What Families Need to Know About Mixed States in Adult Bipolar Disorder

Date Posted

December 19, 2017


Nicola Smith


For most adults with bipolar disorder, their mood alternates over time between manic (elevated) and depressive, with normal states in between. During a mixed state, however, a person experiences manic and depressive states in rapid sequence or simultaneously.

It usually takes time to find the right treatment for someone with bipolar disorder. This delay can have a heavy impact on the families of those who have been diagnosed. While it can be difficult knowing how to approach the treatment process with your loved one, understanding your role as a family member or caregiver can help everyone work together toward wellness.

These are a couple of common issues that families of adults living with bipolar disorder face, along with strategies for addressing these challenges.

Observe and Document Symptoms and Behavior

The rapid mood and energy fluctuations that characterize a mixed state can take a toll on a person with bipolar disorder; they may not be able to function at all or may be able to do so sporadically. Understanding and being patient with the challenges your loved one is facing is crucial to being able to help them.

Remain aware and observant of your loved one’s behavior so you can help to identify patterns that can be addressed to make treatment more effective. Document what you observe in a list or journal and discuss these patterns with your loved one. Assuming you are a partner in treatment, you can support your loved one in sharing that information with their healthcare providers to better inform their treatment approach.

Practice Self-care

Seeing a family member or loved one face the challenges of a mental health disorder is stressful, not only for your loved one but also for yourself. Acknowledge that what you are experiencing is stressful and try not to internalize your feelings and thoughts.

Do your best to not let your loved one’s mental health challenges adversely affect your own health and wellbeing. Continue (or start) regularly doing things that maintain and improve your self-care, such as exercise, meditation, yoga, and a healthy diet.

In conjunction with looking after yourself physically, make connections with support groups or people you trust so you can confide in them for social and emotional support. Consider seeing your own therapist or beginning family therapy. These outlets will help you communicate your concerns while helping you find other ways to support your loved one and yourself.

Set Boundaries

While your loved one needs consistent support and love, it’s important to set boundaries for yourself (and your loved one). This will help to minimize the risk of your family member relying on you to guide all their behavior or them engaging in behaviors that are destructive to your relationship and family. Remind them that you are there to offer support, however, you need to be able to communicate honestly so you do not burn out or experience symptoms that become “more than stress.”

For example, being afraid to raise an issue with a loved one with bipolar disorder for fear that they may become depressed or angry will not help you – or them – in working toward wellness. Use non-judgmental, action-oriented statements such as, “I felt overwhelmed when I had trouble getting the kids to complete their homework the other night when you were out late. In the future, please let me know if you will be out late so I can prepare myself,” to get your point across without the other person feeling to blame. Make realistic requests of your loved one.

It’s not easy caring for your loved one with bipolar disorder while caring for yourself and other family members. Remember to check in with your own wellness as you do your best to support everyone.

Additional Resources

With a keen interest in holistic health and wellness, Nicola Smith works with heart-centered female entrepreneurs in the health and wellness industry, providing copy that engages to help grow their businesses.