We all need help from time to time, but someone with Bipolar Disorder just needs more help, more often. You may find the thought of helping overwhelming, but it doesn't have to be. It starts off easy – educate yourself. Learn all you can about bipolar. You can't help what you don't understand. There are plenty of good books out there and even more websites. Once you gather the information you need, you will have an easier time to help your friend or family member.

Generally, people don't like asking for help – and those with bipolar are certainly no different. In fact, they may ask less often for fear of feeling like a burden, or simply not being strong enough to ask and sometimes not recognizing that they need help at all. So, be observant. Watch your friend or family member. Do they need a ride to an appointment, help with housework, cooking, running errands or maybe childcare. Not only does your helping actually help, but so does the fact that you care. It is best to ask how you can help when your friend or family member is well, rather than waiting until they're sick or in distress.

When they are sick they need encouragement. They need to be encouraged to continue with their self-care (see post on self-care) which includes following their treatment plan – such as taking their medications and attending all their medical appointments. Accept their reality and their limitations. Don't push too hard. Talk with positive statements – laughing is important, so try your hand at humour.

Offer simple companionship – people with bipolar disorder often feel like they're very alone. Your attention could make a difference. Watch for symptoms and triggers. For example, if you think the person is manic, avoid over-stimulation. If you think they are depressed perhaps encourage them to do one small thing or talk about good times. But avoid clichés – they won't help. Always reinforce strategies for coping. Self-care is such an important part of their wellness. Don't give up. Even if your friend or family member begins to isolate themselves or demonstrate impatience with you, don't give up. They need you.

Watch for signs of suicidal thinking and be willing to act to get professional help if the need arises. Reducing stress is also helpful (see post on stress). If you're worried about your friend or family member, offer to attend their appointments with them. This will give you the opportunity to discuss matters with their doctor and will also demonstrate how much you care. Stigma is huge with mental illness, so help and support is too.

Back in 2005, when I was first diagnosed with bipolar disorder, I was also diagnosed with having “rapid cycling” bipolar. Since finding my med cocktail that really appears to be working, I don't cycle near as often as I used to. Rapid cycling means cycling between moods (depression, mania, hypomania, or mixed) at least four times in a year. Rapid cycling can come and go during the course of the illness. So that means, even though I'm relatively stable right now, I could at any point begin to cycle again. Another criteria for rapid cycling is that the bipolar episodes must be separated by a period of two months of recovery, or be followed by an episode of the opposite polarity.

When cycling is even more frequent, moods shifting during weeks or days, it is known as ultra-rapid cycling. And when mood shifts occur less than 24 hours apart it is called ultra-radian cycling. Rapid mood swings are exhausting and can make you feel completely out of control. As your energy level and mood shifts, you can experience severe irritability, anger, impulsivity, frustration, and emotional difficulties – on top of the regular symptoms associated with the mood episode.

10-20% of people with bipolar disorder also suffer from rapid cycling. And rapid cycling appears to be more prevalent in women than men. Because of the frequent shifts, the symptoms are more difficult to control. Treatment is important and reduces the risk of serious depression and suicide. Treatment usually includes a mood stabilizer such as lithium. Caution needs to be taken when using anti-depressants. They can sometimes trigger rapid cycling. When cycling, it is important to try to stabilize your sleep habits, avoid non-prescribed drugs and alcohol, and adhere carefully to your doctor's treatment plan. It is helpful to keep a record of which medications have worked or not worked. All this can help reduce the impact that rapid cycling has on you.

                                                            (Sources: WebMD, Mood Disorders Association of Ontario)