Caretakers of Someone with Bipolar Disorder: When to Step in and When to Step Back

Jerry Kennard Health Pro
  • Many of the questions asked of our community members involve personal relationships. Whilst the title of this post might suggest I have answers for folk who, directly or otherwise, might be thought of as caregivers, I don't. It's not that I'm suddenly bereft of an opinion or two, it's simply that every situation is different and so a list of, what-you-should-do-in-this-situation, statements are of little value.


    However, people frequently ask questions that, in one way or another, tap into concerns of over-involvement or the setting of boundaries. So, I've given it some thought in the hope this might generate additional thoughts and discussion from readers.

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    Caregivers (I'll use the term in a fairly broad way) have a difficult task in knowing when to step in and when to step back. In some ways it's easy to imagine why it seems simpler to remain involved, but is it good, and is it healthy for either party? Over-involvement is undermining as it sends a message about someone else's ability to cope. Over time it could encourage over-dependence or complete resentment. Despite this, over-involvement is really quite common, and it says something about the difficulty people sometimes have in establishing healthy boundaries.


    Self-sacrifice appears to be a feature of over-involvement but far from it preventing episodes of illness the evidence suggests otherwise. Poorer adherence to medication and an increased likelihood of illness seem much more prevalent. With this in mind my offerings focus on the role of caregiver as someone who wants to respect the autonomy of the person to whom they offer care, support and love.


    All relationships require the setting and acceptance of boundaries. For the caregiver this can mean a number of things. It's about:


    • Accepting the fact that there are different phases to bipolar. When the person is well they may be able to help and support you, and this is something to accept and nurture.
    • Acknowledging that you can't fix everything, so don't try.
    • Being flexible and adapting your responses to situations as they emerge rather than straining on the leash to jump in.
    • Working with the person, who may be a friend, family member or partner, to plan for eventualities as the illness progresses.
    • Listening to how your behavior needs to change when the person is no longer ill.
    • Not having unrealistic expectations of yourself. You do realize that you're still allowed emotions? You may still express your anger, frustrations and even humor at situations, just don't blame the person for their illness.
    • Understanding that it's not your illness and that no matter how much you might like to control it, the responsibility ultimately isn't yours.
    • Looking for positive things in life that you both enjoy. These will help to enrich and sustain you in times that are less than easy.

    That's got the ball rolling. Maybe you agree with some but not all of the things on my list and maybe you'd like to add a few extra?


Published On: July 05, 2010