How to help someone before and during a manic episode

Make a Plan. Before an episode of mania starts, make a plan together. First off, they’ll be more receptive to your ideas. They’ll be more in control and be able to look objectively at previous episodes of mania. Decide together what will help them, and what support and help they want when they are seriously ill. Write down your decisions, and keep them in a safe place for when you need them.

Focus on triggers. You could look at their work commitments and any other projects they have and offer your own opinion on them. It may be you feel they’ve taken on too much, which could lead to stress and burnout, that could then lead to an episode. Be calm and gentle with the suggestion, so they don’t feel you’re being overly protective or critical.

Stick to healthy routines. Again to keep them healthy, and during an episode, you could help them stick to a routine. Making sure they have regular meals and a sleep routine will either help to keep them well, or be in a healthier place when the hypomania/mania ends. 

Join in with their activities. During an episode you could do things together with them. If they are being creative, join in. It shows you’re interested in what they are up to, and means you can make boundaries on how long they spend on the activity. Again, don’t force them to stop, but remind them of other things they need to do that day, or that they need to eat, sleep and look after themselves.

Help with finances. You might have to manage their money when unwell. This can be organised beforehand. Doing things such as putting a site blocker on their phone or computer – that only you know the password to. It’ll stop them from spending money on websites you know they use often. You may need to take their cards from them, and have access to their bank account. If they need money for something, they will then have to ask you. It might feel like you’re infantilising them, but believe me, they will appreciate it when they are stable.  

Sometimes when someone is very ill, their behaviour can be challenging.  It’s difficult to understand and to deal with. Often when someone is manic/ hypomanic, they can be very disinhibited. Their behaviour could be embarrassing for you. It might be strange and they act oddly around you and others. It could even be upsetting or aggressive. It’s important that you talk about this, and don’t let it fester. It probably isn’t the best time to talk to them right there and then, because in a manic or hypomanic state they might not listen to reason. Actually, they almost definitely won’t. They won’t be able to see your point of view. So, its best to wait until they’re stable. Write down what you want to tell them, so you don’t forget what it was they said or did. Writing it down can help you cope with your own feelings, without reaching boiling point. Calmly discuss their behaviour, and how their words or actions made you feel. Try not to judge or be overly critical. Remember that they were ill at the time, and would not have been aware of how much they upset or concerned you. Tell them how their actions and words made you feel. Don’t accuse them of acting in a certain way or generalise; instead turn it around and explain how you felt at the time.

When someone is manic, they might lash out at the people closest to them. You’re allowed to be upset if they’re pushing you away or upsetting you. Remember why they’re acting that way; they are ill and dealing with difficult moods and emotions. When things start getting too difficult, it’s ok to take time out. If you’re worried what will happen if you need some time away, then talk to friends and family to help out. It could also help to talk to other people in a similar situation.

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