Seeking input from people who experience mania/paranoia
January 28, 2020 11:45 PM Subscribe
A person I care about has been diagnosed as bipolar with manic episodes that manifest in paranoia and conspiracy theories. I’m looking for input from people who experience similar things about how to communicate with this person in a way that’s effective and respectful.
First off, I have my own therapist I have talked this through with and I understand what best practices are from the clinical point of view. As one of the people in this person’s life that they trust right now, my approach has been to spend low-key time with them, try to support and reassure them, and generally try to avoid the topics they are agitated about.
Some things they believe happened are things there would be a journalistic or legal record of if they were true. Other things could be differing memories of the same events. Still others are legitimate grievances this person has that seem to have taken on much greater significance for them now than they had expressed about the same events previously.
In general, I treat any discrepancies between their claims and my understanding of events as differences in memory. I reassure them that I believe them even if we remember things differently from each other. Where I’m running into issues is sometimes this feels patronizing, like I’m placating this version of the person until the “real” one comes back. I know it’s useless to fight with them over these things but it can feel like I’m being disrespectful by not engaging with these things that are very upsetting to them right now.
What I would like some input on is making sure I’m doing this in a way that will still feel respectful from their perspective when their brain chemistry changes. For people who have experienced mania and/or paranoia: are there specific approaches from other people that you found either more or less respectful once you were out of that specific period?
First off, I have my own therapist I have talked this through with and I understand what best practices are from the clinical point of view. As one of the people in this person’s life that they trust right now, my approach has been to spend low-key time with them, try to support and reassure them, and generally try to avoid the topics they are agitated about.
Some things they believe happened are things there would be a journalistic or legal record of if they were true. Other things could be differing memories of the same events. Still others are legitimate grievances this person has that seem to have taken on much greater significance for them now than they had expressed about the same events previously.
In general, I treat any discrepancies between their claims and my understanding of events as differences in memory. I reassure them that I believe them even if we remember things differently from each other. Where I’m running into issues is sometimes this feels patronizing, like I’m placating this version of the person until the “real” one comes back. I know it’s useless to fight with them over these things but it can feel like I’m being disrespectful by not engaging with these things that are very upsetting to them right now.
What I would like some input on is making sure I’m doing this in a way that will still feel respectful from their perspective when their brain chemistry changes. For people who have experienced mania and/or paranoia: are there specific approaches from other people that you found either more or less respectful once you were out of that specific period?
I have been in your shoes on a number of occasions. My experience is that the person who was experiencing the paranoid thinking was never particularly eager to engage with what their delusions had been or any of the specifics of what had happened when they were paranoid. They certainly never expressed that they felt I had not done enough to engage with or validate their delusions.
The fact that you are there, being supportive, doing your best to help, is the most important thing. I think that when they are in a better mental state that is what they will see and remember.
posted by Lazlo Hollyfeld at 7:27 AM on January 29, 2020 [2 favorites]
The fact that you are there, being supportive, doing your best to help, is the most important thing. I think that when they are in a better mental state that is what they will see and remember.
posted by Lazlo Hollyfeld at 7:27 AM on January 29, 2020 [2 favorites]
Defying the Verdict by Charita Cole Brown and A Beautiful Mind by Sylvia Nasar are two excellent and accessible books that detail personal and relationship circle challenges and trauma with mania and paranoia.
posted by parmanparman at 10:44 AM on January 29, 2020 [1 favorite]
posted by parmanparman at 10:44 AM on January 29, 2020 [1 favorite]
I have paranoid manic episodes, but only 1-2 a year. I am much more likely to be depressed. That being said when I am manic I need people to ask me questions that propel me out of my delusions. “Why do you think there’s someone in the house with you?” “Would you like me to go with you to check?” That sort of thing, but low key, gentle. This works for me even though it is sort of patronizing. My therapist has me write down my disordered thoughts in a notebook. This also helps me put everything in perspective. I think the key thing is that I know I’m having an episode and I want to fix it. I know I can’t better until I go through the steps, which starts with my meds and leads through my family and friends supporting me until I swing back.
Feel free to memail for more info.
posted by Biblio at 6:18 PM on January 29, 2020 [1 favorite]
Feel free to memail for more info.
posted by Biblio at 6:18 PM on January 29, 2020 [1 favorite]
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posted by misanthropicsarah at 6:44 AM on January 29, 2020 [1 favorite]