Psychological Support (bipolar depression)

I have gone back and forth on whether to respond to this, fear of revealing too much about myself. But whatever.

I've dealt with chronic anxiety/depression all my life, my sister is bipolar and manic depressive (she's in a mental hospital right now actually). Long history of depression, suicide, alcoholism, prescription drug abuse, etc. in my family, it all goes together.

With something like bipolar/manic stuff, my (imperfect) understanding is that it needs to be managed with drugs, first and foremost. The person sees it as altering their personality, it feels wrong to them. When I took meds for my anxiety, I absolutely understood that. I felt in a haze. I wasn't so sad anymore, but I also didn't get any joy from the simple things I typically enjoy - music, or a good taco, or whatever. But I had the luxury of getting off the meds once I had righted the ship a little bit and figured out alternatives - therapy, meditation, etc.

Your friend probably doesn't have the option to ditch the meds, sadly. But there are probably ways to integrate things like meditation/breathing exercises, self-talk and things like that into their life that will help. Diet, exercise and sunlight are HUGE factors in day-to-day mood management. It might all sound like a bunch of hippified crap (it did to me at first) but it works and the fact I'm still kicking around is testament to that.

If your friend is truly in a really bad spot, a stint in a mental rehabilitation center might be the best option. There is obviously a lot of stigma around that, but it's really not so different from an extended therapy session, with the added bonus of removing the person from the everyday life situations that are proving harmful to their health.

But ultimately only the person can do it for themeselves and so many people have to hit rock bottom before they reach the conclusion they have to do something about it. If your friend continues to decide that the highs are worth the lows then there's not much you or anybody else can do about it.