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The Reality of a Bipolar Disorder Diagnosis:
Tips for Family Members and Friends

by Julie A. Fast

The following is part two of a two part article on accepting the bipolar disorder diagnosis. Part one talked about how those with bipolar disorder can accept the diagnosis. This article focuses on how family members and friends can learn to help as well. This is a difficult topic with no easy answers. But friends and family members need some direction when things get tough. You are often the ones who take care of those who are struggling, refuse to accept the diagnosis and possibly have a dual diagnosis problem.

Understanding Why People with Bipolar Disorder Refuse a Diagnosis or Can’t See They are Ill

1. Denial

As those of you who use the Health Cards know, bipolar disorder is an unbelievably complex illness to treat. I often tell people that it would help everyone around me if my brain would somehow bulge out of my head when I’m sick. Then my friends and family members could just look at me and say, “Julie’s sick. We need to help her.” It’s hard to deny a brain bulge!

It’s never that simple. One reason so many people with bipolar disorder deny that they have the illness is that there are no obvious PHYSICAL bipolar disorder symptoms. Cancer can be seen and measured. Broken legs can’t be denied very easily can they? But because bipolar disorder symptoms are emotional and “psychological,” they’re almost always seen as personality problems or personal issues. We’re hounded for our unreasonable behavior, so how can this possibly be an illness? It’s a lot easier to deny an illness that has no outward physical signs.

The second reason for denial is more serious. Denial is a symptom of bipolar disorder itself. This means that your loved one may be in denial because they’re sick, not because they’re stubborn mules who simply refuse to see the truth. Bipolar disorder won’t let them see the truth. It’s a very strong illness. Of course you can see clearly and without any doubt that the illness is completely ruining their lives, but they can’t see it because they’re sick. Many, many people bipolar disorder deny they have the illness for this reason.

How you can help: Presenting a person a list of symptoms of bipolar disorder and asking them to highlight any of the symptoms they have in common can get through to them. This is how I suggest friends and family members use the Sample Health Cards. The next suggestion is that you look for the treatment window between mood swings. This is the best time to talk with someone and determine if they’re willing to get help, when they’re relatively stable. The final step is to set limits on what you can and can’t accept and let the person know this when they’re in-between mood swings.

You’re in a really tough and heartbreaking position if you want to help someone who denies they have the illness. If someone with untreated bipolar disorder adversely affects your life and the lives of other friends and family members, this is totally normal, but it’s very hard on the people in their lives. I once had someone say my books don’t address denial of the illness as much as they could. The problem with this observation- those in denial don’t read books! But you can and should read them and learn as much as you can about the illness so you know what you’re up against.

2. Mania

When someone suddenly stops their medication and denies they’re sick, this often indicates a manic episode and needs to be taken seriously. This is the time to call the person’s doctor and ask for help. One of the reasons I suggest that all people with bipolar disorder use the Health Cards or a comprehensive treatment system is that they help friends and family members see the signs of an episode before it goes too far and a person simply stops their meds and decides they’re cured.

How you can help: You must know the first and most subtle signs of mania and talk with the person before it goes too far. This can often be discussed when the person is stable. Make a list of what happens when the person starts to get manic so that you can all be ready.

3. Loss of Hope or Giving Up

Depression is the number one cause of loss of hope and the absolute best way to deal with loss of hope is to treat depression first. If your loved one continually says there’s no point to life and won’t get help, this is a sign that they need immediate and comprehensive help for depression. Show them the Depression Sample Health Cards. Remind them that all people with depression have the same symptoms – and that lack of hope is one of the most common symptoms. Once again, talking with someone who’s depressed is very difficult. What always happens is that you think you’re having a rational discussion, but in reality it’s the bipolar disorder that’s doing the talking for the other person. I call this interaction the Bipolar Conversation and offer suggestions on how to avoid it in all of my books. You really have to learn to respond to bipolar disorder instead of reacting to what the illness makes a person say and do. You can’t tell them that there is hope. They won’t believe what you say. But you can say- this is an illness and let’s treat the illness first. That works.

4. Your Loved One Can’t Accept the Reality of the Diagnosis

People with this problem go back and forth between accepting bipolar disorder and getting help and then denying they need to make changes in order to stay well. (I struggled with this for years- especially in terms of mania) This can be very frustrating for you, but believe me, it’s normal and just might go on for a long time. This is a life long illness that tends to get worse unless aggressively treated with a comprehensive treatment plan. Statistics support this. But it’s so normal for people to go back and forth with their acceptance levels. I would say it took me at least five years to finally accept that bipolar disorder wasn’t going to go away.

How You Can Help: You can help people like myself by supporting the behaviors that do make a difference such as exercise, eating a bipolar friendly diet, learning to respond instead of reacting to the illness and being really clear on what you find acceptable and not acceptable. Once again, the best tool I know for dealing with the person who is off and on again about their treatment needs is the Health Cards along with regular doctor appointments and the correct dosage of tolerated medications. Sure, I know this can seem impossible when someone doesn’t even want to accept that they have an illness that needs treatment, but you are the well person and you have to keep believing some balance can be found.

5. Dual Diagnosis

A dual diagnosis occurs when a person is diagnosed with bipolar disorder and/or an alcohol or drug addiction. Believe me, there’s nothing worse for bipolar disorder than alcohol and drug abuse. Period. And yes, this includes pot. These substances affect brain chemistry and a person with bipolar disorder has enough problems with brain chemistry already.

Having said all of this, I’d like to add that I, like many people with undiagnosed bipolar disorder self medicated with alcohol and pot for years and years.

What else was I going to do with all of the ups and downs I didn’t understand? I used food as well. This is so normal. If the person you love has an alcohol or drug problem because of this illness, they’re not alone. This doesn’t make it any easier for you, but at least you know it’s not stupidity that makes someone drink until they’re sick because they’re depressed.

Thankfully there are some solutions. I found that as soon as I started to treat my bipolar disorder comprehensively (and realized why I was self medicating, I stopped drinking for five years.) This is not uncommon when a person is finally diagnosed with bipolar disorder. It means we weren’t addicted to drugs or alcohol. If the person you love is not too addicted, then treating bipolar disorder first will make a huge difference. I suggest that people make an alcohol or pot Health Card and learn exactly when they feel the need to use these substances to feel better. They can then replace the substance with something more effective in treating bipolar disorder. This is how I reduced my drinking and stopped pot completely. Of course if the addiction is serious, professional help is needed for the addiction as well as bipolar disorder.

How You Can Help: It’s especially important that people monitor their mania symptoms carefully. There’s no question that judgment is simply gone when the mania or hypomania goes too far and drinking and drugs lose their danger. My desire to drink doubles when I’m manic and I used to convince myself it’s ok. Well, it’s not okay and all of my friends and family now know that if they see me drinking beer at 4:00 in the afternoon that there’s something going on and we need to talk about mania. This is when my mother really uses the Health Cards so she knows what to do. (The Health Cards teach family members and friends the signs of mood swings in a very personal and easy to understand format.)

Then there are the people who are truly addicted to alcohol or drugs. This article is about how you can help someone you love accept the bipolar disorder diagnosis so that they can get help. Unfortunately, if they are addicted to drugs or alcohol, then you’re in a very, very tough situation and until the drugs and alcohol are taken care of your choices are limited in what you can do. It’s so hard to write about this topic because I know that some of you are reading this and realizing that the person in your life needs so much more help than you can give. I want to be positive because this illness can be treated.

I can’t say that a person with an addiction problem can sit down and use the Health Cards for their addiction. I’m not naïve. A prescription pill addict is not going to sit down and get the help they need when they’re focused on getting their next fix.

But you can learn about the illness and how to help them. Your very first step is to learn all you can about bipolar disorder symptoms so that you can know the difference between mood swings caused by the illness and behavior caused by drugs and alcohol. This can completely change the way you interact with your loved one and significantly reduce your confusion as to what to do.

I talk with many families and partners in my coaching work who are confused as to why a comprehensive bipolar disorder treatment is not working. After talking with them about their situation, I can usually tell what is the illness and what is addictive behavior. This helps the families and partners know what they are up against so that they really can use the Health Cards to deal with mood swings and then talk with health care professionals and often their loved one about the drug and alcohol problem.


Acceptance is obviously a topic large enough for a book, but the tips in this article are the best place to start. Change is 100% possible. I know of many, many families and friends who have helped their loved one accept the illness. Your education on the illness comes first, then you can offer real help, support, and guidance for the person you care about.

If you received this article by signing up for the newsletter at you should have received part one yesterday. If you don’t see Acceptance part one in your e-mail box, check your spam or junk folder. Be sure to add “” to your e-mail safe list to ensure delivery of all future newsletters.

A Note From Julie

Thank you for all of your support and kind comments about my work. You are the reason I’ve made the Health Cards Treatment System for Bipolar Disorder available to the public and the motivation behind all of my work. With your help, the Health Cards are recognized around the globe as the number one self-help treatment program for bipolar disorder for both consumers, friends and family members.

The Health Cards provide many strategies for the holistic treatment of bipolar disorder. I support myself and my cause of helping others to get better through all of my books, and the amazing thing is that it’s because of the Health Cards that I can work again. I want everyone with bipolar disorder to have the same choices. This illness is so strong, but there are treatment plans that work. You really can get better. Every person with bipolar disorder needs a treatment plan that incorporates medications, behavior modification, lifestyle changes, and the help of friends and family into one easy to use system. The Health Cards work for those with the illness and can be used by family members and friends even when the person they care about is not currently open to a treatment plan.

Thank you for your supportive emails!

Please note that I am no longer able to personally answer e-mail as I continue to spend much of my time writing, speaking and coaching family members. I have learned to balance my work and daily life in order to remain stable. I do so appreciate all of your support and appreciation. Please refer to the website and my books for possible answers to questions you may have. My blog also addresses a wide variety of issues. I especially appreciate comments left on the blog as I am interested in your opinions. This is also a great place to share your experiences with others.

Remember, all people on disability can receive a discount on the Health Cards System. Just send a blank e-mail with the word disability in the subject

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Print It, Share It, E-mail It: You can share this e-mail with your groups online and off, your health care providers, friends, and family. When we learn to be proactive in treating bipolar disorder, we quit moving from crisis to crisis, regain our lives, and save our relationships.

Thank you,