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Bipolar Relationships: What to Expect

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Ups and downs are natural in any romantic relationship, but when your partner has bipolar disorder it can feel like you’re 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Understanding why your partner acts out sometimes or becomes withdrawn is the first supportive step you can take in strengthening your relationship.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 partner’s behavior and what you can do to foster a healthy, stable relationship.

What does it mean if your partner is bipolar?

Bipolar disorder is a mental health condition marked by intense mood changes. People with the illness switch back and forth from mania or hypomania (an emotional state of being energetic and gleeful or sometimes aggressive or delusional) to having episodes of depression.

The lifelong condition tends to run in families, although the cause of bipolar disease is unknown. However, it can often be successfully managed through treatment. There are two primary types of bipolar disorder:

Bipolar 1

Bipolar 1 is a more severe form of the illness and is defined by manic episodes that have one of these characteristics:

  • Hallucinations, delusions or paranoia
  • Hospitalization required for safety
  • Impulsive behavior with significant consequences

“When people are manic, they pursue pleasurable activities with great enthusiasm and with no regard for the consequences,” says Jennifer Payne, M.D., psychiatrist and director of the Women’s Mood Disorders Center at Johns Hopkins Medicine. “They may gamble, spend excessive amounts of money, use drugs or become promiscuous.”

Bipolar 2

People with bipolar 2 experience hypomanic episodes, which still include out-of-character behavior but aren’t as extreme as those with bipolar 1. Hypomanic episodes may include:

  • Increased energy and drive.
  • Rapid speech.
  • Decreased need for sleep.

“During hypomanic episodes, a partner with bipolar 2 may obsessively pursue sex with you or others,” says Payne. “They may stay up all night and have lots of wonderful ideas they want to tell you about at 3 a.m.”

Treatment Challenges

Bipolar disorder is usually treated with a combination of medications and therapy. However, successful treatment can be a challenge since many people miss the euphoria and energy of manic episodes.

Often people with bipolar disorder view these elevated mood states as their best selves — when they’re the most productive or creative — and will stop treatment in order to experience that again. Sometimes those with bipolar disorder will even intentionally trigger a manic episode.

“Lack of sleep is a trigger of manic episodes for a lot of people,” says Payne. “Sometimes patients with bipolar disorder will deliberately skip getting the sleep they need in order to initiate an elevated mood state. For example, a person might want the high energy that comes with a manic episode to get a project done.”

The key to your partner’s successful management of the illness is a commitment to continuing treatment and ongoing communication with their psychiatrist. This can take place at therapy sessions, during regular checkups or whenever necessary to discuss troubling symptoms.

Many people with bipolar 1 do well on lithium, a mood-stabilizing drug. Those with bipolar 2 may not fully respond to medications often used to treat bipolar disorder. If that’s the case for your partner, it’s important for them to continue to work with their psychiatrist to find an effective treatment.

Being in a Relationship with Someone Who Is Bipolar

There are certainly challenges in any romantic relationship, but bipolar disorder can make things especially difficult in various aspects of life:

Intimacy

It’s common for people with bipolar disorder to desire frequent sex during manic or hypomanic phases. Your partner may initiate intimacy much more than normal, or masturbate or use pornography more frequently than usual. Those with bipolar disorder may also engage in risky behaviors such as unprotected sex or extramarital affairs while manic.

During episodes of depression, your partner may avoid sexual contact altogether. This can be confusing or feel like rejection, especially if your partner recently desired lots of sexual activity during a manic or hypomanic period. Many medications for bipolar disorder can also lower sex drive.

Work

Your partner’s ability to perform well at work can be affected by bipolar disorder. Severe mood swings, along with manic symptoms such as poor judgement and impulsivity, or depressive symptoms such as low energy and disinterest make it tough to find and maintain a job. Stressors at work may also trigger or exacerbate your partner’s symptoms. If your partner can’t hold down a job, this could put more pressure on you to provide financial support until their illness is well-managed.

Parenting

Many people consider parenting the most stressful (albeit rewarding) job of their lives. But any kind of stressor — good or bad — has potential to trigger manic or depressive episodes for people with bipolar disorder.

In addition, the erratic behavior associated with bipolar disorder can be confusing and scary to children, who look to parents to provide stability. Helping your partner get and maintain treatment to control symptoms is crucial for providing a safe and secure home for children.

How to Make a Bipolar Relationship Work

It takes effort to keep any relationship strong, but it can be especially challenging when your partner has bipolar disorder. Payne offers these recommendations:

Go to Couples Counseling

Couples counseling is essential for working through upset over a bipolar partner’s actions. It’s common for someone with bipolar disorder to hurt and offend their partner. When someone is first diagnosed, there are often relationship issues that need to be addressed. Couples counseling can help you:

  • Understand that there’s an illness involved in the hurtful behavior.
  • Forgive the behavior that happened during an altered mood state.
  • Set boundaries with a partner about maintaining treatment.

Get Involved with Treatment

Ask if you can be involved with your partner’s treatment, which may include occasionally going to the psychiatrist together. Being a part of your partner’s treatment has multiple benefits, including:

  • Gaining a better understanding of the illness.
  • Providing additional insight for the psychiatrist.
  • Learning to spot signs of impending episodes.
  • Alerting the psychiatrist about mood changes.

Even if your partner hasn’t signed off on you exchanging information with their psychiatrist, you can still report worrisome signs (the doctor just won’t be able to tell you anything). This gives the doctor a chance to make quick medication changes that may help your partner avoid being hospitalized.

Practice Self-Care

Self-care gets a lot of buzz these days, but nowhere is it more important than when you’re caring for someone with a serious illness such as bipolar disorder. It’s essential to dedicate time to your own physical and mental health, whether that’s going to a support group, talking to a therapist or attending a yoga class.

Being in a healthy relationship with someone with bipolar disorder requires not only careful management of their illness, but also setting aside time to take good care of yourself.

How to Manage Romantic Relationships

Romance and bipolar disorder

The shifts in mood associated with bipolar disorder can cause extreme changes in behavior. During manic episodes, a person with bipolar disorder can have an unusual amount of energy and may not be able to sleep. When experiencing depressive episodes, a person with bipolar disorder can seem tired and sad. They may not want to go out or do things.

These major shifts in mood can make communicating and socializing difficult. While the symptoms of bipolar disorder can be managed with medication and psychotherapy, they can still take a toll on relationships, perhaps especially romantic ones.

Read on to learn ways to manage a romantic relationship, whether you or your partner have bipolar disorder.

If you have bipolar disorder, you may already be familiar with the impact your condition can have on a romantic relationship. You may feel nervous about starting a new relationship and finding the “right” time to tell your partner you have bipolar disorder.

These concerns are understandable, but it’s important to keep in mind that you can have a healthy romantic relationship. For the best chance of success in a new relationship, be sure to communicate openly and follow your treatment plan.

What you can do

  • Tell your partner about your disorder. Do this before you make a long-term commitment to that person. Describe what they can expect when you’re experiencing a mood shift. It’s also helpful to tell them what you usually do to manage your moods. This way, your partner won’t be surprised when you experience a mood episode. They may even be able to help you get through it.
  • Stick with your treatment plan. Perhaps the best way to reduce relationship stress is to follow your treatment plan. This can help minimize your symptoms and reduce the severity of your shifts in mood. Discuss your treatment plan with your partner so they can help you keep on track.
  • Keep an open line of communication. Tell your partner when you feel a mood shift occurring so they’re not alarmed by a sudden change in your demeanor. Also, be open to them when they tell you that they notice that your mood is “different.” Many times, others can see changes in our mood when we cannot.
  • Be honest. If you’re having a severe episode and struggling with your symptoms, don’t hesitate to notify your partner and ask for help when you need it. For example, if you’re experiencing a depressive episode and don’t feel like leaving the house, explain this to your partner instead of making an excuse to stay home.

Dating someone with bipolar disorder can be challenging, because you can’t control when your partner experiences a mood shift. To help your relationship succeed, focus on communication, support your partner’s treatment plan, and don’t forget to take care of yourself.

What you can do

  • Educate yourself. This is the first thing you should do when you start a relationship with someone who has bipolar disorder. Read about the condition so you understand what your partner is dealing with — and what you’ll be dealing with.
  • Ask about their experience. Ask your partner how they act during shifts in mood and what they do to manage their moods. It’s also beneficial to ask them what you can do, if anything, to help them during these episodes.
  • Try to be patient. It can be frustrating if your partner’s mood shifts interfere with your dating plans. When times get tough, take a deep breath and remember it’s the condition — not your partner — that’s causing your frustration. Take a break if you need one, whether that’s taking a walk around the block or spending a weekend away from your partner.
  • Be open. It’s important to communicate openly with your partner. Tell them how you feel, but never blame them for their disorder.
  • Support their care. Your partner’s best chance for managing their condition lies in following their treatment plan. You can show your support for them by helping them stick with the treatment plan created by their doctor.
  • Get support when you need it. Sometimes, you may need some help coping with your partner’s condition and the effect it’s having on your relationship. Make sure you have your own support system of friends, loved ones, and counselors who can provide advice and encouragement when you need it.

While taking these steps can benefit your relationship, bipolar disorder may still occasionally cause strain in a relationship — even if both of you know what to expect. That’s not unusual. But keep in mind that whether you have bipolar disorder or are dating someone with the condition, it’s possible to establish and maintain a healthy and fulfilling relationship.

Keys to success include maintaining an open line of communication, making sure the person with bipolar disorder follows their treatment plan, and getting support when you need it.

Bipolar affective disorder in women – Central Medical Center “Alliance”

Bipolar affective disorder (BAD) in women has some peculiarities. In particular, they more often have a predominance of the depressive phase. The manic phase is weakly or moderately expressed; full-blown mania develops quite rarely. Another difference of the disease in women is the accelerated change of phases (four or more episodes during the year). It is assumed that this difference is due to periodic fluctuations in the level of female sex hormones. nine0003

Significant factors affecting the course of bipolar disorder in women are pregnancy and the onset of menopause.

BAD and pregnancy

Pregnancy can affect the course of bipolar disorder in different ways. The condition of some women is stabilizing. Others, on the contrary, develop severe depression. In some cases, the first depressive episode in women is observed during pregnancy or after childbirth.

Another serious problem is the need to take lithium during the period of bearing a child. On the one hand, at this time it is advisable to stop taking any medications. On the other hand, the abolition of mood stabilizers can negatively affect the mental state of the mother, on which both the normal intrauterine development of the fetus and the observance of the regimen necessary for the infant after birth depend. In addition, women with bipolar disorder have a significantly increased risk of developing postpartum depression. nine0003

In connection with all of the above, the decision to take lithium should only be made by a specialist (psychiatrist or psychotherapist). In such cases, it is advisable to plan a pregnancy and notify the doctor in advance of your intentions so that he can choose a treatment regimen in advance. Thus, it will be possible to minimize the risk of developmental disorders in the fetus and the risk of an exacerbation of the disease in the mother.

BAD and menopause

The premenopausal period and the onset of menopause are accompanied by mood swings in any woman. In women with bipolar disorder, an increase in the symptoms of the disease is observed during this period. Often deep depression develops. nine0003

In order to prevent such a development of events, complex treatment is prescribed, which includes hormone replacement therapy and drug treatment of bipolar disorder in combination with psychotherapy.

Treatment of bipolar disorder and its effect on the reproductive system

Taking mood stabilizers can affect the reproductive system in women. In particular, the side effects of lithium include polycystic ovary syndrome, a disease that is accompanied by a sharp change in hormonal levels and, in turn, can cause infertility and a number of other diseases. Therefore, all women receiving lithium preparations should control their menstrual cycle and visit a gynecologist regularly. nine0003

At the same time, one should not refuse drug therapy for BAD due to fear of complications from the reproductive system. Currently, drugs are the main treatment for bipolar disorder. Taking them allows you to eliminate the manifestations of the disease, lead a normal full life: work, build long-term relationships, marry, raise children. And in order to minimize the risk of complications, you should be constantly monitored by an experienced specialist (psychotherapist or psychiatrist) and follow all the doctor's recommendations. nine0003

Bipolar affective disorder and everything you need to know about it

More than 60 million people in the world suffer from bipolar affective disorder (BAD). The essence of the disease is that a person has alternating periods of altered mood throughout his life: from a state with a minus sign to a state with a plus sign. How and why is this happening?

Marina KINKULKINA, psychiatrist of the highest category, head of the department of psychiatry and narcology, director of the Institute of Electronic Medical Education, First Moscow State Medical University. I. M. Sechenova, Corresponding Member of the Russian Academy of Sciences, Professor, Doctor of Medical Sciences nine0032

Moreover, it is often not just about sadness or fun, as is often the case with emotional people, but about extreme degrees of either despair or euphoria. The change in these moods can take place both gradually and suddenly, and often for no apparent reason. This disease is attributed to Byron and Hemingway, Virginia Woolf and Edgar Poe, Van Gogh, Schumann, Vivien Leigh and many others. There is an assumption that even “our everything” suffered from a mild degree of BAD (contemporaries often mentioned mood swings) A. S. Pushkin. Modern stars - Catherine Zeta-Jones and Mel Gibson - openly admit to having this mental disorder. And rapper Kanye West even put the inscription on the cover of his album: "I hate being bipolar, it's amazing." A very accurate description of the essence of this disease. nine0003

Genetics does not solve everything

BAD affects both men and women, but the weaker sex - more often. As for the age of onset of the disease, this disorder can also appear in a teenager (especially if there is an appropriate heredity), and in an adult, and even in an elderly person. Everything is individual. The main risk factor is genetics, but a specific gene that would be responsible for the development of bipolar disorder has not been identified. This is a polygenic disorder, and it makes no sense to take genetic tests to find out how great the risk of getting sick is, because scientists still do not have a consensus on what specific combination of genes can lead to a violation. But even if there is a genetic predisposition, it is not certain that the disease will develop. This was proven by studies on identical twins, one of which developed bipolar disorder over the years, while the other did not. Accordingly, there must be some other predisposing moments. Science knows about some of them: life at the limit of possibilities with constant hands-on work, stress and chronic lack of sleep, as well as night shift work, frequent flights with a significant change in hourly flights and, of course, the use of psychoactive substances contribute to the development of the disease. Therefore, they should be avoided. Scientists have yet to learn about other factors. nine0039

But not boring?

The number of people suffering from bipolar disorder among the population, according to various estimates, varies from fractions of one percent to several percent. Recently, psychiatrists note, the proportion of affective disorders has increased significantly, which can be explained by improved diagnostics. At first glance, the BAR does not look like something scary and dangerous. To ignorant people, this disorder even seems attractive - sometimes sad, sometimes fun, in general, you won’t get bored. In addition, being different from everyone else is now fashionable. And then, there is an opinion that people with BAD have higher intelligence and creative abilities than the “gray masses”. But even if this is so, then none of those who suffer from it will definitely call BAD a pleasant thing. It is especially difficult for those patients who do not seek medical help on time. Without treatment, both phases of bipolar disorder can last for months (although sometimes the disorder occurs with frequently alternating phases). Moreover, it is impossible to say which of the periods of the disease is more difficult, manic or depressive. nine0039

Bad when very bad

Those who have experienced real depression say that this is the worst thing that can happen in life. In this state, the whole world is seen in black, the mood is depressed, self-esteem drops, life loses its meaning. A person suffering from BAD in the depressive phase perceives his very existence as a chain of tragic mistakes, constantly blaming himself for all the troubles and sins, even those that do not even exist. In addition to mental suffering, physical ones also arise: a person even moves with difficulty, as if swimming against the current, it is difficult for him to perform the most familiar actions. In addition, he can feel tension throughout the body, experience various pain sensations. With an average degree of depression, people often complain of debilitating pain in the abdomen and other parts of the body. On this occasion, they turn to doctors, but the diagnosis cannot be made. And the daily pain continues to harass. Psychiatrists call this somatoform symptomatology. With severe depression, many have the so-called atrial depression. Patients complain of pain and heaviness in the chest, they say that "a stone lies on the heart." But even an in-depth examination does not reveal cardiac causes. nine0003

Often, with depression, patients (especially the elderly) complain of difficulty in thinking, memory impairment, they say that they have become stupid, they believe that they are developing dementia, they are afraid of “losing their mind”. In fact, affective disorders do not destroy the intellect. When treated with antidepressants, when the mood stabilizes, abilities are restored.

But the worst consequence of depression is suicide. Most suicide attempts are made in this state. Sometimes people in a very pronounced depression, believing that they have done something irreparable, and believing that the consequences of their actions can harm loved ones, decide on extended suicides, in which they settle scores not only with their lives, but also take their loved ones with them ( more often children). nine0003

Bad when too good

The manic stage of BAD is subjectively more pleasant. Patients are not just in a very good, but in a great mood: they love the whole world and themselves in it. The reflection in the mirror pleases, there is not the slightest doubt about one’s own talents and mind, there is more than enough strength and energy, a bonus is accelerated mental activity. Many in this stage sleep for an hour a day, but do not experience fatigue. Sometimes they don’t sleep for whole days - and at least they are cheerful, like an “energizer”. It seems to be great. But no. With mania, desires and new ideas arise too quickly, so a person grabs at each new business, but, as a rule, does not bring any to the end. So productivity at this stage is no more than during depression. But it would be nice if that was the only thing. nine0003

The main danger of mania is that a person has no criticism at this moment, and he can do things that he will later regret very much. For example, he can give away all his property to others (sometimes to unfamiliar people or scammers who specifically use this state of his). Or, say, take out loans to go on a trip to the other side of the world, and take a bunch of friends with him. Maybe even steal something - for example, to make an expensive gift. Many patients at these moments enter into hasty intimate relationships, mistaking a chance meeting for the love of their life (and completely “forgetting” that family and children are waiting at home). Finally, often with mania, people, experiencing euphoria, ignore their severe somatic symptoms, as a result, they do not go to the doctor for a long time, and thus trigger a serious illness (pneumonia, for example). In addition, not all patients in the manic phase are "darlings." Often they show unreasonable aggression if, for example, others do not agree with their "brilliant" advice. As a result of such “angry mania”, conflicts and even situations arise that require the intervention of law enforcement agencies and the hospitalization of the patient without his consent in a psychiatric hospital. nine0039

Good intentions…

The worst thing that relatives and friends of a person with bipolar disorder can do is ignore his problem, devalue suffering, while blaming the patient himself and appealing to his conscience. For example, they can call on a depressed person to “pull himself together, not become limp”, say that he is “mad with fat”, etc. A patient at the stage of mania is most often accused of immorality, irresponsibility, frivolity, promiscuity in relationships, etc. However, doing so is like blaming a person with diabetes for not being able to eat sweet cake, or a patient with heart failure for not running a marathon. BAD is a disease like many others. And she needs to be treated. The sooner you start the right therapy, the sooner you can stabilize the patient's condition and the better the further prognosis will be. nine0039

Psychiatrists don't bite

Despite the fact that recently people (especially young people) have ceased to be afraid to turn to psychiatrists, not everyone still decides to go to the doctor. Indeed, on the Internet in the public domain, you can find hundreds of questionnaires to test yourself for any mental disorder. And then, after reading various tips, you can also “cure”. Doctors strongly advise against doing this. The smallest harm of self-treatment is that it will not help or lead to incomplete improvement, but it can also worsen the condition. For example, inadequate intake of antidepressants in bipolar disorder can lead from a depressive phase into a severe manic state, from which it will then be difficult to get out. Only a psychiatrist (and not a psychologist, neurologist or doctor of any other somatic profile) can identify bipolar disorder and choose the right treatment. Treatment should be strictly individual, that is, the doctor selects it based on the characteristics of a particular patient and taking into account a specific moment in the course of the disease. The goal of therapy is not only to equalize the patient's mood, but also to prevent recurrence. In the treatment of bipolar disorder, the main role is played by drugs for stabilizing mood - mood stabilizers (lithium salts, some anticonvulsants (anticonvulsants) and antipsychotics of new generations). Modern drugs are much better tolerated than their predecessors, have fewer side effects, as they are designed for long-term use over many years. Against the background of their intake, women can even become pregnant and give birth. In depression, antidepressants are prescribed in exceptional cases, given the danger of changing the depressive stage to manic. nine0039

You won't be able to forget

The insidiousness of BAD is that this disease cannot be cured once and for all. But, alas, often, when the patient's mood can be balanced by medication and he begins to feel good (such a state - intermission - is completely indistinguishable from a state of complete health), he can stop taking the drugs. This is a big mistake that does not allow to achieve a stable result of treatment. Sometimes it is required to use medicines (necessarily under the supervision of a doctor) for several months, but more often for years (with periodic visits to the doctor). It is the long-term use of maintenance therapy individually selected by the doctor that allows patients to achieve a stable good condition and feel the joy of life for many years. nine0003

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