Quick apologies for the lack of post yesterday, (though I’m sure the lack of consistency bothers me considerably more than any of you readers) but I have found myself facing the worst flu I’ve had in a decade. You can imagine it must be bad when I couldn’t even open my laptop and post the already-written post I had prepared for yesterday, but my main goal was simply survival and avoiding the emergency room.
Thankfully it didn’t come to that, and though I am still in bed I no longer feel like I am in any immediate danger, I still hurt like the dickens.
I woke up realizing it is Valentines day (which means my plans for today are definitely a bust), but what immediately came to mind this morning made me want to postpone what I had to say yesterday until later this week.
I’ve never been able to witness such obvious changes in people as I have in the last couple years after meeting so many people with bipolar disorder. Honestly I tend to get a little worried about these folks when things shift one way or another for them, and it can be scary seeing how obvious the change appears in their behavior. It can be scary because of what the change means, but it is also very scary to me because I know I exhibit the same sort of changes and I am never really sure how obvious they are to the people around me.
For those familiar with their bipolar symptoms, it can be much easier to bring these changes to their attention without conflict, and having them pointed out can almost be a godsend. Honestly, I don’t always recognize them right away, so if someone close to me points out that I have been particularly irritable or energetic I feel an overwhelming amount of gratitude.
Unfortunately, bringing up sudden behavioral changes to people who are undiagnosed, even if they are people who are very close to you, can do seemingly more harm than good, if not approached properly.
What do you do when you are worried because someone close to you has recently began exhibiting a sudden change in behavior?
I would say the first thing to accept is that 99% of the time (unless the person is your child), you can’t force people to seek help. This has been one of the hardest things for me to come to terms with, because I have seen a lot of people struggling and yet refusing to seek any sort of help. This can be especially maddening when the person is severely depressed, and the lack of motivation to seek help comes off as a seeming willing perpetuation of the depression. I would say the goal of forcing or coercing someone into seeking treatment is probably unrealistic, especially if this is the first time you are approaching them about a noticeable change.
Instead I would encourage people to take the approach of simply having a conversation about what is going on with the other person. I realize that this sounds deceptively simple, but it can be extremely difficult to bring up. The point of having a simple conversation is to express your concern, and potentially bring the person’s attention to the fact that these changes are noticeable to those around them. Some people believe they can hide these behaviors better than they actually can, or that what is going on is only going on internally and therefore isn’t effecting their outward lives, so it is important to confirm that what is going on is both real and noticeable.
Here are a couple tips for the conversation:
- Re-itterate the fact that you are worried because you care. It can be helpful to tell the person that you love them or care about them, and that you’re worried because you really care. People are usually much more willing to open up after being reminded how much you value your relationship with them, and even light banter about previous experiences together can help the person you’re approaching feel more at ease and remind them that they value the relationship too.
- Don’t be accusational. Placing any sort of blame will only make the conversation feel confrontational, and will make the person being approached feel defensive. Saying things like, “you’ve been really irresponsible lately” or “you don’t care about anything anymore” puts an accusational tone on things, so instead try to focus on how you feel. Things like,”I feel really lost because you haven’t seemed as present lately,” or “it makes me really upset to see you hurting,” tend to get a better reaction.
- Don’t assume you know what the culprit is behind this change. Sudden behavioral changes can be caused my many things, not just mental illness. Adolescents can exhibit behavior changes simply because of the period they’re experiencing in their lives, substance abuse and sexual abuse can also cause sudden changes in behavior. Even in my own life, I had someone close to me keep accusing me of having a substance abuse problem, even though I didn’t partake in drugs or alcohol at all and I had previously had two psychiatric hospitalizations. Don’t put a label on what you’re seeing, because there is a big chance you don’t know the whole story.
- Point out the behavior is unusual. Again, many people might think they’ve been able to hide what is going on, or they may not be aware that they are acting differently. Try to stay away from statements like, “you’ve been acting weird,” and say something instead like, “you’ve always seemed to be a very carefree person to me, I am just concerned because that doesn’t seem to be the case right now.”
- Ask if they’ve talked to anyone about it. Some people will open up about what is going on during this initial conversation, but many wont. Some people will be defensive about this topic no matter what route you take to talk about it, it can be a little shocking to have someone confront you about your behavior so don’t be offended if the person doesn’t want to talk about what is going on right away. Instead, make sure they know you are available and willing to talk with them if they want to. You may also want to make a gentle suggestion that they speak with their doctor about the change, as it may have medical implications.
- Make notes. If you’re having this conversation over the phone (or even in person) it is ok to make notes about what you want to say! Personally, I get nervous on the phone, and when a serious conversation like this comes up it can be helpful to have even just an outline of what you’d like to say worked out.
Sudden changes in behavior are important to recognize, and from what I understand it isn’t the behavior that should be causing worry so much as it is the sudden change. Some sudden changes, like with some symptoms of mania or hypomania, may not seem particularly negative at the time, but it is still very important to point out a sudden change in behavior since it is possibly an indicator of something larger going on. For the most part, though, people will wait to point out these changes until they see some risk involved, like potential suicide, catastrophic financial moves, or the possibility of being fired. It is incredibly important to speak up before things get really out of control, one conversation could potentially save a life.
As important as it is to speak up, it is important to be receptive. When most people see a sudden change, they might express it to you in a way that is confrontational or offensive because they don’t know any other way to bring it up. As frustrating as that is, being open to these conversations can be extremely beneficial, and I think it is important to remember that if someone bothered to say something to you about it, even if in a reckless way, I’m sure they did it because they care.