I was diagnosed with bipolar disorder as an adolescent. I came to faith in Christ soon after. Though I find my primary identity in him, I have struggled—like many believers with bipolar—with fear and shame in the church. Some well-meaning brothers and sisters have offered unhelpful advice like “just cheer up” or “have more faith” or “pray about it more.”
I love my church. Its members are my family. But many churches have historically treated mental illness as taboo or even at odds with Christian doctrine. In recent years, it seems, more churches are becoming open to mental-illness diagnoses. Brothers and sisters have been reaching out to me for advice about caring for people with bipolar.
It’s difficult to know how to help or respond when you learn someone in your church family is suffering from bipolar, but a good place to start is striving to understand the struggle. Here are four things to know as you walk beside your brother or sister.
1. Bipolar disorder exists on a spectrum and has multiple states.
Bipolar disorder is characterized by an imbalance of the neurotransmitters serotonin, dopamine, norepinephrine, glucamate, and acetylcholine. Like other illnesses, it exists on a spectrum, with different categories of the disorder involving episodes of mania and depression to varying degrees.
During mania, we have high energy, are more talkative than usual, make a lot of plans, and don’t require as much sleep. We can be irritable, irrational, obsessive, impulsive, and may experience hallucinations. This stage is usually not suicidal. I enjoy hypomania because I’m very productive.
The depressed state produces lethargy and isolation. We barely have energy to get out of bed, and basic chores become very difficult. We don’t want to make any plans. We long for sleep, which only makes us more tired. Feelings of worthlessness and suicidal thoughts run rampant in this state.
The most dangerous state is mixed, when the mind is hypomanic but the body is depressed. Our brains are going nonstop, making plans that we have no energy or will to carry out. We become very irritable, irrational, easily upset, and take things more personally. We want to sleep but can’t. This state produces the most suicidal thoughts, which are harder to combat.
2. Our struggles are not always a sin issue (but they can be).
Highs and lows occur naturally and often spontaneously for people with bipolar. Episodes of mania and depression may occur without identifiable triggers. Friends will ask, “What’s wrong?” or “What happened?” Sometimes nothing happened. Human bodies have not functioned as originally designed since sin entered the world, and chemical imbalances in the brain are a reality of this fallen state.
Human bodies have not functioned as originally designed since sin entered the world, and chemical imbalances in the brain are a reality of this fallen state.
But sometimes there are identifiable triggers, and sin can be one of them. That sin may have been committed against us, or it may be our sinful patterns. Mania in particular can involve spiraling into sinful behaviors related to impulsivity, increased sex drive, tendency toward substance or alcohol abuse, inflated sense of self-importance, and reckless spending. Many times I don’t remember exactly what happens in extreme states—only that I did something I regret.
Depression often involves feelings of hopelessness and worthlessness that can lead to sloth and despair. I know that I am loved, that I have hope in Christ, and that I have value as an image-bearer of God—but I don’t feel it. My head and heart are at a disconnect.
Tenderly encourage us to examine our hearts for the root cause of an episode. We still need accountability, and bipolar is not an excuse for any sin.
3. You don’t have to be an expert to love us.
We value your friendship and your presence. And we know it’s not easy to be our friend. Bipolar disorder manifests differently for everyone, so there’s not a formula to follow. If a person has disclosed this diagnosis to you, she believes you to be trustworthy. Feel free to ask questions about her specific experience, triggers, and ways to support her. She may not want to talk in the midst of an episode, but when she is ready, listen. Try to come up with a strategy during stable times.
Checking in regularly is a practical way to help. We may or may not want to be alone during episodes. We might be more irritable and decide to isolate ourselves for fear of lashing out at others. Continue to include us in plans, even if we keep turning you down or flaking out.
Be discerning and not alarmist if we mention suicidal thoughts. We’ve likely had them before and will probably have them again. It’s good to ask if we’ve made any plans. The expected answer is no. An answer of yes should prompt a referral for professional help.
Avoid asking, “Are you ok?” or “Did you take your meds?” You may mean well, but we tend to take offense at these questions. Instead, sending specific affirmation is a great encouragement. I save texts, handwritten notes, and voicemails to return to in difficult times. And the best thing you can do is intercede for us in prayer.
4. Bipolar disorder is something we have, not who we are.
We are all broken in some way. God has given each of us weaknesses and struggles that he will use for his purposes. For some of us, bipolar describes our struggle—but it doesn’t define our identity. Christ meets us where we are and offers us his wholeness.
Despite the different versions of ourselves that may be manifest through bipolar, we are most truly defined by our union with Christ.
Despite the different versions of ourselves that may be manifest through bipolar, we are most truly defined by our union with Christ. In him we are loved, forgiven, chosen, and set apart as God’s special possession.
God’s love and his Spirit empower us to grow in Christlikeness and to be renewed and restored in order to love others and make his name great among the nations. God’s power is made perfect in our weakness. So I, like Paul, will boast even more of my weaknesses to make much of God (2 Cor. 12:9). Truly, “The LORD is my strength and my shield; in him my heart trusts, and I am helped; my heart exults, and with my song I give thanks to him” (Ps. 28:7).
The Gospel Coalition