Butterfly emerging from a cocoon

How To Help Someone In Denial Of Mental Illness

Here is an expanded and rewritten 2400+ word blog post on helping someone with bipolar disorder who is in denial, using a friendly and conversational tone:

Helping Someone With Bipolar Disorder Who Is In Denial

Have you ever worried about a loved one who seems to be exhibiting the dramatic highs and lows of bipolar disorder but denies there is any problem? I’ve got experience being that denier AND also on your side of the situation.

It’s not uncommon for people with mental health conditions like bipolar to be in denial about their symptoms. And we’ll touch on the reasons for it just below.

In this guide, you’ll learn many practical strategies for assisting someone with bipolar disorder who is in denial. We’ll cover:

  • Key facts about bipolar disorder
  • Common reasons for denial
  • Ways to gently encourage acceptance
  • When to involve professionals
  • Frequently asked questions

As guides go, this is a fairly long one. It’s not because I have a ton of extra time, though.

It’s because relationships are both precious and fragile in this world. They’re a bedrock to someone who feels that their mental health isn’t reliable.

And solid human connections take a lot of work. Most folks would agree that it feels like more work when their loved one isn’t feeling themselves.

It’s a devastating blow to Armed with compassion, knowledge, and patience, you can make a real difference in your loved one’s wellbeing and recovery.

Key Takeaways

  • Bipolar disorder involves mood episodes of mania/hypomania and depression, causing dramatic shifts in energy, behavior, and emotions.
  • Denial and reluctance to get treatment are common due to the nature of the condition.
  • Listen without judgment, share your observations calmly, and emphasize your care for the person.
  • Suggest realistic lifestyle changes to establish stability and routine.
  • In a crisis, call emergency services or a bipolar disorder helpline.
  • With support, many people with bipolar disorder can manage their symptoms and live full lives.

Understanding Bipolar Disorder

Bipolar disorder is a mental health condition characterized by intense emotional highs (mania/hypomania) and lows (depression), with periods of stable mood in between. These mood swings are often accompanied by changes in energy, activity levels, and the ability to carry out day-to-day tasks.

Bipolar disorder causes unusual shifts in mood, energy, and activity levels that can significantly disrupt a person’s life. When someone close to you appears to have bipolar but won’t acknowledge it, you may feel helpless about how to support them.

According to the National Institute of Mental Health, the main signs of bipolar disorder are:


  • Loss of energy
  • Intense sadness
  • Difficulty concentrating
  • Withdrawing from others
  • Significant changes in sleep and appetite
  • Thoughts of death or suicide

Mania or hypomania:

  • Heightened mood and energy
  • Extreme optimism
  • Impulsiveness / Risky behavior
  • Racing thoughts
  • Little need for sleep
  • Irritability

While the exact causes are unknown, research suggests that genetics, brain structure, and stress play a role. Bipolar disorder often develops in the late teens or early adult years. Episodes of mania and depression may occur infrequently or multiple times a year.

With effective treatment, many people with bipolar disorder can manage their symptoms, achieve remission of mood episodes, and live fulfilling lives. Common treatments include medications like mood stabilizers and psychotherapy.

However, the cyclical, unpredictable nature of bipolar makes it challenging to diagnose. Denial and resistance to treatment are quite common.

Why Denial Occurs

People with bipolar disorder may be reluctant to accept their diagnosis or need for help for various understandable reasons:

  • Lack of illness awareness: During manic episodes, they may feel euphoric, energetic, and infallible. When depressed, they’re overwhelmed by sadness. These states distort their perception of being “ill.”
  • Fear of stigma: The stereotypes and misconceptions surrounding mental illness can make someone deny real symptoms to avoid feeling judged.
  • Avoiding lifestyle changes: Acknowledging bipolar means accepting the need for treatment and behavior modifications that the person may be unwilling or feel unable to make.
  • Resistance to “labels”: Some people dislike being categorized as having a mental health condition and what that implies about their character or abilities.
  • Unawareness of hypomania: Hypomanic symptoms may be perceived as high productivity rather than abnormal mood. The milder form means bipolar is missed.

Denial acts as a coping mechanism. Rather than confront painful or frightening realities, it feels safer to pretend everything is fine. As a loved one, your support can gently help break through the denial.

Encouraging Acceptance and Healing

Helping someone accept they may have bipolar disorder requires patience, compassion, and trust. Avoid escalating emotions. Instead:

  • Listen without judgment: Let them vent and be heard. Don’t lecture.
  • Communicate your care: Express genuine concern coming from a place of love.
  • Share observations calmly: Describe specific behaviors that seem unusual without blaming.
  • Suggest realistic changes: Recommend lifestyle adjustments to establish stability and routine.
  • Offer to assist with treatment: Help them find an excellent bipolar specialist, schedule appointments, and track moods.
  • Provide educational resources: Share knowledge from reputable medical sites and bipolar advocacy groups.
  • Remain consistent: Revisit your concerns if initial attempts are rejected. Follow through on promises.
  • Give it time: Coming to terms with bipolar is a gradual process. Belief may only emerge after experiencing an extreme high or low episode.
  • Look after yourself: Get support so you don’t become burned out or overwhelmed.

While not accepting a diagnosis can be frustrating, try to exercise compassion rather than criticism. Bipolar disorder genuinely alters a person’s perceptions and behaviors in ways that make objective self-assessment difficult.

Shortly after a diagnosis, that person is typically hyper-sensitive to any changes in the reaction of their closest friends and family. That’s why the following list is so important.

This is why it can be hard to help someone in denial. If you try to talk about how bad their mood is or ask if anything is making them unhappy, you could find them shutting down and refusing to reply.

Promoting Routine and Balance

Lightbulb turning on (represents gaining understanding)

Establishing a regular daily routine and work-life balance can also encourage stability for someone reluctant to get treatment. With all possible patience, suggest trying:

  • Going to bed and waking up at consistent times to regulate sleep.
  • Eating healthy meals at regular intervals to avoid energy crashes.
  • Exercising to relieve stress and boost endorphins.
  • Setting aside relaxing time for enjoyable hobbies and social activities.
  • Using calendars and reminders to stay organized.
  • Avoiding drugs and alcohol which can worsen mood swings.
  • Reducing commitments and stimulation during high-energy periods.

Of course, implementing major lifestyle changes is hard. You may have to model these behaviors yourself to avoid seeming “judgy” early on.

Offer to join them in healthy new habits to motivate and hold each other accountable. Break it down into small, gradual steps to move at the same pace.

Do not try to be the expert

We are all different, we process things differently, we have our own internal processes that we use for everything from life events to experiences, relationships, tasks and jobs, and mental health or wellness issues are no exception.

What may help someone else’s situation is totally irrelevant to you unless it works for you. You cannot assume anything about someone else’s personal process or what will help them.

This is very important to note as there are many theories about why someone might need treatment they deny exist.

Theories like externalization — blaming others instead of yourself for problems and symptoms – can make people feel even more invalidated and depressed.

If you come across a behavior or pattern that seems unhealthy, acknowledge that this does not seem healthy for you or your loved one(s). Ask how you could possibly help if the other person was unwilling to seek outside assistance before.

Look at their reactions

A lot of times, people who know someone that is in denial will try to get them to acknowledge the signs by looking at their reactions when you do not want to talk about something or are trying to avoid it.

If they notice that they become very angry or irritated quickly, sometimes they will say or do things without realizing it because of past experiences.

This could be saying or doing something that made them feel bad before so they subconsciously use that as a source for anger.

They may also show certain behaviors such as withdrawing, avoiding conversations, or being secretive. All of these can indicate if someone in your life is in denial.

There are some ways to help a person in denial come to terms with mental health issues.

One way to start is to have honest talks about how they can improve their lives.

By having those discussions, you will bring out more information than just whether or not they agree that there is a problem. You will also find out what parts of the disease affect them and why. This helps identify appropriate resources and treatments.

Help them express their feelings

When someone you love is experiencing mental health issues, it can be difficult for them to recognize what’s going on for them.

They may deny or ignore symptoms they are aware of, and even reject professional help. This can make trying to talk about your friend’s condition very challenging.

But there is something you can do that will almost always work. You can try talking to them about how they’re acting. Ask if they’ve been feeling depressed or anxious lately, if they seem distracted more than usual, if they have trouble sleeping, and if they appear to be avoiding certain people or situations.

If you’re able to get through with this test then you could potentially save your loved one’s life.

Ask how they are

There is an important first step in helping someone who has been diagnosed with mental illness, or anyone for that matter, is in denial. You have to ask them how they’re doing!

This may sound weird but it makes sense. When you’re going through something difficult like dealing with depression or anxiety, there’s a lot of talk about how people feel.

So instead of assuming what everyone must be thinking, try asking more directly how they are feeling. This can help you understand their emotions better and maybe even give them the chance to explain things to you.

If possible, learn some basic signs of emotional distress so you know when to look for these answers.

Share your experiences

Compass (represents finding direction-purpose)

As mentioned earlier, one of the biggest things that can help is having conversations about mental health with others.

This could be talking to someone who you think may need help or trying to help them find it. It could also be speaking with people who are in crisis and seeking help.

By being aware of what other’s experience and tips for coping with depression, anxiety and PTSD, you will know how to help them!

It goes without saying that everyone deals with stress and grief differently. There is no right way to process these things, so don’t try to impose yours on them.

Don’t assume anything about their situation unless they tell you – we all have secrets we keep to protect ourselves.

Be non-judgemental and acknowledge there are some days that will be harder than others. Hopefully those times get shorter as time passes.

Look for the humor

Finding the funny in things can help you deal with tough situations, which is why comedians are so valuable as people-watchers. They spend a lot of time looking at how people act and talking about it, making jokes depending on what they see.

Comedians also seem to have trained themselves to be able to recognize when someone needs help, or if someone may need help. They know how to draw out the emotions that person has buried away and look for clues such as laughter or crying.

If you’re able to spot something being mocked or laughed at, then try asking questions or giving direct comments to see if that helps them feel more comfortable. Sometimes just saying “I understand” or “It will get better soon�” is enough to make a difference.

Or you could ask whether there is somewhere they would like to go or talk about their feelings, maybe even offering to come along too.

Provide reassurance

When someone is in denial about their mental health, it can be difficult to help them see things from your perspective. This is totally normal!

Many people struggle with thoughts about their mental health for years before seeking professional help. In fact, some feel that if they talk about how bad their moods are or if they admit that something made them angry then this will make it get worse.

This isn’t true at all. Only by talking about what you’re feeling can you work through those feelings and find the solution that’s best for you.

It may also be hard to believe that there could be an underlying problem when nothing has changed about the person outside of the symptoms they’re experiencing.

If a friend or family member seems less friendly than usual, changes in their behavior that were previously present, and they seem to be putting more effort into avoiding you than engaging, then chances are they’ve noticed something was wrong.

You might want to speak to them, but making a conversation might not go so well. They might deny any problems or say only hurtful things.

In these cases, trying to understand where they’re coming from can be very challenging. It takes time and energy to do this, which can sometimes put pressure on relationships.

That’s why it’s important to let yourself walk away. You’ll have more success helping them later if you don’t hang around too long.

Draw parallels from fictional portrayals

Considering fictional representations of characters with bipolar disorder can further humanize the real-life struggles of those coping with this challenging condition.

For example, Carrie Mathison, the brilliant but volatile CIA agent in the TV thriller Homeland, fully captures the highs and lows of bipolar. Viewers witness her frenetic energy, risky behaviors, paranoia, and crashes into suicidal depression.

In the novel The Marriage Plot, one main character grapples with the disorienting experience of developing bipolar disorder as a young adult. He oscillates between exhilarating highs and immobilizing lows.

While exaggerated for drama at times, these and other fictional depictions provide windows into the subjective experience of bipolar that build empathy for the real individuals managing this disorder.

These fictional personalities and situations are perfect fodder for non-threatening conversations. If you see an opportunity to weave those examples into interactions, please do!

Wrapping Things Up

Over time, noticing improvements from a more consistent routine and self-care may inspire someone to acknowledge their condition. But denial can be difficult to overcome, and acute symptoms may require emergency intervention.

Getting Urgent Help

While you want to be sensitive to their feelings, don’t ignore alarming symptoms that require immediate attention. Of course, you may need to spend more time around this person before understanding what constitutes “alarming” behavior.

But there are some pretty clear lines that shouldn’t be croosed without some response. Call emergency services or a bipolar helpline if you witness:

  • Suicidal statements: Expressing a desire or plan to commit suicide requires emergency evaluation.
  • Extreme mania: Highly impulsive, risky behavior or severe loss of touch with reality needs swift intervention.
  • Psychosis: Delusions, hallucinations, and extremely disorganized speech indicate a full manic or mixed episode.
  • Catatonia: Physical immobility, mutism, staring, and other features of catatonic depression are medical emergencies.
  • Self-harm: Cutting, burning, head banging, and other forms of self-injury should be addressed promptly.
  • Medication refusal: Stopping mood-stabilizing drugs can trigger relapse. Seek help getting back on track.

While involuntary commitment against someone’s will is a last resort, safety must be the priority in acute bipolar crises. With compassionate support, many individuals come to appreciate help received during severe episodes.

Frequently Asked Questions

If you’re supporting someone with bipolar disorder who is in denial, you likely have many questions. Here are some common concerns:

Frame things in terms of caring and wanting to understand. Say you’ve noticed some behaviors that don’t seem like their usual self and you want to help, not judge. A letter may feel less confrontational.

It’s okay to disengage and try again later when emotions have cooled down. Their reaction likely stems from feeling overwhelmed or afraid. Stay calm and don’t take it personally.

While medication makes symptom management easier for most, some prefer to rely solely on therapy and lifestyle strategies. This can work, but close monitoring for warning signs is essential.

Joining a local support group through the Depression and Bipolar Support Alliance can connect you with others who understand. Therapists can also help you handle the stress and provide tips.

Yes, with support and education, many people move from denial to acceptance over time as episodes prove the need for intervention. Keeping lines of communication open is key.

Armed with knowledge, resources, and emotional support, you are empowered to lovingly assist your friend or family member on the path to wellness. With your help, overcoming denial is possible.

Remember, you cannot make someone accept a condition they are not ready to confront. But knowing you care will help them through it when they are ready can make all the difference. With patience and compassion, recovery is possible.