Help me set compassionate boundries during freind's hypomanic episode.
April 10, 2024 5:00 AM Subscribe
How do I engage with them while they are going through this? And do I mention anything to anyone else about it?
This is my first time encountering someone going through a hypo-manic episode (that is what it was descried to me as so apologies if that's not the preferred term). It's safe to assume I know nothing about the right things to do when answering.
Last weekend I went to visit a friend per their invitation after not seeing them in person since October. When I arrived, it was clear things were not ok with them. They were talking complete nonsense, were surprised I was there despite inviting me, and after quickly being shown the door, I left very confused.
Prior to this is they were still posting on socials- although in hindsight it's been really odd things, but this is a creative person so not totally out of character.
The short story is I had no idea anything was going on until I saw them this weekend. I was able to talk to their parents. They currently experiencing a pretty long and severe hypomanic episode. My friend is getting home care while seeing a bevy of professionals weekly if not daily, so I am not concerned on the care they are getting. It seems like a really hard time for them and their whole family.
They can't sustain a phone conversation, but have been messaging me and other friends for help finding lawyers (part of this episode seems to entail wanting to sue a lot of people who don't actually exist), buying (I found out many many things they can't afford), making plans they can't show up to, etc etc.
With no one in our social circle knowing what was going on, many of us (I included) just thought it was business as usual and here is the name of an attorney, you can buy this thing here, etc etc.... but now I understand that is feeding into the problem.
I don't want to ignore their texts. I want them to feel supported. I don't want to help them buy a $5k bag or waste a lawyer's time or make plans with them that they can't keep or won't remember.
I also realize it is no one's business what they are going through, but I am worried about the other people they are texting who are in a similar situation to me- completely in the dark and accidentally enabling destructive behaviors.
I know "sorry, I can't help you with that" is a complete reply, but what can I talk to them about without exasperating the situation? Should I be talking to them about anything? How will I know when this episode has passed and they really do want to see a movie on Friday? If you've been in a similar situation, what were things you did that were helpful?
Finally, is there anything I need to look out for that would tell me to contact their family immediately?
This is my first time encountering someone going through a hypo-manic episode (that is what it was descried to me as so apologies if that's not the preferred term). It's safe to assume I know nothing about the right things to do when answering.
Last weekend I went to visit a friend per their invitation after not seeing them in person since October. When I arrived, it was clear things were not ok with them. They were talking complete nonsense, were surprised I was there despite inviting me, and after quickly being shown the door, I left very confused.
Prior to this is they were still posting on socials- although in hindsight it's been really odd things, but this is a creative person so not totally out of character.
The short story is I had no idea anything was going on until I saw them this weekend. I was able to talk to their parents. They currently experiencing a pretty long and severe hypomanic episode. My friend is getting home care while seeing a bevy of professionals weekly if not daily, so I am not concerned on the care they are getting. It seems like a really hard time for them and their whole family.
They can't sustain a phone conversation, but have been messaging me and other friends for help finding lawyers (part of this episode seems to entail wanting to sue a lot of people who don't actually exist), buying (I found out many many things they can't afford), making plans they can't show up to, etc etc.
With no one in our social circle knowing what was going on, many of us (I included) just thought it was business as usual and here is the name of an attorney, you can buy this thing here, etc etc.... but now I understand that is feeding into the problem.
I don't want to ignore their texts. I want them to feel supported. I don't want to help them buy a $5k bag or waste a lawyer's time or make plans with them that they can't keep or won't remember.
I also realize it is no one's business what they are going through, but I am worried about the other people they are texting who are in a similar situation to me- completely in the dark and accidentally enabling destructive behaviors.
I know "sorry, I can't help you with that" is a complete reply, but what can I talk to them about without exasperating the situation? Should I be talking to them about anything? How will I know when this episode has passed and they really do want to see a movie on Friday? If you've been in a similar situation, what were things you did that were helpful?
Finally, is there anything I need to look out for that would tell me to contact their family immediately?
Ah, yeah - if you haven't been through that pattern with someone a few times it can be really hard to tease out what's hypomanic vs. more stable behavior and to tell how best to handle.
I agree that staying in touch in a fairly neutral way, not making or encouraging them to make any big commitments, is probably a good place to land. Some of the impulsive stuff burns itself out pretty quickly for many people - so if you can distract or change the topic away from that day's impulse to buy that $6k guitar (or whatever it is, in my house it was usually guitars) you can pretty handily sidestep at least that particular impulse purchase even if some other shiny thing comes along soon.
If you're up for letting your friend talk at you it's fine to let them ramble. Don't push back against any delusional stuff about people who don't exist or try to talk them out of it. You can nod along or respond to the feelings rather than the facts ("that sounds stressful/scary" is true whether the people are real or not), or again, distract and change subjects. Chances are at least some of anything you talk about now is not going to make it into your friend's long-term memory, so this isn't a time for any major conversations about the state of your friendship or anything. This is a "wait it out while the care team finds the meds/strategies to dial your friend down a little to a more stable place" time.
posted by Stacey at 5:35 AM on April 10 [3 favorites]
I agree that staying in touch in a fairly neutral way, not making or encouraging them to make any big commitments, is probably a good place to land. Some of the impulsive stuff burns itself out pretty quickly for many people - so if you can distract or change the topic away from that day's impulse to buy that $6k guitar (or whatever it is, in my house it was usually guitars) you can pretty handily sidestep at least that particular impulse purchase even if some other shiny thing comes along soon.
If you're up for letting your friend talk at you it's fine to let them ramble. Don't push back against any delusional stuff about people who don't exist or try to talk them out of it. You can nod along or respond to the feelings rather than the facts ("that sounds stressful/scary" is true whether the people are real or not), or again, distract and change subjects. Chances are at least some of anything you talk about now is not going to make it into your friend's long-term memory, so this isn't a time for any major conversations about the state of your friendship or anything. This is a "wait it out while the care team finds the meds/strategies to dial your friend down a little to a more stable place" time.
posted by Stacey at 5:35 AM on April 10 [3 favorites]
In this state of disconnect, more than likely brought on by unresolved past trauma, a currently unresolved trauma or stress (or drug/alcohol abuse) they do not see the context of their actions. They probably already feel isolated and havent been in touch with anyone stable in order to see how they appear. Do the decent thing and show them you care but reaffirm to them that they dont seem well and might need a break. People are likely pushing them away due to not knowing how to help. If you have the patience to, listen to them. If you don't give them the hard reality of your concern for their well being and then show them you mean it by giving them a referral to a licensed therapist
posted by The_imp_inimpossible at 6:06 AM on April 10 [1 favorite]
posted by The_imp_inimpossible at 6:06 AM on April 10 [1 favorite]
I also realize it is no one's business what they are going through, but I am worried about the other people they are texting who are in a similar situation to me- completely in the dark and accidentally enabling destructive behaviors.
Here is what I would do, while understanding that if it later gets me cut off for gossipping or talking shit, so be it: Reach out to the other people, and keep it vague: Hey, I talked to Z's parents because I was worried about Z, and there is some stuff going on, help is happening, and the best position for us is to distract/redirect on stuff like getting a lawyer or spending large amounts of money. Show love and stay connected, just don't help with anything that seems like a bad idea.
And actually, maybe just have another conversation with Z's parents to ask really specifically how to best be a team player with them and the rest of the care team. They may wish for redirection to be done a certain way. And they may be able to tell you exactly when to alert them to concerns, like if Z says they're about to travel somewhere.
posted by Lyn Never at 6:54 AM on April 10 [5 favorites]
Here is what I would do, while understanding that if it later gets me cut off for gossipping or talking shit, so be it: Reach out to the other people, and keep it vague: Hey, I talked to Z's parents because I was worried about Z, and there is some stuff going on, help is happening, and the best position for us is to distract/redirect on stuff like getting a lawyer or spending large amounts of money. Show love and stay connected, just don't help with anything that seems like a bad idea.
And actually, maybe just have another conversation with Z's parents to ask really specifically how to best be a team player with them and the rest of the care team. They may wish for redirection to be done a certain way. And they may be able to tell you exactly when to alert them to concerns, like if Z says they're about to travel somewhere.
posted by Lyn Never at 6:54 AM on April 10 [5 favorites]
How aware of this are they? I have lovingly said to a friend “wow, you seem really disregulated right now and it’s probably not a good time to make any major decisions. What can help you get regulated?” And then listen and spitball suggestions and model calm emotions to help the emotional contagion for whatever time I could.
posted by St. Peepsburg at 7:14 AM on April 10 [3 favorites]
posted by St. Peepsburg at 7:14 AM on April 10 [3 favorites]
In general hypomanic episodes and manic episodes come with an increased sense of well-being ( there are cases where this is not true) so in terms of talking to them simple statements like " Oh I can't talk about that right now" or "hmm I don't know much about xyz" or " can I get back to you later" are responses that should work without being too harmful or disappointing to the person.
A well timed question about about an interest may get them onto a different topic quite easily. Sometimes people can get stuck on particular topics but sometimes people in hypomanic states will jump from one thing to the next with a question or just by letting them talk. You could also talk about you a little bit, a movie you want to see, a relationship problem just anything they may be willing to chat with you about.
In general, the best thing you can do is have patience and compassion and not take anything they do personally. Lots of people with this condition come out of these states with so much regret, guilt and work to be done financially and with relationship repair. If you are able to that, they will likely be super greatful in the end.
In terms of contacting family, if they are involved in care as you say there's likely not much that you would need too say. But if your friend discloses plans to travel impulsively , any suicidal ideation you should pass that information along. Basically things that would require inpatient hospitalization imminently or remove him from his support system/ care team.
posted by AlexiaSky at 7:17 AM on April 10 [8 favorites]
A well timed question about about an interest may get them onto a different topic quite easily. Sometimes people can get stuck on particular topics but sometimes people in hypomanic states will jump from one thing to the next with a question or just by letting them talk. You could also talk about you a little bit, a movie you want to see, a relationship problem just anything they may be willing to chat with you about.
In general, the best thing you can do is have patience and compassion and not take anything they do personally. Lots of people with this condition come out of these states with so much regret, guilt and work to be done financially and with relationship repair. If you are able to that, they will likely be super greatful in the end.
In terms of contacting family, if they are involved in care as you say there's likely not much that you would need too say. But if your friend discloses plans to travel impulsively , any suicidal ideation you should pass that information along. Basically things that would require inpatient hospitalization imminently or remove him from his support system/ care team.
posted by AlexiaSky at 7:17 AM on April 10 [8 favorites]
“Mild neutral contact” as one of the other commenters put it is a good position to take. One concrete way to make that distinction for you is the one between ideation and action. This is hard to tease apart when someone is (hypo)manic, but you’ve already supplied good examples of that distinction: when your friend asks you for help to put their manic ideations into action. That’d be a good point to turn to the complete answer of “Sorry I can’t help you with that.” If you want to continue the conversation after one of these points, just change the subject to something else. And lest you’re concerned that this might discourage your friend from reaching out more…it almost certainly won’t if they’re actively (hypo)manic.
As far as when to reach out to family, I suppose it would be when you see evidence that your friend has started taking action (not just talking) to do something that could irreparably hurt themself or others, whether that’s physically or financially (e.g. spending their entire savings and/or jumping into an obvious scam, as just one example). I do caution on this point though, because this is an opening to getting pulled deeper, often inadvertently, into assuming more responsibility for their care than is reasonable for you.
posted by obliterati at 7:22 AM on April 10 [2 favorites]
As far as when to reach out to family, I suppose it would be when you see evidence that your friend has started taking action (not just talking) to do something that could irreparably hurt themself or others, whether that’s physically or financially (e.g. spending their entire savings and/or jumping into an obvious scam, as just one example). I do caution on this point though, because this is an opening to getting pulled deeper, often inadvertently, into assuming more responsibility for their care than is reasonable for you.
posted by obliterati at 7:22 AM on April 10 [2 favorites]
I've been there. Since they are already getting help, the most important thing, if you want to be helpful, is not to cause additional excitation (mild neutral contact, as others helpfully said). Even when you disagree or disapprove of their statements/actions, do not say so. Also, don't introduce novelty. Anyone who can't manage this right now is better not to interact with your friend until they are stabilized.
posted by kitcat at 1:28 PM on April 10
posted by kitcat at 1:28 PM on April 10
Yes, when I was young (like 23) my mother asked me to take my aunt (who I knew to have some mental problems) to the airport where she would be flying to Seattle (from Philadelphia) to visit an old male friend who did not know she was coming. She packed green trash bags with her clothing etc. I tipped the skycap generously and he was very helpful. I offer this as an example of the difference between ideation (her desire to visit an old friend on a whim) and putting such a really bad idea into action. Don't do what I did.
posted by forthright at 1:38 PM on April 10 [2 favorites]
posted by forthright at 1:38 PM on April 10 [2 favorites]
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My own experience is that mild neutral contact during the manic phase is about all you can do unless you are a health professional or living with them. It’s really common for bipolar people to burn through relationships during a manic phase so staying calm and gently present is a big deal.
posted by dorothyisunderwood at 5:08 AM on April 10 [12 favorites]