Understanding Bipolar Disorder

You can help someone survive the fears and extremes of manic-depression.

by Nancy Hagerman

Christy (not her real name) wept as we spoke on the phone. She is bipolar and deeply depressed. “I feel nothing. I can’t worship, and I know Jesus doesn’t love me anymore. At prayer meeting they told me if I had enough faith, Jesus wouldn’t let me feel like this. My pastor said it was a sin to be so sad and that I needed to straighten myself out if I didn’t want to go to hell.”

These well-meaning “friends” were not friends at all. They abandoned a wounded soldier on the battlefield, but only after pouring salt in her wounds. Like many people, they didn’t know that according to the National Institute of Mental Health (NIMH), approximately two million adults – one percent of the population 18 and over – is afflicted with bipolar disorder. This illness has nothing to do with how much faith one has, nor is it a sin deserving of punishment. And treating it isn’t as simple as the victim straightening herself out. It takes time and patience, mixed with an accurate understanding of the subject.

Depression and mania

Bipolar disorder, commonly called manic-depression, is characterized by alternating periods of depression and mania. Though the cause of the disorder is not completely understood, episodes are often triggered by stress. Evidence suggests that manic-depressive disorder is biological, caused by a chemical imbalance in the brain. Many believe it is inherited.

Depression and mania vary in both severity and cycle length. (A cycle is the time it takes to go from depression to mania and back again. This can occur within a few hours, days, or in some cases, years.) During periods of depression, victims are overcome with feelings of hopelessness. They find it difficult to get out of bed and may become suicidal. They lose energy and experience persistent lethargy and significant changes in appetite and sleep patterns. They feel worthless and struggle to concentrate. Some carry on with regular activities, but inside they are full of numbing misery and cannot enjoy life. Others isolate themselves and remain in bed, not even attempting to go to work.

Mania, on the other hand, often begins unexpectedly. Victims may have boundless energy, restlessness, and a high level of activity. They don’t need much sleep. Their speech and thoughts race, and they have an inflated sense of self-importance. Some who suffer from manic-depression become unreasonably hostile, irritable, and agitated, while others experience delusions, paranoia, feelings of invincibility, and hallucinations.

In other words

Sufferers of bipolar disorder often try to describe their moods so others can understand. Psychcentral.com shares some insights into the feelings of depression and mania patients.

Depression: I doubt completely my ability to do anything well. It seems as though my mind has slowed down and burned out to the point of being virtually useless. . . . [I am] haunt[ed] . . . with the total, desperate hopelessness of it all . . . Others say, “It’s only temporary, it will pass, you will get over it,” but of course they haven’t any idea of how I feel, although they are certain they do. If I can’t feel, move, think, or care, then what on earth is the point?

Mania: The fast ideas become too fast and there are far too many . . . overwhelming confusion replaces clarity . . . you stop keeping up with it — memory goes. Infectious humor ceases to amuse. Your friends become frightened . . . everything is now against the grain . . . you are irritable, angry, frightened, uncontrollable, and trapped.

Bipolar myths

Myths about bipolar disorder are widespread. “Helpful” friends, like Christy’s, who act on their misconceptions only make things worse. Understanding the nature of the illness is the first step in becoming a supportive ally.

Results from a bipolar awareness survey, completed in September 2005 by the National Alliance on Mental Illness (NAMI), reveal some of the misperceptions about bipolar disorder:

  • Approximately one in five (17 percent) respondents believes that people with bipolar disorder can control their illness without medication if they really want to.
  • Only 40 percent of U.S. adults feel people with bipolar disorder have difficulty discussing their condition with others. However, an overwhelming 79 percent of bipolar people say this is because they fear repercussions if they discuss their condition.
  • A majority of U.S. adults fail to recognize most of the classic symptoms of bipolar disorder. Sixty-four percent of survey respondents see rapid, unpredictable emotional changes as a symptom of bipolar disorder, but less than half of respondents recognize other symptoms. Twenty-five percent of the general adult public admit they are not sure of the symptoms of bipolar disorder.


Those with bipolar disorder need support, not condemnation. If someone you know is bipolar, the Depression and Bipolar Support Alliance (DBSA) offers suggestions on how you can offer encouragement.

Educate yourself about the disorder. Recognize symptoms and encourage the individual to seek help before those symptoms become too severe. You might offer to go with your friend to the doctor for moral support.

Listen and offer emotional support. You do not need to supply answers to all questions, but show love and acceptance. A hug can speak volumes. Do not argue but point out that feelings are never reliable, especially at a time like this. Encourage the person to seek the Bible for the truth about how precious she is to God, and share verses with her. The Psalms are helpful.

Call the person’s doctor if you sense a severe episode is coming and feel your friend is a danger to herself or others. Always take a suicide threat seriously. Insist the person talk to her doctor, and call 911 if you think the danger is immediate.

Above all, pray with and for the person. Only Jesus can truly reach into her torment and bring genuine healing.

A place of rest

People like Christy need to be told that it’s OK to doubt God as they go through the darkness of bipolar disorder. We must assure them that God will never abandon them and that Jesus doesn’t expect them to straighten out on their own. That’s His job. He said:

Come to me, all you who are weary and burdened, and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy and my burden is light (Matthew 11:28-30, NIV).

On the other side of the shadow — and there really is another side — bipolar sufferers will know God much better. Their lives will be richer, deeper, and filled with joy, and the peace of God will reign in their hearts.