Wife with bipolar disorder
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Understanding why your partner acts out sometimes or becomes withdrawn is the first supportive step you can take in strengthening your relationship.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.
10 Tips for Living with a Bipolar Spouse
If you’re married to someone living with bipolar disorder, you already know it’s a rough ride sometimes. The mood swings can make your days together sometimes exhilarating and other times frustrating. Yet you and your bipolar spouse can beat the dire statistics that predict the end of many of these marital unions.
New Orleans resident “Mary” has been married to her husband for 25 years. Almost halfway through their marriage, he was hospitalized at age 42 and received a diagnosis of bipolar disorder. The diagnosis was not surprising due to a strong family history — but it helped to clarify the situation, says Mary, age 51.
“The diagnosis made it easier, because you know the reason, but it doesn’t change anything. It is a roller coaster. You can have months that are perfectly fine and then all of a sudden it will come from nowhere,” she says.
Mary says she knows the statistics showing higher rates of divorce and abuse in marriages that include one spouse with bipolar disorder. She describes her husband as a “rapid cycler” (“On a day to day basis you never know what it’s going to be,” she explains) and says there are many days and weeks when she is tired, frustrated, and wondering why she is still married. After so many years of marriage and successfully raising a daughter together, she has developed a philosophical and compassionate view of her husband and her relationship.
Coping with Bipolar Spouse Mood Swings
Here are some tips for surviving and thriving in your relationship:
Breathe. When things are tough, take a deep breath and step back. “It’s a disease — it’s not the person. So you try to remember that,” advises Mary.
Build support. Caring for someone with a disease can keep you focused on his needs, but you also need your own sources of support. Joining a support group for family members of bipolar patients can help. Working with your own therapist may also be a good idea. Support from understanding family and friends is also invaluable. Mary has never joined a support group — and says she probably could have benefited from one — but she does find support in her friends.
Get away. Mary says part of what keeps her sane is her job, for which she occasionally travels. Despite the fact that her business trips often coincide with times when her husband stops taking his medications, she values her time away.
At home, when her husband’s moods are out of control, Mary acknowledges, “I try to avoid him.”
Laugh. Whether you can insert humor into the situation and get a good response is highly individual, but Mary says this tactic works for her. “I try to make him laugh, to get him out of it,” she says.
Enforce meds. Mary has made it clear to her husband that taking his medication is non-negotiable. “If you can keep them on the meds, you’re okay. It’s a fight. It’s like having another child,” she says. If he refuses to take his meds (as he often does when he is manic), she leaves, even if only to spend the night at a friend’s house to make her point. That usually gets him back on track.
Recall your love. There are hard times in marriage to a bipolar spouse, acknowledges Mary. But she prefers to see the man she fell in love with, even when his moods are unpredictable.
Know (or grow) your philosophy of marriage. Mary believes in the commitment she made when she married her husband.
“You know, I married a man for better or for worse. I did not marry a disease." While she acknowledges bipolar disorder is difficult, she also notes, "The person I fell in love with is still there. Would I want someone to leave me? I don’t think so,” she explains.
Look for triggers. “When your spouse is in a stable or more favorable mood, pay close attention to what environmental triggers precipitated and are maintaining the stability. Often there are specific environmental stressors or soothers — including relationship issues — that influence mood swings. Use the soothers to help maintain the mood that both of you are desiring,” advises marriage and family therapist Tracy Todd, PhD, based in Alexandria, Va.
Ask. Despite the mood swings, your spouse can tell you what he needs. “Have an honest discussion about what is helpful to your spouse when he is in an undesirable mood. Incorporate ideas, plans, and strategies so that there can be a minimization of harmful effects,” advises Todd.
Keep talking. There may be days and weeks when it is not easy, but communication is essential. “Communication during and between mood swings is critical to managing the accompanying stressors,” says Todd.
Ultimately, Mary’s experience has given her a unique depth of compassion, both for family members whose loved ones have bipolar disorder and for people who live with bipolar disorder. “[I've said before] that I would hate to be in his head — I can’t even imagine how he feels,” she says.
Is it possible to be happy in a marriage where one of the spouses is mentally ill? Both, having graduated from universities, worked, lived separately from their parents. And six years later, Alina suddenly fell ill.
On the eve of the New Year, Alina's father suddenly died of a heart attack. The funeral took place, and then Anatoly began to notice that something strange was happening to his wife.
“My father had died a few years earlier and I was crying like crazy,” he recalls.
- And Alina did not shed even a tear - apparently, this is how she was brought up in the family: you can’t show feelings. Then I still thought: “Wow, how is she holding on!”
But the next day after the funeral, Anatoly found his wife crying over an album of photographs. And after a couple of days, she began to stubbornly assert: her father was killed. On this occasion, they even had a little fight - Anatoly asked his wife not to say stupid things.
A few more days passed, Alina calmed down. And a week after the funeral, unexpectedly for everyone ... she opened the window and jumped out.
“I was running down from our fifth floor, fully convinced that there was a corpse below,” Anatoly recalls, “and suddenly I saw that she was alive!”
It turned out that despite the height from which she fell, Alina escaped with several fractures.
One of the neighbors called an ambulance, the woman was taken to the hospital.
“And then I believed in God,” Anatoly added.
“The pit is deep, but you can climb out and live a normal life”
At the hospital, doctors treated Alina's fractures. The fact that the patient was talking was noticed later. The surgeons called a psychiatrist to the patient, he prescribed pills, but after a while they were canceled.
Of course, doctors should consult with each other, but Alina then drank a lot of medicines for bone fusion, and the attending physician simply did not begin to find out their compatibility with psychotropic drugs. Alina got worse, sometimes she was delusional, sometimes she just screamed.
“At first, I was very distracted by the fact that I had to do rehabilitation. I was looking for doctors who would help my wife develop her arms and legs, - says Anatoly. - But at times despair covered - like a person next to you, but at the same time - this is not him, and the former is completely gone. I looked at my wife in horror: “God, what happened to her?”
Later, Alina was transferred from surgery to traumatology, and when she was discharged, she was diagnosed with schizophrenia (apparently, this is how the first psychiatrist designated it).
Fortunately, acquaintances helped to find a good private specialist, who reassured all those close to him a little, explaining that in the old psychiatric school this diagnosis was interpreted very broadly.
“Most likely, your wife has a manic-depressive psychosis (now Alina's diagnosis sounds like “psychosis on the background of bipolar affective disorder, BAD” - ed.), – said the doctor. “The pit is deep, but you can crawl out of it and live an almost normal life.”
“Get a divorce, no, I didn't think about it. I didn’t go to the temple at that time, but for some reason I was already sure that marriage is concluded once and for life, - Anatoly explains. - Probably, there were too many divorced relatives around me.
Then, when he started going to church himself, the thought appeared that Alina should be baptized and married as soon as possible.”
“Sometimes you just have to wait a couple of days, and Alina will “come back””
Within a few months, Alina was walking without crutches, she completely recovered physically.
And mental problems have since become permanent. Doctors were found, drugs were selected, but all this did not cancel the periods when the depressed state was replaced by a terrible euphoria. It used to be that acquaintances asked Anatoly in bewilderment: “What is going on with you? Alina called me yesterday, she seems to be completely drunk.
A couple more years passed, the couple started going to church and got married. In general, Alina felt better, although there were several breakdowns, after which she ended up in the hospital.
“During exacerbations, I became my wife's enemy No. 1, this was perhaps the most difficult. But, in general, if you adapt to the disease, then you can live, - says Anatoly. “I know that if a severe attack begins, you need to call the doctors, wait a few days, and then Alina will come to her senses, “come back.”
He considers it very important in Alina's life that over time she herself learned to recognize signs of deterioration in herself.
Sometimes she herself called the doctor, agreed that she would come for hospitalization. “It’s true,” Anatoly scolds the doctors, “several times, instead of immediately injecting his wife with a drug that helps her, they tried to prescribe “easier” pills - and then a few days later Alina was admitted to the hospital in a serious condition.”
Over the past years, Anatoly himself has learned to navigate well in medicines, in doctors, and in the states of his wife. Perhaps, largely due to such attentiveness, Alina has not had psychosis with being admitted to the hospital for several years.
“Our situation is greatly facilitated by the fact that, despite her illness, Alina has survived as a person, she is the same, she has criticism of her own condition. She reads all the new literature that comes out on bipolar disorder.
We have not lost contact, we go to exhibitions together, to the conservatory, to visit relatives, we go to the country. Alina is an excellent housekeeper, reads a lot, sometimes works - gives mathematics lessons to private students, ”says Anatoly.
“I don't advertise my wife's illness to outsiders, everyone is aware of my own”
Most of the spouses' relatives know about Alina's illness. “It all started with such a terrible event that friends and relatives were aware,” recalls Anatoly. “And, of course, I try not to tell outsiders about Alina’s illness - why, because the attitude to mental illness in our society is still tense.”
It's also lucky that Anatoly's wife's illness does not prevent him from working.
“I only had to ask for time off a few times – once Alina was in the hospital and I had to go to her urgently. Then I went to the authorities and asked them to let me go for two days. I don't even remember any other special cases.
Now Anatoly is thinking more not about his wife's illness, but about some of her attitudes, rules of life that could lead to this illness. For example, the fact that Alina is very worried, but always inside, does not express feelings outwardly.
“Since childhood, she grew up with the idea that you shouldn’t cry in front of people. But crying when you're grieving is just fine! - says Anatoly. “Or the fact that, if something happens, she immediately begins to save everyone, even when people do not ask for help.”
When asked whether he himself sometimes feels the need to talk to someone close about his wife's illness, Anatoly thinks for a moment, and then answers:
“Yes, no, perhaps. I go to church. My wife and I have one confessor, he is aware of the situation, I talk to him.”
“The main thing is to see the meaning”
Alina and Anatoly have been going to the same church for more than 20 years.
“I remember, out of neophyteism, I once tried to “build” Alina,” Anatoly laughs. - He imposed lenten strictness at home, urged on with baptism. My confessor then restrained me, saying: “Calm down, don’t put pressure on her, she doesn’t need this, and she can’t cope with this.
”
According to Anatoly, it was faith that allowed him to find meaning in all this, to endure what had happened: “Maybe, if it weren’t for my wife’s illness, I wouldn’t have come to faith.
To a person in my place, I would say: everything is not fatal. Medicine is developing, now we have gone incredibly far from the 19th century, when our relatives would simply be placed for life in the “house of sorrow”, as psychiatric hospitals were sometimes called in those years. And now every year they come up with new drugs.”
Anatoly believes that the church rule that in case of mental illness a spouse can be divorced should be clarified. After all, the concept of "mental illness" is very broad, and if desired, it can be used to simply abandon a person.
Illustrations by Ekaterina Vatel
Love and bipolar disorder - Bipolar.su
How to maintain a relationship with a patient with bipolar disorder?
Managing any romantic relationship, whether it be courtship or marriage, can be a very difficult task.
And if bipolar disorder is also involved in the relationship, with its roller coaster mood swings, the relationship will become even more problematic and require a certain amount of tension.
Jim McNulty, 58, married in 1970. According to him, at first everything was just fine. The courtship looked absolutely normal, Jim and his wife got along very well. Then the mood swings started. During the manic phase of the illness, he could spend much more than he could afford. Then Jim's mood changed dramatically, and he was drowning in the abyss of depression. Such wild leaps had a negative effect on marriage and, moreover, began to threaten the complete ruin of the family.
In the end, Jim signed over the house to his wife to financially protect her and their two young children. The result of the struggle between love and illness was the victory of bipolar disorder. Jim's wife asked him to leave as she could no longer cope with her illness.
Relationships and Bipolar Disorder
When people decide to start a relationship, they hope for stability.
But the manic-depressive psychosis of one of the partners can destroy such expectations and seriously complicate the relationship. A person, especially not treated, is prone not only to mood swings, but also to changes in personal qualities, relationships, which can jeopardize the constancy that is the basis of relationships.
In addition, not all sufferers of manic-depressive illness show distinct phases of mania and depression. But when such episodes occur, sufferers can give vent to their feelings and destroy relationships.
During a manic state, a person can lose his common sense, which will entail unreasonable spending, infidelity, alcohol and drug abuse, and even problems with the law are not ruled out. Therefore, the phase of mania in one of the spouses can be extremely detrimental to relationships, since the patient is capable of actions that threaten the financial condition of his partner and personally him and his health.
The other pole is depression.
This state makes a person withdraw, abandon everyone and everything around him. Such moods are very upsetting for the partner, because he is trying to pull the patient out of his shell, but has practically no chance of doing so.
For those who have a partner with bipolar disorder, we recommend reading the book “Why is it so difficult to be with you. How to love people with neurosis, depression and bipolar disorder.
Dating, love, and bipolar disorder
Bipolar disorder can be a problem early in a relationship. When you first meet someone you like, it's natural to want to make a good impression. Therefore, immediately reporting an existing illness will not be the best solution for a favorable start to a relationship. There is always a fear that by such a confession you can scare a person away and lose the opportunity to meet someone else. On the other hand, you still have to let your partner know about your illness.
Doctors advise not to talk about your psychiatric problems on the first date.
But if you feel that the attraction is mutual, you want a serious relationship with this particular person, you need to dot the i's.
Knowing what can trigger cycles of hypomania, mania, and depression and paying attention to warning signs that you are entering a new phase of your cycle can go a long way in helping you avoid unpleasant situations in new relationships. After all, the more the patient is aware of the features of the manifestation of his cycles, the greater the responsibility he will be able to take on. Some common symptoms of upcoming changes in mood include restless sleep and increased or decreased activity levels.
Marriage and Bipolar Disorder
Events ranging from work stress to financial problems can lead to strife and friction in a marriage. But when one of the spouses has a manic-depressive psychosis, minor stress factors become enormous. This explains why at least 90% of marriages where one of the partners suffers from bipolar disorder eventually break up.
Jim McNulty witnessed the destruction of not only his own marriage, but also the marriages of many other patients. He led a cheerleading team for almost 19years. During this period, he met a dozen couples who came to the meetings of a group of people whose relationships were torn to shreds. Jim believes that bipolar disorder puts a lot of extra strain on a relationship, especially if the person is unaware of their condition and has not been diagnosed.
How to make relationships better?
Having a love relationship when you are suffering from bipolar disorder is really difficult. But not impossible. To save a relationship, and subsequently marriage, requires constant work on yourself by both partners.
The first step to take is to see a doctor and treat the condition. Your doctor may prescribe mood-stabilizing drugs, such as lithium medications and antidepressants, to help relieve your symptoms. Therapy with a qualified psychologist, psychiatrist or social worker is also important.
Thanks to this treatment, you can learn to control your behavior, which brings stress to your partner. If your spouse agrees to go through the entire course of treatment with you, this will help him or her better understand the reasons for your actions and learn how to respond to mood swings in the right way.
In addition, if your spouse is directly involved in your treatment, this will bring the couple even closer together.
Although you may want to crawl into your cocoon when you are depressed, or feel like the king of the world when you are manic, it is important to be able to accept help when it is offered. It can be useful to draw up a contract that states in advance under what circumstances and in what condition you will agree to help from your partner.
For the spouse of a person with bipolar disorder, knowing the best time to offer services includes recognizing the states and moods of the wife or husband. It is important to learn to understand the emotional throwing of a partner and to be on the alert all the time.
