The First 48 Hours: Telling Your Family and Friends About Bipolar Disorder

by John McManamy Patient Expert

Whether or not to tell your friends and family about bipolar disorder is a difficult decision. Here you'll find tips on how and what to share.

The five most hated words to someone with bipolar disease are: 'Just snap out of it.'

I've found myself biting my tongue and force-feeding those words back down my throat more than once. You see, as well as being a patient, I am the loved one of a patient. If you think my own illness drives me crazy, you should see how my wife's illness drives me crazy. Yes, even I – sensitive, loving, caring me - can be driven to the brink.

By the same token, I'm capable of arousing hate in Mother Teresa. I exaggerate only slightly. Mother Teresa is my wife, Susan. I wonder how she puts up with me.

So, what chance can you possibly have with family and friends? Is there any point in trying to establish a rapport, or should you quit while you're still behind?

First, the bad news. Unless your family and friends are drowning in the same end of the gene pool as you are, they can never understand the illness. It's like trying to explain a headache to someone who has never had a headache. You may as well tell them that Jupiter's great red spot is acting up today, . that's why you're behaving a bit strangely.

The good news is that family and friends will rally to your cause despite their hopeless ignorance. These people will prove indispensable in your quest to get well and stay well.

Family Relationships

Chances are, disclosing your disease to family is a moot point. They probably suspected you had bipolar disorder long before you did. After all, your Attila-the-Hun moments are pretty hard to hide from those residing under the same roof. Odds are they were the ones who dragged you kicking and screaming to the emergency room in the first place. They have seen you at your very worst. You are blessed to have them still in your life. Many of us haven't been so lucky.

Following is some practical advice, based on my experiences as both a patient and family member:

• Keep your expectations realistic. From your family's perspective, your illness will always be a riddle wrapped in a mystery inside an enigma.

• Educate your family. This illness has already tested their patience to the limits and will continue to do so. Hand out books, brochures and Web site print-outs. Although it is not entirely accurate, you can explain you have a chemical imbalance of the brain. Also, make sure they understand that in terms of recovery, Rome wasn't built in a day.

• Acknowledge the suffering you may have caused others. You are going to need their good will, and your best insurance is to come clean about what you've put them through. This applies even if your illness is to blame.

• Form partnerships. Your loved one needs to be a player in managing your illness. This means knowing your triggers and how to help you avoid them as well as being involved in any contingency planning and reminding you to remain compliant with your treatments and lifestyle regimens. In a crisis, this is the person who will be making the executive decisions.

• Communicate. Waking up on the wrong side of bed takes on a whole new meaning with a mood disorder. The same is true for a bad day at the office. Your loved one needs a heads up.

Hopefully, your family will turn into your greatest asset. Your illness can often bring you closer -- your shared hardships forging a stronger bond. But the experience can also drive you apart, leaving you feeling unloved, unwanted and embittered. You may have no choice in the end but to break off a bad relationship, but please let this be your last option, rather than your first.


For good reason, people with bipolar disorder tend to remain in the closet because of the fear, ignorance and stigma surrounding the illness. On one hand, you are going to need all the support you can get. On the other, one indiscretion can have severe consequences.

The issue of whether to disclose or not to disclose comes up all the time in my support group. It always comes down to personal circumstances and trust. As a general rule, tread carefully if your friends are your working colleagues. You have everything to gain as well as lose.

Like your family, your friends probably knew all along you had bipolar. They may have even dropped you broad hints, such as 'I have a cousin who ...'

Bipolar is the very last illness in which you can afford to go it alone. Isolation can literally suck the life force out of you. You need friends to connect you to the world, to stimulate you, to ground you, to help pick you up when you are down. It may be easier to keep your friends by being open about your illness, or you may have to be discreet.

Having a trusted friend to talk with about your illness will make your life a whole lot easier, but you may feel (for good reason) that you can't rely on your current circle of acquaintances. In this case, finding a support group is your best option. The only requirement is to show up. It could turn out to be the wisest decision you ever made.

Read more stories by John McManamy.

John McManamy
Meet Our Writer
John McManamy

John is an author and advocate for Mental Health. He wrote for HealthCentral as a patient expert for Depression and Bipolar Disorder.