1. Pray for courage and compassion - if your loved one has Bipolar Disorder you will be hurt in some way, perhaps not physically, but certainly emotionally. This is inevitable and unavoidable. You have to consciously decide to how you are going to respond when this happens. Try not to take it personally.

2. Educate yourself. The more we understand about the condition, the more appropriate our responses will be. As someone once said, "Awareness leads to control."

3. Avoid the temptation to dismiss the symptoms by mislabeling them as character flaws. Bipolar Disorder is a physical illness which affects the behavior. It is known to have an inheritable biological component as well as an environmental component. Someday it may be as well understood and treatable as a paper cut, but for now any easy answers are beyond the reach of science.

4. Skipping a few hours of sleep here and there may be trivial for many people, but for those affected by Bipolar Disorder it can easily trigger the episodes which can cause so much pain and suffering. You must decide if you are willing to do whatever it takes to provide an environment where your loved one can sleep well and regularly.

   • Maintain a stable sleep pattern.

   • Maintain a regular pattern of activity.

   • Avoid alcohol or illicit drugs.

   • Try to eliminate causes of stress.

5. Be financially responsible. The classic symptoms of Bipolar Disorder include "spending sprees" and "unrealistic beliefs in one's abilities and powers." The ultimate consequences of financial excesses will only create more stress, lead to more episodes, depression and possibly even suicide.

6. You cannot take care of anyone if you don't take care of yourself first. If you have ever traveled by air, you've been told "Put your own oxygen mask on first before assisting the person next to you." The reason is simple - a lack of oxygen might debilitate you before you can succeed at getting the mask on the person next to you - then both of you are lost.

Red Flags

1. Make note of change in sleeping patterns, especially if your loved one has lots of energy on just a few hours of sleep.
2. Is she restlessly searching for ways to work off extra energy? Washing the car every day? Make note of this.
3. Be alert to increased talkativeness. If her mouth runneth over, this could be another symptom, especially if the talk seems pressured.
4. Be aware if your loved one starts making "clang" associations - such as going on about microphones, xylophones and bites o' cones.
5. If your spouse/partner is suddenly more sexually demanding, enjoy it - but it could be a symptom.
6. Check your phone bill for calls to 900 sex numbers. This, unfortunately, is another symptom of bipolar hypersexuality.
7. Study your credit card bills diligently! Mania can cause disastrous spending sprees. Consider taking the cards and checkbook away.
8. Notice if he complains that his thoughts are racing uncontrollably.
9. Be on the alert if she starts having delusions of grandeur - for example, making exaggerated plans like "I'm going to quit my job and write a novel" or "Let's move to Yemen this weekend!"
10. Watch out for unreasonable irritability and/or hostility. This is not just a symptom - it can be dangerous. Be cautious!
11. Increased religious zeal or involvement can be another sign of mania. Make note of this if you see it.
12. If she describes auditory or visual hallucinations or shows paranoid behavior, contact her psychiatrist immediately. These are serious symptoms.
13. During a manic episode, a person is likely to wear brightly colored or flamboyant clothing. Note this if it occurs with other symptoms.
14. If manic symptoms occur following a change in medications, contact the prescribing

Black Flags

1. If you start having trouble getting to sleep or staying asleep, keep a record and watch for other symptoms.
2. Be on the alert if your wife starts sleeping excessively. Seriously depressed persons can sleep as much as 20 hours a day in some cases.
3. Be concerned if your husband begins cancelling social engagements and staring at television programs he otherwise wouldn't watch.
4. Notice if mail - even bills - is piling up unopened, or other common tasks such as laundry, taking out garbage, etc., are not being done.
5. Marked change in appetite (increase or decrease), or significant weight gain or loss, can signify many conditions, including depression; consider it in light of other depressive symptoms.
6. Keep track of episodes of unexplained and uncontrolled crying.
7. Document feelings of sadness, guilt, worthlessness or despair that last most or all day for several days.
8. Be alert if you or your loved one exhibits signs of unusual worry, anger, negativity, helplessness or hopelessness.
9. Pay attention if you or a loved one begins to have difficulty making even simple decisions. This is a very common warning sign of depression.
10. Be sensitive to behavioral changes such as disorganization, inability to concentrate, or indifference to everyday necessary tasks.
11. Notice if actions and thoughts seem to be slowing down (psychomotor retardation) or speeding up jerkily (psychomotor agitation).
12. Watch your loved one for physical signs of depression such as slumped posture, frowning, decreased eye contact, frequent sighing, inattentive speech, or decreased sexual desires.
13. Contact the doctor quickly if you experience, or your loved one reports, recurrent thoughts of death and suicide.
14. If depressive symptoms appear after a change in medication, contact the prescribing doctor promptly.