Living With Someone With Bipolar Disorder
W. Nate Upshaw, MD
Dr. William Nathan Upshaw is the Medical Director of NeuroSpa TMS®. Since receiving training from the inventor of TMS Therapy nearly a decade ago, Dr. Upshaw has been a pioneer, champion and outspoken advocate of TMS Therapy. Dr. Upshaws holistic experience in the field has transformed him into Floridas leading advocate for widespread accessibility to TMS Therapy.
Bipolar disorder is a difficult condition to live with, but when its well-managed it presents no barriers to good relationships. Uncontrolled bipolar disorder is another story. The extreme highs and lows associated with bipolar disorder can prove disruptive to even the strongest of bonds. The lack of stability in a persons mood and the significant alterations in a persons behavior can be devastating to a relationship.
Typically, a person with bipolar will spend weeks to months in a fairly stable mood, with depressive episodes interspersed throughout. Some people however are rapid cyclers and will go through at least 4 full phases of mania and depression a year.
How to Live With a Bipolar Spouse
It takes a structured and methodical approach to prevent a bipolar marriage breakdown, but its possible. Consider the following steps to keeping your sanity when living with someone with bipolar disorder.
Have You Guys Spoken With Someone To Help Manage Medication And Care While You Are Potentially Pregnant
Megan: Yes, we look at it as a team situation. I’ve talked to the reproductive doctor and she said that she wants me to stay on my bipolar medication throughout the entire pregnancy. She said that in my case, with the mental illness that I have, the benefit of taking the medication during pregnancy outweighed not taking it.
Encourage Your Loved One To Take Bipolar Disorder Medication
Medication is the cornerstone of treatment for bipolar disorder, and most people need it to regulate their moods and avoid relapse. Despite the need for medication, many people with bipolar disorder stop taking it. Some quit because theyre feeling better, others because of side effects, and yet others because they enjoy the symptoms of mania. People who dont think they have a problem are particularly likely to stop taking medication.
You can help your loved one stay on track by emphasizing the importance of medication and making sure they take all prescriptions as directed. Also encourage your loved one to speak to their doctor about any bothersome side effects.
Side effects can be very unpleasant if the dose of the medication is too low or too high, but a change in medication or dosage may solve the problem. Remind your loved one that abruptly stopping medication is dangerous.
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Ignorance Isnt Always Bliss
Part of the condition of being bipolar involves something called anosognosia. This comes from the Greek, and means without disease knowledge.
Now here is the frustrating and tricky part where bipolar marriage and marital conflict are concerned. The partner cant get why their bipolar spouse tends to deny the very existence of a diagnosis that, in other mood states, they would admit readily.
It looks like defensiveness, stubbornness, arrogancefill in the blank.
But in reality, while this anosognosia can have many different components, a brain deficit in the prefrontal cortex is often a large factor. They cant help not knowing in that moment what they already know.
On the other hand, some people in treatment for Bipolar Disorder gratefully welcome the structure and incremental gains in their quality of life and a better bipolar marriage.
Bipolar Disorder is an intimidating medical condition because it dictates the very contours and terrain of your life.
Managing Bipolar Disorder is a spousal team effort. While some people respond miraculously well to certain medications and treatment regimes, like everything else with bipolar your mileage will vary.
Accept Your Partners Bipolar Diagnosis
Although medication and life-style changes can certainly rein in bipolar symptoms and make the disorder easier to manage, bipolar isnt an illness that can be cured indefinitely. That said, a bipolar diagnosis is not always a bad thing. Your loved one is the same person he or she has always been. Accept the diagnosis for what it is, and know you will enjoy times when the condition is under control.
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When Youre Married To Someone With Bipolar Disorder
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Learn more about bipolar disorder and relationships by reading our relationship blogs.
Bipolar disorder wears many faces. There are as many experiences with bipolar disorder as there are people with bipolar. These experiences run the gamut from wonderful and exciting to confusing, disappointing and devastating. This article addresses some of the issues that can arise when dealing with a spouse with bipolar disorder.
Like all individuals, people with bipolar disorder have many good attributes, but at times, they also display less desirable qualities, such as being withdrawn, irritable, moody, and depressed. They may be affectionate and loving sometimes and then cold and distant at other times. The person may welcome and enjoy sex one day, while rejecting affection the next day. These erratic behaviors can be quite challenging for all concerned, especially spouses.
At times the person with bipolar disorder may experience manic or hypomanic episodes during which they can be fun, interesting, talkative, upbeat and full of energy. At other times, the person may experience depression that effects them physically, spiritually and soulfully. The spouse might feel confused, not knowing how to deal with certain behaviors.
- Academic struggles
- Reckless behavior
- Extreme defiance
- Controlling behaviors
- Suicidal thoughts or attempts
Have Courage When Life Isnt Easy
Lets be real. A bipolar diagnosis takes its toll on every relationship. The process of reining in unhealthy coping mechanisms and moving toward health isnt an easy, smooth path. Finding ones way to recovery involves trekking down an uneven, gravel road with plenty of potholes and rubble. Knowing that it sometimes gets worse before it gets better will give you the perspective you need to persevere through the tough times.
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Kyle What Was Your Take On What Was Going On At The Time
Kyle: I felt like I had zero control of her situation, period. When she was in that deep depression, I didnt know she was bipolar, that was never even a thought. I encouraged her to listen to the nurse practitioner. I just figured that shed studied this in school, that this was her profession, so I thought that this was the best option for Megan. It was really challenging watching her struggle, to not be able to really help.
Megan: I just want to add that you really did alleviate the situation, because you really stepped up during that time and did all the grocery shopping, all the laundry. He took care of our dog, he paid all the bills, he went to work. He did literally everything to step up to help me and be there for me. And he didn’t put any pressure on me at all.
Any of the times I’ve ever been depressed, hes always been very supportive. He didnt ask me, whats wrong with you. Or why can’t I do this or that? Hes been so respectful. And I’m so grateful to have a husband like that, to support me and be there for me. He doesn’t understand what depression feels likebut he’s witnessed me not being able to shower, not being able to get off the couch, being in the same clothes I’ve worn for five days in a row. And while he doesn’t know what I feel, he understands that the struggle I deal with is real. And I just really appreciate him so much, because it takes a really strong partner to be with someone whos struggling with mental illness.
Healing And Caring For Yourself After A Breakup
Any breakup is likely going to be difficult, especially if you had a long-term commitment to your partner. Dr. Reiss said that this situation may lead to feelings of guilt.
If you start feeling guilty when the reality is that you had not made the commitment the other person implicitly expected, your guilt will trigger anger, depression, etc. in both yourself and in the other person and make it worse, Dr. Reiss said.
He added, Work through your own guilt as much as possible before, during, and after the breakup.
Itll also take time to heal. Dr. Saltz suggested doing your best to learn from any relationship that didnt work. Its always good for you to review for yourself why you chose this person, what was the draw for you, she said.
Is that something that, in retrospect, you feel good about, or does it fit some pattern that hasnt been good for you? Just try to learn from a relationship that didnt ultimately last and understand more about yourself in that regard.
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What Would You Like To Share With Others Who Find Themselves In The Same Situation
Kyle: Just being open and honest with your loved ones and those around you.
Megan: Devastated doesnt even describe the despair and pain that I felt after my manic episode and my psychotic social media posts. So many people in my life at that time, in my social circle, that I trusted and thought were my closest friends abandoned me. They didn’t try to understand, be forgiving, and compassionate for me. And that was devastating. But it turns out that was actually the biggest blessing because it showed me who was a true, solid friend. It’s so important for people with mental health illnesses to have a strong support system.
If youd like to follow Megans mental health journey, check out:
How Has Your Marriage Changed Through This
Megan: From my perspective, were doing well. We have gone through a lot of healing. Its a journey. Its not linearyou take a step forward, then take a couple steps backwards. I think marriage is difficult, no matter if you have a mental illness or not, but having a spouse with a mental illness does make it more challenging.
Kyle: I would say we’ve been on an upward trajectory ever since she was diagnosed. Weve definitely had times where we have had to take a step back. But we learn from it and just keep on marching forward. The last few years have made me more sympathetic to mental health struggles. No one in my family or circle of friends was ever deeply affected.
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Bipolar Relationships: What To Expect
Ups and downs are natural in any romantic relationship, but when your partner has bipolar disorder it can feel like youre on an emotional rollercoaster. Not knowing what to expect each day is stressful and tiring. Over time, it wears on the relationship.
Understanding why your partner acts out sometimes or becomes withdrawn is the first supportive step you can take in strengthening your relationship. Learn exactly what a bipolar diagnosis means, how it could affect your partners behavior and what you can do to foster a healthy, stable relationship.
Bipolar Spouse: Coping With Bipolar Husband Wife
Having a spouse with bipolar can be challenging. Here are techniques for coping with bipolar spouses.
Having a bipolar husband or bipolar wife, often puts the other spouse in the role of caretaker and caregiver of the relationship. Because they live with a bipolar spouse, they are expected to hold everything together when emotional hurricanes hit their families. They hang on in spite of everything that is flying around them just waiting for the calm. Many people close to them expect them to be strong and almost heroically brave, when sadly, they, too, have weaknesses and fears.
So many people in their community are focused on the well-being of the bipolar person that they forget about the spouse. It can be very difficult to be the other half of a partnership in which someone is chronically ill. The spouse feels like all he/she ever does is put up and put out and that they never get anything back in return. It can be emotionally and physically draining when your spouse is continually the one that is the focus of your combined attention. The spouse often forgets to acknowledge his/her own needs and wants because their attention is so completely funneled to their partner. They may long for someone they can confide in, someone to listen to their concerns. Sometimes, the spouse can become resentful of the bipolar sufferer, and then, unfortunately, the relationship hits the rocks.
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Other Ways You Can Help Your Spouse Yourself And Your Marriage
Make a plan together
As a spouse, you may be the most in tune with how symptoms occur in your loved one. Over time, you will likely be able to pinpoint when your spouse is getting ready to enter either a cycle of mania or a cycle of depression, says Nina.
You may not be able to stop the cycle, but you can develop plans to ride them out together.
For instance, you can have a plan in place to prevent your partner from making large purchases or engaging in harmful behaviors when theyre having a manic episode.
You can also weather depressive episodes by helping them get their tasks completed or giving them a pass on the garbage or yard work when you know theyre not up for it.
Even just having plans in place for when an episode comes on can give you a sense of control and help you prepare.
Talk about impulsive and reckless behaviors
Since impulsivity and reckless behaviors can be symptoms of bipolar disorder that affect marital life, addressing them openly when your partner is in a stable state called euthymia can make a difference.
Create a plan with your partner to help reduce damage from behaviors, says Jackson. An example would be agreeing to limit access to credit cards if they have a history of impulsive spending or gambling when experiencing mania or hypomania.
Likewise, agree to opt for the passenger seat or a rideshare, or reschedule a long road trip if they have trouble with speeding or reckless driving during mania.
Dont take mood changes personally
What’s It Been Like Staying Sober
Megan: When I got diagnosed with a mental illness, it felt like a death sentence. I knew deep down in my gut that I shouldn’t drink anymore because of this diagnosis. But there’s societal pressure everywhere to drink. I thought drinking was fun, but now I wake up every day without a hangover. I’m able to do my self-care, like exercise, and do positive things for myself. I love to clean and organize and that helps me feel good.
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Figure Out Your Level Of Involvement
How involved are you in your loved ones life? Dealing with a bipolar spouse with whom you have already built a life is a very different situation than dealing with a bipolar housemate. Evaluate both how much support is needed and how much you are realistically able to offer.
Minimal involvement might start with offering to get in touch with someone who is better able to help when things get bad. Increased levels of involvement could include helping the person spot when he is beginning to enter into a manic or depressed state, helping him remember to take his medication, or driving them to the doctor. If you have permission, you might even speak with his therapist yourself the outside perspective you can offer can be invaluable for a treatment provider to more fully understand whats going on.
Something Was Very Wrong
When Jeff was in the thick of this medical chaos in August 2014, he had a period of about a week where, out of the blue, he had strange psychiatric symptoms. He spoke nonsensically, often repeating a phrase over and over again. He created wild scenarios for things hed do in the future, such as producing a self-massage video that would make him rich.
There was no diagnosis for this episode, though he may well have been experiencing symptoms of psychosis. Psychosis is a mental health condition that occurs in up to 55 percent of people who have bipolar disorder. It was frightening to watch this unfold. Would he come back? The doctors didnt know.
Although Jeffs mental health problems were pressing, his physical health was so poor that his heart surgery was scheduled immediately. The surgery was partially successful and relieved his most urgent symptoms. But as Jeffs physical health improved, his mental well-being was increasingly precarious.
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How Bipolar Disorder Affects A Marriage
For many people, getting married is a positive experience and aspiration. Being married provides an emotional connection and partnership in life.
However, every relationship has its challenges. When one partner in a marriage has bipolar disorder, the relationship can become complicated when they are unwell.
Creating A Support Plan
Creating a support plan is a useful way for someone to learn how to help their partner with bipolar disorder. This might include planning activities, making a list of useful contacts such as a trusted relative or a therapist and making adjustments to daily routine.
Having a support plan in place reassures both partners that they will know how to respond to a very high or low period.
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