How to help someone before and during a manic episode

Make a Plan. Before an episode of mania starts, make a plan together. First off, they’ll be more receptive to your ideas. They’ll be more in control and be able to look objectively at previous episodes of mania. Decide together what will help them, and what support and help they want when they are seriously ill. Write down your decisions, and keep them in a safe place for when you need them.

Focus on triggers. You could look at their work commitments and any other projects they have and offer your own opinion on them. It may be you feel they’ve taken on too much, which could lead to stress and burnout, that could then lead to an episode. Be calm and gentle with the suggestion, so they don’t feel you’re being overly protective or critical.

Stick to healthy routines. Again to keep them healthy, and during an episode, you could help them stick to a routine. Making sure they have regular meals and a sleep routine will either help to keep them well, or be in a healthier place when the hypomania/mania ends. 

Join in with their activities. During an episode you could do things together with them. If they are being creative, join in. It shows you’re interested in what they are up to, and means you can make boundaries on how long they spend on the activity. Again, don’t force them to stop, but remind them of other things they need to do that day, or that they need to eat, sleep and look after themselves.

Help with finances. You might have to manage their money when unwell. This can be organised beforehand. Doing things such as putting a site blocker on their phone or computer – that only you know the password to. It’ll stop them from spending money on websites you know they use often. You may need to take their cards from them, and have access to their bank account. If they need money for something, they will then have to ask you. It might feel like you’re infantilising them, but believe me, they will appreciate it when they are stable.  

Sometimes when someone is very ill, their behaviour can be challenging.  It’s difficult to understand and to deal with. Often when someone is manic/ hypomanic, they can be very disinhibited. Their behaviour could be embarrassing for you. It might be strange and they act oddly around you and others. It could even be upsetting or aggressive. It’s important that you talk about this, and don’t let it fester. It probably isn’t the best time to talk to them right there and then, because in a manic or hypomanic state they might not listen to reason. Actually, they almost definitely won’t. They won’t be able to see your point of view. So, its best to wait until they’re stable. Write down what you want to tell them, so you don’t forget what it was they said or did. Writing it down can help you cope with your own feelings, without reaching boiling point. Calmly discuss their behaviour, and how their words or actions made you feel. Try not to judge or be overly critical. Remember that they were ill at the time, and would not have been aware of how much they upset or concerned you. Tell them how their actions and words made you feel. Don’t accuse them of acting in a certain way or generalise; instead turn it around and explain how you felt at the time.

When someone is manic, they might lash out at the people closest to them. You’re allowed to be upset if they’re pushing you away or upsetting you. Remember why they’re acting that way; they are ill and dealing with difficult moods and emotions. When things start getting too difficult, it’s ok to take time out. If you’re worried what will happen if you need some time away, then talk to friends and family to help out. It could also help to talk to other people in a similar situation.

Ideas To Help Someone With Psychosis

I’ve listed on the blog before about what not to say to someone with psychosis, and although that’s important, I realised I didn’t go into much detail about what helps. As I’ve mentioned before, psychosis covers experiences from hearing, seeing, or feeling things that aren’t really there, and delusions. Delusional thinking causes us to believe grandiose ideas about ourselves, or may make us paranoid and secretive. Here’s a list of 6 things you can do to help.

Be gentle and calm. It’s easy to get frustrated with someone when what they’re saying doesn’t make any sense. You might feel like calling them out and confronting them. Don’t. What they’re experiencing is very real to them at that moment. Challenging their beliefs could easily push them away – if they’re paranoid it could even fuel the delusion.

Listen and try to understand. Listen to what they say and stay calm. You don’t have to agree with what they’re saying. Don’t encourage a delusion as this can make things worse. Ask them what would help, and if you’re struggling to understand educate yourself a little more about what psychosis is.

Focus on their feelings. It’s important to talk about how someone is feeling rather than the experience they are having. If they’re feeling stressed or worried, this could be the reason for why they are having an episode of psychosis. Making them feel safe and secure can help guide them through the experience.

Show them respect. Don’t be critical of what they’re going through or over protective. You might feel that you know better, and telling them what to do will help. However, it often creates a divide. You can respect their wishes to an extent. For instance, if they want to be supported in the home, rather than in hospital you should respect that, unless they become a danger to themselves or others.

Put a crisis plan in place. A crisis plan involves deciding on treatment options and hospital visits. You can also put together an informal plan with your loved one, where you set boundaries. By this I mean, what you can and can’t deal with when they’re in crisis. It’s helpful to be honest and have a plan in place before a crisis hits.

Look after yourself. It can be challenging, upsetting, and sometimes distressing looking after someone going through psychosis. It’s important to take care of your own wellbeing and health during these times.

This isn’t an exhaustive list, only what I would find helpful and how I’d like to be treated when experiencing psychosis. Ultimately, everyone who goes through psychosis has a different experience of it and their needs will not look the same as mine. This is why it’s vital you talk to that person to get an understanding of their unique experiences, before they become ill.