How to deal with someone who is depressed or manic
Share with friends
General Behaviors
Relationships with a family member suffering from depressive or manic disorder cannot be “regulated” from the outside. And yet, relatives already have quite a wealth of experience that can be generalized. There are no standard ways to behave and therefore no simple advice. Living with people with bipolar disorder is always balancing on the line between closeness and distance, help and maintaining autonomy, overprotection and neglect. But first of all, it is important to maintain a balance between respecting the needs of others and respecting your own boundaries.
Avoid excessive demands
You can provide support as long as you yourself are physically and mentally stable. Your help will only be useful if you take care of yourself, notice in time and avoid excessive demands on yourself. Increased demands increase emotional stress, the feeling of guilt of the other, his aggressiveness towards himself and others, as a result a depressive or manic attack may occur. It may not be noticeable at first glance, but you can be sure that the patient is very sensitive to your mood and your excessive demands on yourself. If you don’t pay attention to your own workload, you can get sick yourself, and this will not benefit either you or your loved one.
Take small steps
During periods of depression, a person loses so much initiative, self-confidence and energy that he is no longer able to cope with even the simplest things. As a rule, the situation does not look like that those suffering from depression simply do not have a desire, although there is a possibility, but that they objectively do not have a desire, they are not able to want something. Superficial encouragement and demands to finally pull yourself together will not solve the problem. During depression, general criteria become invalid. Try to avoid reproaches and not make excessive demands. In times of doubt, do not blame the person, but the disease, even if such a distinction sounds unnatural. Give your loved one the opportunity to participate in your affairs, but limit yourself to small successes, take small steps.
Do not infringe on independence
If your loved one is unable to do certain things due to illness, you will want to take on all the work yourself: You will still be able to do it faster. And it will cost much less nerves. If the patient is experiencing a manic state and it seems to you that he is doing everything wrong, all the more likely is the desire to take everything into your own hands as soon as possible. If you start taking on too much and too quickly, this can cause the patient to have another attack of mania or depression. Remember that independence is a very important component and should not be infringed upon. Help only where it really seems important to you (for example, hygiene), and intervene only if the patient’s behavior poses a threat to you, then outside help will be useful.
Show empathy
People suffering from depression need, above all, emotional support, participation and sympathy. Pity depresses, sympathy encourages. However, it is not without reason that patients refuse to feel for themselves. They need internal independence so that, in addition to their feelings, their feelings, they are able to bear your feelings, your sympathy. You can be sure that your loved one feels and appreciates your emotional support, but you need to take into account the fact that he will not be able to respond to you in the same way or as before. Perhaps you can better navigate this difficult period of one-sided emotionality if you remember a time when things looked partially different? If such a time really happened, there is no need to be afraid to remind your loved one about it.
Know about time limits
Depressive and manic states are limited in time. They have a beginning and an end - with or without treatment. The problem is that during these periods the sense of time perception changes. To your loved one, his painful condition, contrary to reason, seems eternal. This can drive him to despair or, conversely, make him happy. For you, who know that the phases of the disease have time limits, this fact can give strength and inspire hope. Remember this and be guided in the future.
Biographical significance
For all its physical dynamics of development, depression always has a biographical side, its own history of relationships. Everyone experiences trauma in their lives, and in any relationship there are mutual grievances that can lead a sensitive person into a depressed or manic state. In this respect, depression and mania provide a kind of window through which to look. Often this is possible only after the acute phase, and sometimes not without outside help.
Attitude to one's own grievances
Depression can be seen as aggression directed inward. Even if the aggression is not directed directly towards you, you will still somehow feel it. But usually depressions are offensive in nature: a depressed child disappoints all expectations, a sick mother burdens and causes fear. And the spouse closes all his feelings. When the patient is in manic states, his own grievances are experienced even more acutely. Your spouse says hurtful, insulting things to you or is harsh towards you, your child or parents may behave in an insolent manner. Sometimes in such cases it is necessary to maintain an internal distance; just be careful not to close the door too tightly. The acute phases of the disease are not the best time to make final decisions. It is reassuring to know that the unusual behavior of a sick person is only a manifestation of his illness. But in times like these you need active support, i.e. a person you can trust and who you can talk to. These could be your friends, your spiritual father, or, in extreme cases, your attending physician. In addition, self-help groups or groups of relatives of patients will help you to support you.
Do not mention it
Depression and mania are common phenomena. They are often associated with high expectations and standards regarding the patient's productivity, efficiency, beauty and eternal youth. People prone to manic-depressive disorders are often subject to pressure from our society, which prescribes certain standards of behavior for them. Depression forces the patient and his loved ones to reconsider the usual norms regarding the performance of certain actions. Even if in the acute phase the possibilities for this are limited, you can still help your loved one at least in small ways, so as not to “kill him outright” with all the rules at once. Both you and your loved one must remember that pleasing everyone in everything is an impossible and unnecessary task.
Help from outside
Instill in your loved one the need to seek outside help. Don't be afraid to argue that you would like to share your worries or responsibilities with others. Neither the help of a psychotherapist nor drug treatment will instantly relieve the patient of depression or mania. However, it can make things easier for everyone experiencing the disease. Thoughts of suicide are a serious reason to insist on professional help.
The right to make mistakes
Everyone is familiar with times of depression and partly manic states. There is a special burden of worries on your shoulders, which can lead to a state of depression, and even more so if you develop too vigorous “manic” activity. You, too, are “just” a person. Your powers are not limitless. And your sick relative should know about this; because he already feels it. Sometimes, due to extreme fatigue and irritation, you react differently than you intended. Surely you make “mistakes”. People suffering from mania and depression need genuine human relationships. And they cannot do without mistakes and weaknesses. If you admit this to yourself, you will relieve your loved one of guilt. Source: psihos.ru
Share with friends
Drug treatment
Today, doctors have a wide range of medications at their disposal - antidepressants to cope with depression. Some of them are described below. The main thing to understand before starting to use these drugs is that treatment is only possible under the supervision of a doctor.
Selective serotonin reuptake inhibitors (SSRIs)
Most often today, doctors begin treatment for major depressive disorder by prescribing these medications. Drugs in this class are the safest and cause fewer side effects than other types of antidepressants. SSRIs include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft, Stimuloton), citalopram (Cipramil), and escitalopram (Cipralex).
Serotonin and norepinephrine reuptake inhibitors (SNRIs)
These drugs are duloxetine (Cymbalta), venlafaxine (Effexor XR, Velfax), desvenlafaxine (Pristiq) and levomilnacipran (Ixel, Fetzima).
Norepinephrine and dopamine reuptake inhibitors (NDRIs)
Bupropion (Wellbutrin, Aplenzin, Forfivo XL) falls into this category. This is one of the few antidepressants that are not characterized by side effects in the sexual sphere.
Atypical antidepressants
These medications do not belong to any other class. Trazodone (Trittico) and mirtazapine (Remeron) are sedating and are usually taken in the evening or before bed. Newer medications include vortioxetine (Brintellix) and vilazodone (Viibrid). Vilazodone, as practice has shown, has a much lower risk of side effects in the sexual sphere compared to other antidepressants.
From the editor: Capabilities of the human brain
Tricyclic antidepressants
Medicines such as imizin (Tofranil), nortriptyline (Pamelor), amitriptyline, doxepin, trimipramine (Surmontil), desipramine (Norpramin) and protriptyline (Vivaktil) can be very effective in treating major depressive disorder, but tend to cause more serious symptoms than New generation antidepressants, side effects. It is not recommended to start taking tricyclics unless you have first tried treatment with SSRI drugs.
Monoamine oxidase inhibitors (MAOIs)
MAOIs such as tranylcryptomine (Parnate), phenelzine (Nardil) and isocrboxazid (Marplan) are usually prescribed when other drugs have not been effective. This is done because medications in this group can cause serious side effects. Taking MAOIs requires a strict diet due to dangerous (often fatal) interactions with certain foods? such as certain types of cheese, pickles and wines? and certain medications, including birth control, vasoconstrictors (such as common cold medicine), and certain herbal supplements and spices. The fewest side effects of all drugs in this class are caused by Selegiline (Deprenil, Cognitiv) - one of the latest developments by scientists, when used in the form of a skin patch
It is important to remember that MAOIs should never be used concomitantly with other types of antidepressants. There should be 2-3 weeks between stopping MAOIs and starting a different class of medication (as well as vice versa).
Other medicines
When treating depression, the treatment structure may include other medications in addition to an antidepressant. This is usually done with the aim of obtaining or enhancing the antidepressant effect, which without such a combination is clearly insufficient. Your doctor may recommend combining two antidepressants, or adding other medications such as mood stabilizers or antipsychotics. Sometimes tranquilizers or psychostimulants can be added to the treatment structure for some time.
Possible reasons
I will give examples of three conditions that can lead a person to visit a psychiatrist. However, the patient himself rarely notices the presence of a problem.
- Presence of addiction. This is not necessarily an addiction to alcohol, cigarettes or drugs. Here we can talk about addiction to the Internet, games, shopping, smartphone. When a person is deprived of the object of his dependence, outbursts of aggression and uncontrollable actions appear. The whole life of an individual comes down to one thing; he no longer notices what is happening around him. You can’t do this without the help of a specialist.
- Having more than an idea. For example, a situation with obsession with your figure. When a person tortures himself with hunger, deliberately induces vomiting, and does not eat anything in order to lose weight. With significant weight loss, it still seems to him that he is full, continues in the same spirit until the moment when this process becomes automatic and the need for food disappears, the individual begins to gradually fade away. In such a situation, you need to urgently contact a psychiatrist.
- The presence of severe stress. If there are strong phobias in life (for example, a person was previously in a car accident, now he is afraid to drive a car), or increased anxiety, then you can get rid of them, significantly improving the state of your life.
Psychological trauma can lead to the development of irritability, insomnia, panic attacks and obsessions.
