Today I’m writing about how to talk to somebody who’s in denial with their bipolar disorder. And the reason I know that this happens a lot is that fifty percent (50%) of the people with bipolar disorder actually can’t recognize that they have the illness (and I’ll tell you why in a minute) so of course they will be perceived as being in denial. So I’m going to write about something different then denial. I’m going to actually write about having a clinical lack of insight to the illness. And what lack of insight means is that for half of the people with bipolar disorder, they medically cannot know they have this illness. It sounds odd right, like, Bob ‘what are you talking about?’ And I’m like, I know, I know until I understood this; I thought it was denial too. So just bear with me for a second. There’s another symptom that this 50% of those with bipolar have and it is called anosognosia.
Anosognosia means a lack of insight. And I’ll give you an example of this. Stroke patients that have a part of their prefrontal lobe damaged by the stroke, develop this symptom and they can’t know that they’ve had a stroke. They literally medically, intellectually, physically cannot know. There have been thousands of documented cases on stroke victims where they’re paralyzed and don’t realize it.
And, and you would think that over time, that person would understand that they can’t lift their left arm, but they won’t. Anosognosia is a lifetime symptom, so they will never have the ability to be aware of their illness, of their symptom. The same holds true for half the people with schizophrenia. People have anosognosia as another symptom to their illness. And that means that they cannot recognize that they have bipolar disorder. We, we see it as they’re in denial because they don’t accept the fact that they have bipolar disorder. But the problem is the illness doesn’t let them know that. So what do we do? How do we help somebody like that? Well telling them that they need to be on their bipolar meds isn’t going to work for most of them because they don’t think they have bipolar disorder.
And if I didn’t think I had bipolar disorder and somebody was telling me to take a handful of psychotropic drugs every day, that is going to give me side effects, I would tell them to get lost. And that’s probably what’s happening in your conversations with your friend or loved one, your ill loved one, they can’t recognize they have the illness. So the way I try to approach to help them is I tell them about my story. My story is basically I take the meds because I get to see my children as long as I take them. Meaning that my behavior is well enough that my children want to be around me when I’m on my meds. So I no longer think of taking bipolar meds. I think it taking my child med, my “to see my child meds” and that’s the whole reason I take them.
Even if I got better, even if I felt like I got cured from bipolar, I would not stop taking my meds because I still want to see my children. So they’re my “see my children meds”. And the secret is, is to find with your loved one what it is that they can’t seem to get in life that is missing that they ought to be able to get. In a lot of cases, like for me it was, I couldn’t get to be with my children. It’s a really big deal. And with other cases it might be that they can’t get to be with their, um, their loved ones where they can’t keep a relationship or they might not be able to keep a job. And because of that they find themselves desperate for something to help them with, but they don’t understand what it is that they need.
And so I would ask them, is there anything that you just see, can’t seem to get that you really, really want in life. And if there is something, if they say, well, you know what, I just can’t seem to hold a job. You don’t want to say, well it’s because you have bipolar. You don’t want to do that because why? They don’t think they do because they can’t know that they do. So you could just say, Hey, I saw this Facebook live guy and he, a story about how he wasn’t able to get something he really wanted and that was time with his children and that the doctor suggested he might have bipolar disorder or that he did. And instead of him taking the drugs because he has bipolar disorder, he found he tried an experiment and he took the meds and over time by taking the meds he was able to get see his children.
So he links his meds to getting to see his children. Now what or your friend or loved one might want to do is to try and experiment with the meds to see if that helps him or her get the things that they just can’t seem to get in life. Maybe that’s the job. Maybe it’s a relationship. Maybe it’s holding onto their money. It. The important part about all of this is that it has to come from them. It has to be their reason, the thing that they’re trying to get. It can’t be your reason. It can’t be my reason. It can’t be our reason. We know we want to tell them you need to be on your bipolar meds cause you got bipolar. We know we want to say that, but that’s not going to resonate with them. And if they’re, if they’re taking them for your reasons, they’re not going to stay on them very long.
But if you’re taking it for their reason like I do, they’ll stay on them for an indefinite period of time for as long as they want to have that job or for as long as they want to have a good relationship with a significant other or for as long as they want to hold onto their money or whatever it might be. So that’s how you can talk to somebody with what we called denial. Just keep in mind that the illness, the illness prevents them from knowing they have an illness. That’s how brutal this illness of bipolar disorder is. It teaches us that we’re not ill. It teaches us to get off our meds. It isn’t happy with us ever being happy. It wants to destroy our lives over and over and over and over and over again. So keep that in mind. And next time you’re having a conversation with your bipolar friend or loved one, see if you can reach out and find a thing that they need that they try to get that they can’t get and see if you can help them with some of the tips that I just shared with you today.