What are the symptoms of bipolar disorder? How do you tell someone you want them to try to get help without them telling you off and never speaking to you again?

M.C.

There are two questions contained in your inquiry: a basic question about the symptoms of a particular condition (in this case, bipolar disorder, formerly known as manic depression), and a query about how to encourage someone to get help. Your combining both these questions leads me to suspect you think a friend or relative has bipolar disorder (rather than your musing over the possibility for yourself) and would like him or her to get treatment.

If that's the case, I must say that I'm not sure it's wise for someone without specialized training in psychological assessment and diagnosis to try to diagnose a friend, relative, or acquaintance. (It may not be a good idea for licensed professionals to try to diagnose someone they have a personal relationship with, either, for that matter.) Even trained professionals can be wrong about diagnoses, particularly when they make them after limited contact with a patient or without being told all the pertinent facts. However, it's possible to encourage people to get help without trying to convince them they have a specific condition.

One could, for instance, mention the problems and/or symptoms the person appears to be having, and how those behaviors seem to be affecting the individual and others -- for instance, problems on the job, or interpersonal difficulties, or the effect erratic or abusive behavior might have on the person's young children. Or one might share the observation that the person appears to be miserable (if that's true). Then, one could mention that help is available and encourage the person to seek it.

In whatever situation you might be contemplating, for instance, you could suggest the other person consult with a licensed mental health professional, such as a clinical psychologist, for more input into the possible nature of their problems and the options available. If you have ever had professional counseling or psychotherapy and found it beneficial, it might also help to mention your experiences as a way of letting the other person know you don't consider seeking help to be a sign of weakness or stigma (as, unfortunately, some people still do), but an indication of strength and willingness to use appropriate resources.

If psychiatric medication (such as a mood stabilizer, often prescribed for people with bipolar disorder) might help, the psychologist can make a referral to a psychiatrist (a medical doctor with specialized mental health training) or another professional who could prescribe and monitor the medication. The psychologist or therapist can also recommend the person undergo a complete medical examination to rule out any possible medical illnesses that could produce symptoms mimicking psychiatric conditions. But I'd recommend the individual continue seeing a therapist even if he or she goes on medication, as psychotherapy can help the person identify and address the psychological factors (such as stressors) that can exacerbate even conditions with a strong biological or physical basis.

Once you have privately made these suggestions to the person you have in mind, it's up to him or her to follow through or not. Unless a person is in immediate danger of seriously harming him or herself or others, the person can't legally be forced into treatment. If the person refuses to seek help but continues to exhibit behavior that disrupts your life (or your children's, if, for instance, you're talking about a spouse), it may benefit you to consult with a therapist or counselor on your own for support and guidance on setting and maintaining appropriate boundaries with the other person.