You know that feeling when everything is going great, and suddenly you realize you’re 10 minutes late for an appointment, someone is rude to you or you drop everything you’re carrying? You know how that irritation can send you spiraling? We all experience mood swings and everyday ups and downs, but that’s not the same as a mood disorder.  

According to the Mental Health First Aid (MHFA) curriculum, mood disorders are characterized by the elevation or lowering of a person’s mood. Bipolar disorder is a common mood disorder with distinct variations. The Depression and Bipolar Support Alliance identify five types – bipolar I, bipolar II, cyclothymic disorder, bipolar not otherwise specified (NOS) and rapid cycling. Bipolar I, for example, is marked by extreme mood swings and manic episodes that last at least a week, usually followed by a depressive episode lasting at least two weeks. These symptoms are often characterized by changes in sleep, energy level and the ability to think clearly. 

Bipolar disorder is more prevalent than you may think. According to Mental Health First Aid, about 2.8% of adults in the U.S. experienced bipolar disorder in the past year, and it may account for 25% of all completed suicides.  

Only a medical or mental health professional can diagnose bipolar disorder. As a Mental Health First Aider, you do not diagnose or treat, however you can still use the MHFA Action Plan (ALGEE) to #BeTheDifference to someone who seems to be struggling. 

Assess for risk of suicide or harm. 

If someone appears to be exhibiting signs of mania or depression, approach them about your concerns. Signs of crisis include suicidal thoughts and behaviors, nonsuicidal self-injury and aggression.  

If the person says they are considering suicide, or you think they may be, it is a crisis and you should call 911. Do NOT leave them alone!  

Listen nonjudgmentally.  

If the person is not in crisis, engage them in conversation. Take the time to actively listen and understand what they’re saying.  

A few tips for listening nonjudgmentally from MHFA include:  

1. Ask open-ended questions (“How are you feeling?”) rather than leading questions (“You’re feeling sad, aren’t you?”) 
2. Do not try to finish the person’s sentences. 
3. Use short and simple statements or questions. 
4. Give the person time to think about what has been said or to express themselves. 

Give reassurance and information. 

Show your concern by offering reassuring statements like, “Thank you for sharing your experience with me. A lot of people have reported similar signs and symptoms, and they have found help from a professional.” Here are a few tips for effectively communicating during this step:  

1. Don’t tell someone to “snap out of it” or to “get over it.”  
2. Do not adopt an overinvolved or overprotective attitude.  
3. Do not use a patronizing tone of voice or a facial expression that shows an extreme look of concern.  
4. Do not ignore, disagree with or dismiss the person’s feelings by attempting to say something positive like, “You don’t seem that bad to me.” 

You can also help them get in touch with the National Suicide Prevention Lifeline (800-273-8255) and the Crisis Text Line (text “MHFA” to 741-741) for 24/7 support. For additional resources, visit the MHFA website. 

Encourage appropriate professional help. 

Many people are unaware that mental health disorders like bipolar disorder can be treated, and that recovery – a process of change through which people improve their health and well-being, live self-directed lives and strive to reach their full potential – is possible. 

Help the person connect with support for managing what they’re feeling. If the person needs professional support, find out if they’ve received treatment in the past – they may already have a care team or trusted specialist they can tap into.  

As a Mental Health First Aider, one of the most important things you can do is encourage people to use the resources they have and offer to help them in doing so. First Aiders should always encourage someone experiencing a mental health or substance use challenge to persevere in seeking help.  

IMPORTANT NOTE: Some people may not want to seek professional help due to fear of cost, stigma, not having a doctor they like and countless other reasons. Let them know that if they change their mind in the future, you are a safe person to come to and you will hold space for them. 

Encourage self-help and other support strategies. 

People with bipolar disorder can benefit from self-help as well as support from friends, family, faith communities and peer supporters (people who have also experienced bipolar disorder). Self-help or self-care can take many forms. Here are a few strategies:  

1. Talk to a doctor about recommended nutrition, exercise and sleep habits. 
2. Practice using coping skills like expressing feelings, communicating, connecting with supportive people, deep breathing and setting healthy boundaries and realistic goals. 
3. To improve coping skills, try journaling, connecting with community clubs or groups, using online support groups, developing a hobby, creating art or meditating. 

Your actions could be the first step in someone’s recovery from bipolar disorder. To learn more about the MHFA Action Plan, including how to implement it yourself, become a Mental Health First Aider. Visit MHFA.org to find a course near you. 

1. How to Create Your Own Self-Care Plan 
2. 5 Things to Know for Supporting a Loved One Living with Bipolar Disorder 
3. How to Take Care of Yourself When You’re Feeling Overwhelmed 

Sources:  

Depression and Bipolar Support Alliance. (n.d.). Bipolar Disorder. Depression and Bipolar Support Alliance. https://www.dbsalliance.org/education/bipolar-disorder/#types  

Mayo Clinic. (n.d.). Depression (major depressive disorder). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007#:~:text=Depression%20is%20a%20mood%20disorder%20that%20causes%20a,to%20a%20variety%20of%20emotional%20and%20physical%20problems 

MHFA. (2020). Mental Health First Aid USA for Adults Assisting Adults. Washington, DC: National Council for Mental Wellbeing. 

Nall, R. (2019, Nov. 1). What is mania? Healthline. https://www.healthline.com/health/mania  

Renton, C. (2022, Feb. 3). What is a manic episode? Verywell Health. https://www.verywellhealth.com/manic-episode-5214527