1212mentalhealth-RW (Photo credit: Robbie Wroblewski)


I have noticed that I am getting a lot of searches on my blog about setting boundaries with bipolar family or friends. So I am going to devote a short post to this topic. Unfortunately I am in a lot of pain right now with my fibromyalgia so I am saving some of the longer posts that I had planned to write until later.

So this is my opinion based on my thirty-some years of dealing with this illness and my work with others who suffer with mental disorders.

Note: Do not take what I am about to say as an excuse for bipolar behavior. I am only noting the complexities of dealing with this illness as simply a behavioral disorder. Please read the entire article before making a judgment. I do in fact talk about what the responsibilities of the person who has bipolar disorder are. Ultimately it is up to the person who has to live with the person who is diagnosed as to how much they feel they can tolerate. However I encourage an attitude of compassion, rather than judgment. Also you are welcome to respond to this article as long as you do so in a respectful manner.  If you cannot do that then your comment will not be approved.

Boundaries, for the most part, should be similar to those that anyone without an illness should adhere to. However, there are some caveats:

1. Recognize that bipolar disorder, major depressive disorder, schizo-affective disorder, and schizophrenia are not character disorders. The person you are dealing with is the same person that she was before she got sick, so if she was a good person before then she is also a good person even in the midst of her illness. Often people get bipolar disorder confused with borderline personality disorder (which often even has the same initials as bipolar disorder, BPD). While the symptoms may be similar to each other borderline personality disorder is a part of a person’s character and is formed early on in childhood. Medications tend to not help much.  Therapy is recommended as the most effective treatment. However in people who have a true mental illness based on biology, medications are very effective in restoring function and therapy is considered an adjunct treatment.

2. Because of #1 it is very important that you not shame the person who is dealing with bipolar disorder or any other mental illness. Chances are they are already dealing with a lot of shame, even if they don’t show it. Suicidal behavior is often motivated by feelings of guilt. Guilt is actually a hallmark symptom of the depressive phase of the illness. You are not responsible for any suicide attempts but just keep in mind that the goal is to help the person feel better and guilt trips don’t help.

3. Don’t take their behavior personally. Most of the time it has nothing to do with you.

4. Keep in mind also that some people experience a break with reality in which they are not totally in control of their behavior. See my article Are People With Bipolar Disorder Inherently Evil?

 5. After saying all this I think that the primary way of setting boundaries should be to insist that the person get appropriate help. It may be that it is impossible to live with that person’s behavior otherwise. I have dealt with that problem myself when I took in a homeless schizophrenic who refused to take his medications. He became homeless when he quit his job and went on a wild spending spree. Unfortunately by trying to help him I only enabled him to continue his destructive behavior. Please note that I am not suggesting that a mentally ill person should be left out on the street. There are mental health organizations that can help with finding them medical help and housing. See the bottom of this article for resources.

6.  Keep in mind that most medications do not work overnight and it may take a while to find the right combination. Also most people do not get total relief from their symptoms so they might still have mood swings, just not as bad as before.

7.  Because of #6 most people need to also develop coping skills to deal with their illness. This is where therapy and support groups are helpful. One of the things that I have learned and continue to learn is how to separate my bipolar feelings from my healthy feelings, This is where self-responsibility comes in to play. I can’t take my feelings out on others and this is where appropriate boundaries are needed.

A good resource for family and friends of people who suffer from mental disorders is NAMI (National Alliance for the Mentally Ill). They also offer classes in coping skills for those who suffer from mental illness.

For information on support groups and other programs to help the mentally ill go to the Mental Health America website.

For a good list of therapists and other mental health professionals who can help both the person suffering from mental illness and also family members who need help to deal with their loved one’s illness go to the Psychology Today website and click on “Find a Therapist” on the top of the page.

Related articles