Does your friend live with bipolar disorder? Do you know how to help? We wrote HIGH TIDE, LOW TIDE: The Caring Friend’s Guide to Bipolar Disorder for you both.
Our first book was published in September 2013, but Fran and I have always celebrated the anniversaries of our launch party rather than the publication date. On that basis, October 1, 2026 is our book’s tenth birthday. My first thought on realising this was “Wow!” closely followed by “How on earth did that happen?” I wasn’t sure how to mark the occasion. I’d left it a bit late to organise anything major. A reprise of our 2013 launch party — held simultaneously online and in person at Fran’s apartment in Maine — was too daunting to countenance. A conversation with our friend Aimee who blogs at I’m NOT Disordered helped enormously. “Could you do ten things you learned from writing the book?” she asked. “Ten reasons to buy it? Ten things someone could learn from it?” Her third suggestion really appealed to me. (Thanks, Aimee!) So, without further ado, here are ten things you’ll learn from reading High Tide, Low Tide: The Caring Friend’s Guide to Bipolar Disorder.
1. Yes, You Can Be Friends!
One of the reasons we wrote the book was to demonstrate that people living with bipolar can have deep, meaningful, and mutually supportive relationships. This is important because the main aspects of bipolar — mania and depression — can and do have an impact on friendships and other relationships. Those impacts aren’t all negative but they are real and it would be wrong to downplay or ignore them. When our book was first published Fran and I had been best friends for five years. We celebrated fifteen years as friends in May of this year. We are living proof that mental health in general, and bipolar in particular, needn’t be a barrier to long-term relationships of all kinds.
2. Bipolar Disorder Affects Everyone Differently
There are several types of bipolar disorder, distinguished by the nature and severity of the person’s symptoms. Beyond that, however, different people will be affected differently, even if they share the same diagnosis. Your friend is an individual and their experience of bipolar is unique to them. This is an important point because no single approach is going to work for everyone. We share things that work for us. Many of these will be applicable to you and your friend. This isn’t a prescriptive list, however. Rather, we offer our suggestions as a kind of menu from which you might select this one or that one to try. Over time, you will figure out what works best for you and your friend.
3. Listening Is a Core Skill
Fran and I have met once in person. One day in fifteen years. Our friendship grew and continues to grow through e-mails, chat conversations, voice and video calls. No matter the channel, communication is a give and take. Speaking and listening. Of the two, listening is arguably the more important. Being able to hold space for someone without constantly interrupting, judging them, or leaping in with suggestions, isn’t easy. We naturally want to fix what’s wrong when someone we care about is struggling or in a difficult situation. Listening can be one of the most valuable forms of support you can offer your friend. It’s foundational to our mutually supportive friendship.
4. You Don’t (Necessarily) Know Best
We hope that our book will help you understand more about bipolar disorder and how to support someone who lives with that diagnosis. We encourage you to learn as much as you can about your friend’s condition. In some respects I know more about bipolar than Fran does. However, she knows far more about how it affects her than I do or ever could. Likewise, your friend is the expert on being them, and handling the realities of their life. Being a supportive friend involves offering such help as your friend needs and wants, whilst respecting their boundaries, independence, and decisions.
5. Keep the Channels Open
Your friend won’t always want to talk to you. You won’t always want to talk to them. Things happen. Life gets busy and even the closest friendship needs space sometimes. As a minimum, keep the channels of communication open and maintain a heartbeat of connection. How that looks will depend on your friendship. It’s very rare that Fran and I don’t connect in some way at least once a day. Checking in helps us understand what’s going on in each other’s lives and means we can pick up on changes and spot when difficulties arise. As we like to say, vigilance is a team sport. That said, we recognise this might not work for everyone. Supportive disengagement (being there for your friend when they need space) isn’t explicitly covered in our book, but is something I’ve learned over the years with other friends.
6. Being There at High Tide and Low Tide
Our book’s title reflects the periodic up and down reality of bipolar disorder, with the high tide of mania and the low tide of depression. When Fran and I met she was in a prolonged episode of mania. The person I first got to know was vibrant, outgoing, excited, and exciting. Six months later she was in the deepest depression I’d ever witnessed. She warned her friends in advance that it wouldn’t be pretty, and it wasn’t. Learning to be the friend she needed me to be in the depths of depression as well as the high times of mania took time and I didn’t always get things right. We share what we learned, in the hope it will help others going through similar situations. If your friend lives with bipolar disorder they will experience both mania and depression. As their friend you get to be there too.
7. Suicide Is Serious But You Don’t Have to Be Scared
Not everyone who lives with bipolar will have suicidal thoughts, but it’s something that many people live with, whether they have a mental health diagnosis or not. People you know — your friends and family, colleagues, and acquaintances — live with suicidal thinking. That may be a disquieting thought, but it’s true nonetheless. Fran has never attempted to take her life but she has lived with suicidal thoughts for as long as she can remember. We both take it seriously, but taking it seriously doesn’t mean we’re afraid to talk about it. Quite the contrary. Fran feels safe sharing such thinking with me as and when it comes up. We devote an entire chapter to supporting your friend when they’re feeling suicidal because it’s a topic that’s subject to a great deal of misinformation, stigma, and discrimination.
8. Your Friend Is Much More Than Their Diagnosis
Our book is about being friends with someone who lives with mental illness. It’s right there in the title. Fran will never lose her bipolar diagnosis. It’s a life-long condition, as are her parallel diagnoses of chronic fatigue syndrome (ME/CFS) and fibromyalgia. These conditions affect her life in varying ways and to varying extents. However, they do not define who she is. She’s more than her diagnoses and the same is true of your friend. I am neither Fran’s therapist nor her clinician. I am her friend, as she is mine. We have issues and problems as any friends do, but our friendship is rich and deep. It has stood the test of time precisely because it’s not founded on Fran’s illness but on our commitment to one another.
9. Remember to Look After Yourself
When you read our book you’ll be under no illusions that it’s always straightforward, easy, or trouble-free. We’re as honest about the difficulties and challenges to me as Fran’s friend as we are about what she deals with. You are a person too, with your own needs, concerns, and a life beyond your commitment to your friend. Maintaining healthy boundaries and taking care of yourself is as healthy and vital as it is often overlooked.
10. Physical Distance Is no Barrier
Fran and I live 3,000 miles and five timezones apart, on opposite sides of the Atlantic. Our book focuses on being there for someone living with mental illness but it’s also a book about distance relationships, whether illness is present or not. Almost all of my close friendships are with people I rarely, if ever, meet in person. As Fran and I like to say, no one is too far away to be cared for or to care.
The Bottom Line
Overall, we hope our book helps you understand that being there for a friend or loved one who lives with bipolar disorder isn’t about having all the answers — I certainly dont! It’s much more about empathy, honesty, trust, and mutual respect. It’s about caring enough to keep the connection open even when it’s hard, because there will be hard times. It’s about wanting to be there for your friend because that’s what friendship is.
High Tide, Low Tide: The Caring Friend’s Guide to Bipolar Disorder is available in print and for Kindle. For more information check out our books page.
Photo by Jason Leung at Unsplash.
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