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Telling a depressed person things like “Pull yourself out of it” is cruel and may reinforce the feelings of worthlessness, guilt, and failure already present as symptoms of the illness. Telling a manic person, “Slow down and get hold of yourself” is simply wishful thinking; that person is like a tractor trailer careening down a mountain highway with no brakes. So the first challenge facing family and friends is to change the way they look at behaviors that might be symptoms of the illness—behaviors like not wanting to get out of bed, being irritable and short-tempered, being “hyper” and reckless or overly critical and pessimistic. Our first reaction to these sorts of behaviors and attitudes is to regard them as laziness, meanness, or immaturity and to be critical of them. In a person with bipolar disorder, criticism almost always makes things worse: it reinforces the depressed patient’s feelings of worthlessness and failure, and it alienates and angers the hypomanic or manic patient. This is a hard lesson to learn. Don’t always take behaviors and statements at face value. Learn to ask yourself, “Could this be a symptom?” before you react.
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