, critical, or mean
  • Withdrawing from family and friends
  • Having trouble at work or school
  • Talking suddenly about separation or divorce
  • Complaining of aches and pains
  • Eating too little or too much
  • Sleeping too much or too little

Bipolar disorder symptoms you may notice

In addition to the “low” depression symptoms, you may notice the following “high” symptoms

  • Increased energy and decreased need for sleep.
  • Excessive irritability, euphoria, or aggressive behavior.
  • Increased talkativeness or pressured speech.
  • Disconnected and racing thoughts.
  • Impulsive behavior and poor judgment such as spending sprees, erratic driving, or sexual indiscretions.
  • Inflated self-esteem
  • Increased goal-directed activities
  • Easily distracted

Initial Approach

Your initial objective should be to express your feelings in a thoughtful way, listen to the person’s feelings and empathize with them, and encourage them to get a clinical evaluation. Here are some tips for when you decide to approach your family member, friend, or co-worker.

  • Find a time to talk with as few outside distractions as possible.
  • Tell the person how much you and others care about them.
  • In a caring way, acknowledge the changes in behavior that you have observed. Talk about how these changes have impacted you and the other people in their life.
  • Listen and empathize with that person’s feelings.

Encourage Treatment

Encourage the person to get a clinical evaluation. You can start by helping them to fill out our Depression and Bipolar Test. When finished, you can print the results so that the person can bring them to a clinician for further evaluation. Mention that depression and bipolar disorder are both treatable medical conditions. Often, people feel relieved to learn that they are suffering from a medical condition. Ask the person to see a medical professional, offer to make an appointment, and go with the person or call the doctor in advance to state the person’s symptoms.

What NOT to do

People with mood disorders are suffering from a medical condition, not a weakness of character. It is important to recognize their limitations.

  • Do not dismiss their feelings by saying things like “snap out of it” or “pull yourself together.”
  • Do not force someone who is depressed to socialize or take on too many activities that can result in failure and increased feelings of worthlessness.
  • Although you can acknowledge negative views your loved one may express, do not agree with them. Negative thoughts are a symptom of depression. You need to continue to present a realistic picture by expressing hope that the situation will get better.

If your help is refused

Often when you try to help someone who has a mood disorder, your help is declined or nothing you do seems to help. You end up feeling rejected and discouraged that there is nothing more you can do.

People who are depressed may reject your help because they feel they should be able to help themselves, and feel worthless when they can’t. Instead, they may withdraw or start an argument in an effort to resolve their difficulties. In addition, people with depression may have negative thoughts and feel so hopeless that they do not see recovery as a reality.

Fifty percent of people with bipolar disorder have a lack of insight, so they do not realize they are ill. For example, people with bipolar disorder may believe they are just a “high-energy person.” This makes family involvement in seeking and managing treatment even more critical.

With these difficulties in mind, here are some things you can do.

  • Provide consistent support. Over time, if you consistently show support, the person will see that you are resolute and may accept your help. Continue trying some of the tips discussed in this section.
  • Discuss your feelings. When your help is refused, restate how much you care for the person. Let the person know how you feel, gently, by stating an example of the support you have offered and how it makes you feel when it is rejected.
  • Focus on behaviors. If the person is reluctant to seek help, then don’t try to convince the person that a mood disorder is causing the problems. Instead, talk about their behaviors and the ways in which treatment can help. For example, after you have listened and sympathized with the person’s feelings, try to agree on wellness goals (e.g., consistent sleep and feeling less irritable). Then, try to assign some action steps that you can agree on to reach these goals (e.g., after two weeks, if the person does not improve, you will set up a medical evaluation).
  • Agree on professional help. It is important to make sure your loved one gets the professional help he or she needs. If they are reluctant to see a therapist, talking with a primary care physician may be a less overwhelming option.
  • Get backup. Enlist the aid of family members, friends, and others who can also talk to the person of concern.

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