Loving Someone Bipolar

Pills as a heartLoving someone bipolar can seem like an overwhelming challenge at times.

A quick survey of the internet combined with years of conversations with loved ones struggling to navigate the sometimes stormy waters, yields a great diversity of perspectives.

Julie Fast, a well known bipolar writer, describes her experience living with her partner during a manic episode…

Years ago, my much-loved partner, Ivan, went into a massive manic and psychotic episode that lasted for almost five months. As his sole caretaker, I was very confused and scared. During his manic and psychotic episode Ivan slept with someone else, told me he didn’t love me and wanted a divorce, had the idea that someone was stalking me, and eventually came very close to suicide. Believe me, I’ve been through it all. And we survived. Your relationship can survive as well.

Bipolar disorder is a medical condition that manifests in behaviors that look like personal choices. It’s hard for partners to understand this as the symptoms feel so personal. When a person with bipolar spends a child’s college fund, makes horrible accusations, cuts down all of the trees in the back yard, refuses to listen to reason, and comes close to destroying a relationship, it’s hard to step back and think, This is an illness, but it needs to happen.

Terri Cheney, writing on the Psychology Today website, takes a somewhat less medical model view of bipolar relationships…

I’m frequently asked, “What’s the best way to love someone with bipolar disorder?”  Usually the person asking me has the traces of a frown on his face.  I empathize.  We’re not the easiest bunch in the world, the 5.7 million of us with bipolar disorder.  But then, simplicity is not what you fell in love with in the first place, is it? 

No.  Most likely you were attracted to the volatility, the edginess, the uncertainty.  Loving someone who’s bipolar means loving a panoply of characters:  the girl who’s overcast one morning and the one who’s radiant by mid-afternoon.  There’s an excitement about not ever being able to predict the emotional weather; but it calls on all your relationship skills.

These two perspectives highlight the duality of bipolar: sometimes it is clearly a disorder that is best approached from a medical perspective and sometimes it is a set of traits that include an emotional breadth and an inspirational creativity that is easy to be drawn towards.

I know, as a psychiatrist I found myself drawn to bipolar patients early in my residency training, but I also know that at times I feel completely depleted from trying to help someone who seems to reject any offer of help and deny even needing help, while at the same time heading off in a perilous and self-destructive direction.

Acute or chronic problem?

Julie makes an important point in her article: it matters whether the problems you are dealing with are acute or chronic. Someone with one hypomanic or manic episode needs to be treated with understanding as a victim of disordered brain chemistry. On the other hand, a person who flirts with danger by refusing medical care, or doing things that increase the risk of a manic episode (such as using drugs or ignoring warning signs), is clearly creating a relationship issue that has to be addressed.

It is reasonable within a relationship to insist that one’s partner make a serious effort to take care of themself.

Hold on to Hope

As a psychiatrist, and therapist, for people with mood disorders of all kinds, I know that one of the most important, and sometimes one of the hardest, roles I play is as the keeper of hope.

Terri talks about this function in her post –

Don’t ever give up on hope.  It’s scary when symptoms manifest, and it’s frustrating for everyone when they don’t go away.  But the weird blessing of bipolar disorder is that it’s a disease of constant change.  Eventually, a mood will shift.  Or one of the many medications now available will start to take effect.  I know this intellectually; but I forget it instantly when I’m suffering.

From my own experience, I know that holding on to hope means that sometimes I have to pay special attention to ensuring that my own health needs are addressed. And sometimes it means that I have to get help from a mental health colleague. Both of these are even more important for someone living with a bipolar partner.

Develop a Plan

We love the Wellness Recovery Action Plan as a model for planning for future episodes. Working on this together can be a great way of strengthening the relationship. And a thoughtful discussion, when your partner is not in a mood episode, can help to build emotional intimacy and optimism.

Part of that plan might call for sharing the burden of support with others.

Discussing when and how to reach out to the partner’s therapist or psychiatrist.

And thinking about times when a little bit of distance might be useful, for example when your partner is in a safe environment and is mildly manic, it can sometimes be good to create some distance so that you are not constantly annoying each other.

Two More Perspectives

After I posted this I ran across a wonderful video hosted by the International Bipolar Foundation.

For More Information

Loving Someone with Bipolar by Julie Fast

How Do I Love Thee When You Are Bipolar by Terri Cheney

What is love and how does it work? by Zoey Miller

Avoiding Heartbreak in a Relationship

It Takes Two to Fight