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Ask the Mental Health Expert Archives 2001-2004

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Bipolar Friend

Q. I am a 14-year-old girl and one of my friends is bipolar. We live at a boarding school, and I wanted to know what we could do to help her. My dad has bipolar disease but I still don't know enough about it. One of my questions is: can bipolar disorder lead to schizophrenia or paranoia? What can we do to keep her in good spirits? She is on medication and just got it increased the other day so she is depressed. What can my friends and I do to help her?

A. I think it's great that you want to do the right thing for your friend. All too often, individuals with psychiatric disorders are shunned or feared, rather than befriended. But: if your friend is severely depressed or dropping hints about "not going on with life", harming herself, etc., you should take this very seriously and immediately notify the professional staff of your boarding school. Or, better yet, if she will agree to it, accompany your friend to the school nurse or psychologist, so that he or she can take the appropriate steps, such as contacting your friend's doctor.

Bipolar disorder does not lead to schizophrenia. They are two distinct disorders. However, some people with bipolar disorder may develop paranoid beliefs (delusions) during a severe depressive or manic episode. If you want to learn more about bipolar disorder, I recommend the book Surviving Manic Depression: A Manual on Bipolar Disorder for Patients, Families, and Providers by E. Fuller Torrey and Michael B. Knable (2002).

In the mean time, keep in mind that bipolar disorder is a serious illness, and that it is not your responsibility, nor is it within your power, to keep your friend in good spirits. Bipolar Disorder has a course of its own, and unfortunately is not something that can be fixed by trying to cheer up the seriously depressed person. I'm not suggesting that's what you had in mind, but many people think that all they need to do is tell the depressed person to buck up, or invite them to a party, and that everything will be just fine.

Usually, that sort of relentless cheeriness just makes the person with serious depression feel worse. But, that doesn't mean you should do nothing. By letting your friend know you that you want to be of help, and that you are available just to listen to her, you will be helping her. By asking her how you can be helpful, you will be showing her respect, without forcing her to fake feeling good. Of course, if you can involve your friend in social or recreational activities, that may help lift her spirits some--but don't pressure her to join in the fun if it's clear she doesn't want to do so.

January 2003

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