Bipolar Disorder and Relationships
Even without bipolar disorder, relationships can be very tricky. Entire industries and, as far as I can tell, at least half of all magazine articles and pop songs are dedicated to discussing them.
Bipolar disorder, however, adds its own set of challenges to relationships. In the United States, the overall divorce rate is currently at 33% within the first ten years, but among bipolar people, the rate is as high as 90% according to Psychology Today. This statistic alone is enough to frighten many people who suffer from bipolar disorder.
However, scary statistics do not tell the entire story. It is not as though people simply roll dice to see if their lives work out the way they want. The ten percent who are able to make their marriages work have to be doing something right. Unmarried bipolar people who are in relationships are also often able to make their relationships prosper.
This article will discuss in outline the special dangers that bipolar disorder poses for relationships, as well as a general strategy for dealing with bipolar disorder in relationships. I will also suggest that there are some positive aspects to bipolar relationships as well.
The Dangers of Bipolar Disorder for RelationshipsTo understand how best to have a successful relationship with bipolar disorder, it is first important to understand the special dangers that bipolar disorder presents for any relationship. Some of these stem directly from the symptoms of the disorder, while others are indirect.
Mania and Hypomania
Mania and hypomania pose their own set of challenges for a relationship. In fact, as a rule, mania and hypomania are more dangerous to relationships than depression is. This is because there are certain behaviors that can do sudden damage to a relationship that stem from mania and hypomania.
People who are manic or hypomanic can become especially interested in sex. When combined with the lack of judgement that comes along with mania and hypomania generally, this can lead to infidelity. It can also lead to excessive interest in sex within the relationship that the partner may find overbearing.
Spending SpreesMany people in manic and hypomanic states are prone to excessive amounts of spending due to a combination of poor judgement and increased interest in pleasure. This can cause a great deal of problems within a marriage especially, where the couple is dependent on one another financially.
Many manic and hypomanic episodes manifest themselves in extreme irritability. This can lead to very hurtful, angry outbursts that can cause damage to a relationship.
Depression can also cause a great deal of tension within a relationship, because the depressed person tends to withdraw both from his or her partner and from life in general. This can lead to multiple effects. First, the non-bipolar partner may feel rejected by the bipolar partner who is uninterested in spending any time together. Second, the non-bipolar partner may believe that the bipolar partner isn’t pulling his or her weight in chores or in the relationship in general.
Bipolar disorder can also cause some additional strain on a relationship that aren’t, strictly speaking, symptoms of the disorder.
Many people with bipolar disorder are in a position where they either cannot work or cannot work full-time. This can cause a series of stressors from financial stress to the belief that the bipolar person is just being lazy and not holding up his or her end of the financial needs of the couple or family.
Many bipolar people also have addictions, sometime in order to “self-medicate” the symptoms of the disorder. This can cause all of the same stress as any addiction, including financial problems, obnoxious or dangerous behavior associated with drug use, and health and legal concerns.
General Strategies For Overcoming Difficulties
Despite all of these frightening possibilities, there are still a number of things that bipolar people and their partners can do that will enable them to make their relationships work. Most importantly, bipolar disorder is something that can be be overcome together as a couple. It is something that is very difficult for one member of a relationship to do alone.
Psychoeducation“Psychoeducation” is the fancy word for learning about a person’s mental illness. Simply put, without understanding a mental illness, it will be extremely difficult to help someone who has a mental illness or to understand what is coming from the mental illness and what the person is doing deliberately.
There are a number of good books and resources available for learning about bipolar disorder. The National Alliance on Mental Illness maintains an excellent online resource here that can help get you started. There are also several good books on the subject, including the surprisingly excellent Bipolar Disorder for Dummies. If you are looking for information from a first-person perspective, Dr. Kay Redfield Jamison’s book An Unquiet Mind provides a deeply insightful account of her own experience of living with bipolar disorder. Both of these titles are available at the bookstore.
Getting treatment for bipolar disorder is an important part of leading a happy bipolar life, but it is also an important part of having a successful bipolar relationship. Most people with bipolar disorder function better with medication than without medication, and, because each person’s bipolar disorder is unique, it can take some time to find a combination of medications that works. Even properly medicated, few if any bipolar people are completely asymptomatic, but it can reduce the strain of the disorder on the person and the relationship significantly.
In addition, bipolar people usually fare better with therapy than without therapy. Therapy can help the bipolar person understand what is happening to him or her, recognize triggers, deal with episodes and just generally be happier. Therapy for couples can also be quite helpful, in order to deal with the special kinds of stresses that bipolar disorder raises in a relationship.
Couples counseling can also be very helpful for relationships with a bipolar person, just as it can be helpful for everyone. Not every couples counselor will be familiar with the unique challenges of a bipolar relationship, so it can be good to let them know about the problems that especially affect your own bipolar relationship. They can help deal with some of the past and current difficulties that have arisen as a result.
Special Strategies For Episodes
In addition to these general strategies, there are some specific strategies that you can put in place to help with the effects of hypomanic and depressive episodes in a relationship.
Dealing With IrritabilityIrritability can be one of the worst issues in a relationship, especially if the person is prone to outbursts of anger. Under no circumstances should anyone simply “put up with” verbal abuse on the grounds that the other person is bipolar. Putting up with verbal abuse is damaging to the person abused, to the relationship and even to the soon-to-be-remorseful bipolar abuser.
When the bipolar person is not irritable, it can be helpful to develop a strategy together for dealing with periods of irritability. For many couples, this is simply a matter of reminding the person that he or she is becoming irritable and to stop. A lot of bipolar people who are irritable don’t actually recognize that they are sounding irritable, and still have the self-control to stop once it is pointed out to them.
If this strategy doesn’t work, once can find a strategy for extricating yourself from the situation. This may mean either the bipolar person spends some time away (from a few hours to a few days, depending on the severity of the episode) or that the non-bipolar person does, depending on what is more convenient for the couple. For the most part, bipolar people who are irritable are only irritable during especially symptomatic phases, and it will pass.
Dealing With Finances
If the bipolar person is prone to overspending, he or she can voluntarily be put on an allowance, to prevent access to funds needed by the couple or family. This can be easily worked out at the bank. If credit cards are necessary, the bipolar person can have cards with very low limits, but if not, it is often easier just to have set amounts of cash when needed.
This may seem a little extreme, but the alternative can be much worse. Remember, this can all be done voluntarily before a manic episode starts. At the end of the day, it is done according to the bipolar person’s euthymic judgement, not the temporarily bad judgement that comes from an episode.
In general, it is not a good idea to try to “cheer someone up” who is in a bipolar depressive episode. There is something actually going wrong in the person’s brain that cheer can’t really penetrate. Instead, couples can discuss in advance what responsibilities absolutely must be taken care of, even during a depressive episode. Then, once the episode starts, the non-bipolar person can let the bipolar person know he or she is available for support, but provide space.
Dealing with depressive episodes largely requires a different cognitive approach from the non-bipolar member of a relationship. It is helpful to remember not to take the depressive episode or the withdrawal personally. The depressed person cannot experience pleasure in the same way, finds even ordinary tasks extremely difficult and is often quite anxious. This is not a rejection, so much as a form of recuperation.
Another thing that can be helpful is to think of bipolar disorder as something like a disability or a chronic illness. Someone who is depressed often cannot fulfil his or her half of the chores or workload during a depressive episode, much like he or she would not be able to if he or she were sick with a bad flu or with chronic pain. This isn’t fair, but few relationships with someone who has a chronic illness or disability (and bipolar disorder is both) can survive “keeping score.” “From each according to his ability; to each according to his need” may be bad economics, but it can often be good relationship advice.
Positive Aspects of Bipolar RelationshipsSo far, I have focused on bipolar disorder exclusively as something to be overcome in a relationship, but it can actually be quite positive in a number of different ways. Relationships with a bipolar person can have their own character that is enjoyable in its own right.
People with bipolar disorder have to spend a lot of time thinking about a dealing with their moods. This means that they often know quite a lot about themselves, and, in turn, they can be surprisingly insightful about other people. In a way, they have the equivalent of the muscular arms of a paraplegic in a wheelchair. They have had to develop other strengths to compensate for their disability.
As a result, when bipolar people aren’t episodic, they can be especially empathetic, for example. They tend to be more aware of other people’s mood states. They can also be extremely forgiving, both of eccentricity and of bad behavior, as they are themselves aware of the complexity of human behavior and have themselves stood in need of forgiveness in the past.
Enthusiasm is only slightly less contagious than the common cold, and people with bipolar disorder are nothing if not enthusiastic at times. One reason why many people with bipolar disorder say that they would not give up the disorder if asked is that they enjoy things more when they are hypomanic. This enthusiasm can be shared, but without all of the unpleasant side-effects of the rest of the disorder, and can add a lot of magic to a relationship.
Even once a hypomanic episode is over, there remains what I call the “frayed veil” effect. Many of the things that bipolar people find fascinating when hypomanic remain sources of interest when they are asymptomatic. The beauty of things that hypomanic people see is often real. As a result, life with a bipolar person can include learning a lot about how wonderful the minutiae of life are, which leads to discovery and improves a sense of wonder.
The statistics surrounding bipolar disorder and relationships are scary, there is no doubt. However, bipolar people can and do have successful marriages and relationships. The chances of having such a relationship can be improved by learning about the disorder, seeking proper treatment and developing particular strategies for dealing with the stressors that can arise from syptomatic episodes. In the end, relationships with people who have bipolar disorder can be rewarding in their own right, as the appreciation of beauty that comes with the disorder can lend the relationship a special kind of charm.