Are you always putting yourself last on the list? It is important to take care of your needs, too.

• Acknowledging that what you are experiencing is stressful
• Being careful not to take on too much by delegating or declining tasks when you can
• Following a healthy lifestyle to reduce stress (e.g., getting adequate sleep, eating well, exercising, practicing meditation, doing yoga)
• Resisting using substances to cope (e.g., alcohol)
• Asking for and accepting help from friends, family, and providers
• Learning all you can about the mood disorder
• Developing a strong network for social and emotional support (e.g., support group, spiritual group)
• Holding family meetings to discuss ongoing issues and plan changes
• Confiding in people you trust.

• Blaming yourself or feeling guilty or responsible for your family member’s suffering
• Believing you can "fix" your loved one's condition or problems
• Putting all your energy on the person of concern and neglecting your own well-being
• Setting too many or unrealistic goals
• Confiding in people who are not supportive because they lack information about mood disorders or are uncomfortable discussing sensitive topics (e.g., They might say something like, "Just tell him to look at the good things in life.")
• Not being aware of your own emotional state or suppressing your feelings
• Trying to accomplish everything all alone
• Ignoring your basic needs (e.g., sleeping, eating)
• Not setting boundaries

Boundaries are limits you set that tell others the kinds of behaviors or interactions that you will and will not accept. Often, when our boundaries are broken, we don't recognize it happening but we can notice the feelings attached to it, such as discomfort, frustration, or resentment.

When you set boundaries, you are showing people how they can interact with you. This is especially important because

• setting and enforcing boundaries will ultimately be beneficial for your relationships
• setting and enforcing boundaries will help you avoid caregiver burnout
• everyone in your life should recognize that your mental health matters, too.

Mental health symptoms can get in the way of a person respecting your boundaries. That doesn't make your boundaries irrelevant or wrong. You may have to be flexible, reevaluate them, or get your loved one more support before enforcing your boundaries.

• First, be aware of your feelings and the feelings of others.
• Be clear and direct when explaining your needs and how you are willing to support your loved one.
• Use non-blaming “I statements.” For example, “I felt sad and had trouble helping the kids get to bed alone when you went out with John on Friday.”
• Clarify what is your responsibility and what is the responsibility of the person with the mood disorder. This will encourage independence and accountability.
• Have well-delineated expectations of how you expect your family to treat you and each other (e.g., no yelling, no swearing).
• If expectations of civil behavior are being violated, bring them up for discussion with the family as soon as possible.
• Determine appropriate consequences for boundary-crossing and follow-through (e.g., no computer time for 24 hours on the next day for teens, leaving a conversation if yelling begins).
• Do not tolerate mistreatment (e.g., name-calling and verbal or physical abuse).
• Praise and acknowledge any positive behaviors, efforts, or statements (“I really appreciate your washing the dishes; that was very helpful.”).
• Don’t be afraid to say "NO" when you are being asked to do too much.

For more on boundaries, see pages 34-35 of our Helping Someone Living with Depression or Bipolar Disorder: A Handbook for Families and Caregivers.