When a Loved One Denies Their Bipolar Diagnosis

By Julie A. Fast 

Medically Reviewed by Allison Young, MD

Last Updated: 21 Aug 2024

Although it’s incredibly frustrating when someone is in denial of having bipolar disorder, it’s important to remember that acceptance cannot be forced.

It can be upsetting, stressful, and downright incomprehensible when someone with a diagnosis of bipolar disorder denies the mental health condition and refuses treatment. You may find yourself watching helplessly as behaviors tied to untreated bipolar lead to family distress, broken relationships, problems at school and work, money woes, and alcohol and drug abuse.

If you try to help someone in denial, you will probably be accused of interfering if you even mention the word “bipolar.” This is confusing, because it’s very easy for you to see what’s wrong, and naturally you want to point out the problem in hopes that the person will then get help. Often, however, your attempt just makes things worse.

RELATED: 8 Essential Things to Know When First Diagnosed With Bipolar Disorder

It hurts when a person in denial shuts you out, but, sadly, it’s common.

What’s even more confusing is that you can have an honest conversation about bipolar when your loved one is stable, reviving your hopes that the person will enter or stick with treatment. Then … boom! Here comes the denial again.

Learning to Accept That Your Loved One Is in Denial About Their Bipolar Diagnosis

It may be cold comfort to learn that it is very typical behavior for people with bipolar disorder to deny they are “sick” and to avoid treatment, even if they have been in the hospital or taken medications for bipolar in the past.

Also, it’s important to remember that people in denial are usually miserable, in a great deal of internal pain, and can’t see a way out. It’s easy to believe they really can’t see what’s going on. But unless denial is a result of a mood swing — such as strong mania or paranoia — the affected individuals usually know what is happening. They respond to your concern with aggression, because they are trying to protect their decision to deny the brain-based disorder.

It hurts when a person in denial shuts you out, but it’s common. The person prefers to be around others who don’t mention bipolar, and will paint you as the “bad guy” because you are the one who is stating the truth.

RELATED: 10 Ways to Support Someone Who Has Bipolar

There is good news, however. I’ve talked with hundreds of people who moved through denialto eventually admitting that bipolar is at the root of their problems and they needed help. Over and over again, I’ve been told how, despite their relentless inner pain and confusion, they refused help and pushed away the people who cared about them.

It’s when someone realizes they no longer want a life controlled by bipolar disorder that they begin to listen to loving advice instead of fighting back.

Steps to Take When a Loved One Is in Denial About Their Bipolar Diagnosis

If your loved one continues to be in denial of their bipolar diagnosis, here are a few things to keep in mind.

• Find the sweet spot: Are there periods when your loved one is more open to discussion? Oftentimes, people are more receptive during a mild depressive episode. Once you see a pattern in your loved one’s moods, you’ll have a better sense of when to gently start a conversation.
• Set expectations: If a loved one with bipolar is living with you, you have the right to set expectations for behaviors, such as drug use, drinking, yelling, staying in bed all day, staying out all hours, and yes, refusing treatment. You are always in control of what works best for you. It’s not always about the person with the mental health condition. It will be up to you to decide the consequences — and set and reinforce boundaries — if your expectations aren’t met.
• Understand the challenges: Always remember that bipolar is a mental health condition. No one chooses to have bipolar disorder. People in denial can be very unpleasant, and it’s easy to walk away from them, but don’t forget they are suffering. It’s okay to address this directly. Go ahead and say you understand that it must be hard to have someone tell you what to do. Say that you can tell they feel misunderstood. People in denial may get angry or refuse to reply, but they have heard you. Many times, when they get better, they will tell you they heard you.
• Hold onto hope: I’ve known many people who accepted treatment after years of being in denial, often when loved ones learned simple strategies and got them help at the right time. It isn’t easy to hang on until then. Nothing with bipolar disorder is easy! But bipolar is treatable, even for those who currently refuse to admit they are unwell and need help.

UPDATED: Printed as “Fast Talk: The Denial Factor,” Summer 2011

Julie A. Fast

Julie A. Fast is the author of the bestselling mental health books Take Charge of Bipolar Disorder, Loving Someone with Bipolar Disorder: Understanding and Helping Your Partner, Getting It Done When You’re Depressed, OMG, That’s Me! (vol. 2), and The Health Cards Treatment System for Bipolar Disorder. She is a longtime bp Magazine writer and the top blog contributor, with over 5 million blog views. Julie is also a researcher and educator who focuses on bipolar disorder prevention and ways to recognize mood swings from the beginning—before they go too far and take over a person’s life. She works as a parent and partner coach and regularly trains health care professionals, including psychiatric residents, pharmacists, general practitioners, therapists, and social workers, on bipolar disorder and psychotic disorder management. She has a Facebook group for parents, The Stable Table, and for partners, The Stable Bed. Julie is the recipient of the Mental Health America excellence in journalism award and was the original consultant for Claire Danes’s character on the TV show Homeland. Julie had the first bipolar disorder blog and was instrumental in teaching the world about bipolar disorder triggers, the importance of circadian rhythm sleep, and the physical signs of bipolar disorder, such as recognizing mania in the eyes. Julie lives with bipolar disorder, a psychotic disorder, anxiety, and ADD.

Melinda