Question: How can I tell if a friend or family member has bipolar disorder and needs help?
Answer: There are many phases to bipolar disorder which can be recognized by people who know the person well. In fact one of the questions we ask as psychiatrists oftentimes when we are talking to people with bipolar disorder is whether friends and family think that the person is not their usual self. So, these can come out of episodes, especially manic episodes or depressive episodes, where people exhibit symptoms and behaviors that are really unusual for the person. In manic episodes, people can be irritable, their thoughts are racing, they have lots of excess energy, they're sleeping poorly, and they're starting projects or making decisions that they end up regretting later. And those can often be giveaways for family members to recognize that somebody is struggling with symptoms of bipolar disorder.
On the other side, in depressive phases of illness -- people will often feel low energy, they have trouble getting out of bed in the morning, facing life, and taking care of all of the obligations that we all have to deal with. In addition, there can be suicidal thoughts, hopelessness, helplessness, feelings of guilt and remorse that can often be above and beyond what day-to-day experiences will bring. So these can also be giveaways.
Having said all of this, it's also important to recognize that having bipolar disorder, having any psychiatric condition is a private affair, and it may be counterproductive to intrude too heavily on somebody's functioning, and to ask them whether they have a psychiatric condition. So friends and family should often weigh whether they feel this is going to be helpful to the person, or if it's going to push the person to actually deny that they're having problems and try and keep everything private and not to talk to friends and family about what's going on. So that's a decision that friends and family often have to make when they recognize that a person is struggling with symptoms of bipolar disorder.