Many people keep bipolar disorder a secret from their friends, love interests, co-workers, even family members. Follow this step-by-step guide to striking up this important conversation.
Filling someone in on your health history may not be your typical ice-breaker — and for people with bipolar disorder, sharing the diagnosis can be emotional and challenging.
In fact, the worry you have that people will judge you negatively because of bipolar disorder — the fear of stigma — can actually make your bipolar disorder worse, according to a research review in the February 2015 issue of the Annals of Clinical Psychiatry.
But bipolar disorder is nothing to be ashamed of, and if you are proactive about starting the conversation, you will set a positive tone, whether you’re breaking the news to a family member, your boss, or a new love interest.
In fact, there are many reasons you should be open about bipolar disorder. “If patients carry their diagnosis around as a secret, it becomes a burden and they may feel even worried and alarmed that people are going to find out,” says psychiatrist Daniel Wilson, MD, PhD, vice president and dean of the University of Florida College of Medicine-Jacksonville. Sharing can lighten your emotional load.
Other reasons to have the “bipolar chat” include:
- Getting support. Just as when you have the flu, you will need the love and care of people around you during bipolar treatment and they, in turn, will appreciate knowing what’s going on with you.
- Educating your loved ones. Finding a way to talk about bipolar disorder will allow you to inform the people in your life about your symptoms, as well as your bipolar treatment.
- Identifying bipolar triggers and symptoms. People around a person with bipolar disorder are often the first to notice bipolar symptoms, particularly with mania. “Patients don’t always have the same degree of awareness of what’s happening,” says Dr. Wilson. The National Institute of Mental Health stresses the importance of paying attention to early symptoms of mania or depression and getting treatment.
Breaking the News About Bipolar Disorder: An 8-Step Guide
Once you decide that it’s time to tell others about your bipolar disorder, planning the conversation can be challenging. Use these step-by-step strategies:
- Pick a calm moment. Too often, these conversations are forced by a crisis, says Wilson. “It’s better to have the conversation when the person is feeling well,” he says. That’s why you should share your diagnosis before another episode requires an immediate response. If you can choose the location, find a place where you feel comfortable and one that offers privacy for everyone involved.
- Practice. It’s always a good idea to make a trial run with important conversations. Your therapist or a friend who already knows about your situation could be a good sounding board.
- Fine-tune for your audience. Your exact words will be different if you are talking to a family member, a romantic partner, or a co-worker — so plan accordingly. For example, when you are talking to your boss, it might be helpful to bring along some of the highlights of your work history to show that you’ve been a productive employee over the years despite bipolar symptoms. If you are talking to a new love interest, it’s best to pick a time early in the relationship out of respect for your partner’s right to make choices about continuing to date you with full knowledge of your situation.
- Be a teacher. There’s a good chance the person you are talking to doesn’t know much about bipolar disorder. Come prepared with helpful information. Bring pamphlets or contact information for a support group if you think that would help, or invite the person to meet with your counselor or doctor to fully understand your bipolar treatment.
- Shut out stigma. You might be able to help your loved one better understand the implications of your diagnosis if you use a disease analogy. “I like to compare it to an overactive thyroid,” says Wilson. “It is more complex, but there is a substantial medical component and clearly you want to treat that condition.”
- Make amends. If appropriate, you might want to acknowledge damage done by past behavior caused by bipolar symptoms. “Explaining that it wasn’t just a personal preference to behave in a particular way and that there is this medical aspect to it can be helpful,” says Wilson, adding that many patients feel guilt and shame over their actions and sincerely want to make amends. In some cases, both the disclosure of your diagnosis and acknowledging the impact of your choices might both be better handled in a letter.
- Give them time. Some people are very open and flexible, but others — possibly family members with rigid ideas about family identity — can have a hard time digesting your news. “It’s often helpful to have a cooling-off period, letting people go their own way for a while,” says Wilson.
- Accept their responses. Sharing your bipolar diagnosis may leave you feeling vulnerable and, unfortunately, not everyone will respond the way you wish they would. “I’ve had to advise patients to limit their contact with some family members for a while,” says Wilson. Talk to your therapist if you’re disappointed about the response that your disclosure received.
Keep in mind that what the person you are talking to does with the information you share is out of your control. “I’ve seen many cases of excellent, supportive work situations, and situations in which when people at work found out, they clearly tried to shuffle the person out of the job,” says Wilson.
To better help you manage this unpredictability, Wilson advises involving your counselor or therapist along the way, especially if your disclosure causes a major shake-up in your family dynamic or triggers denial or hostility.