Living with a Partner Who Has Bipolar Disorder

Coping with the difficulties and looking after yourself.

Posted Apr 29, 2020

There is a lot of confusion about what bipolar disorder is, despite the fact that approximately 2.6% of the population is diagnosed with the condition. To anyone on the outside, they may have very little idea of the severity of the condition and, if you’re the partner of someone with bipolar disorder, your family and friends may fail to have any real understanding of what you’re going through. 

Because of this, and because of the stigma which has long been associated with mental illness, being the partner of someone who has bipolar disorder can be an extremely lonely place to be. Coping with your loved one’s mood swings, hyper periods, depression, and possibly violent outbursts is unbelievably hard. Although people more commonly tend to think of bipolar disorder in terms of "highs" and "lows," there is a range of other symptoms which people with this condition may display and which, as their partner, you are responsible for helping them through.

Coping with the "highs"

Bipolar disorder is categorised into:

Bipolar 1 – characterised by extreme manic episodes which can potentially last for weeks. It can be diagnosed in the absence of a depressive episode. 

Bipolar 2 – characterised by more "rapid cycling" and should include at least one depressive period of two weeks or longer. 

The hyper periods can include racing thoughts, rapid speech patterns, feelings of grandiosity and delusion, and following through on all this with risky behaviour including risky financial, sexual, and self-destructive choices. Being on the receiving end of this type of behaviour, as a partner, is extremely difficult. When your partner is in a hyper stage not only are they engaging in things which are damaging to you and your family, they are also unable to engage with you in anything like the same way as they usually would. Trying to explain anything to someone in a manic phase is almost impossible as they’re no longer really themselves. As well as feeling hurt and scared, you’re also deeply upset that your best friend has disappeared for the time being.

Coping with the "lows"

Caring about someone with severe depression is extremely hard. It could be that your partner is too ill to leave his or her bed, which means you have to care for them in addition to any other responsibilities you have. Depression can cause people to shut off and retreat into themselves. If you have issues around emotional abandonment, despite the fact that you tell yourself your partner is just ill, you may feel rejected and abandoned. As with the highs, your partner may retreat so far into their inner self that you’re left emotionally bereft.

Dealing with the threat of suicide

It’s estimated that between 25% and 60% of people with the condition will attempt suicide during their lives, and between 4% and 19% will complete suicide1. Living with a partner who has previously attempted suicide, in the full knowledge that may repeat that effort, is terrifying. There will be times when you approach your house without knowing what you’re going to find. Overcoming a partner’s previous suicide attempt involves dealing with a deeply traumatic experience for which you have probably received little help or support.

Being on the receiving end of anger and frustration

In addition to the highs and lows, bipolar mood swings can include extreme anger and irritation. You may find yourself living with a partner who has a very short fuse and walking on eggshells to avoid upsetting them. This can be particularly difficult if you have children in the house. It could be that your partner’s anger comes out in terms of physical aggression; if this is the case you must seek help for yourself.

Psychotic episodes

Many people will never experience a psychotic episode – either in themselves or someone close to them. When you are in the presence of psychosis, it’s deeply disturbing. Psychosis involves changes in the mind which convince the person experiencing it that certain things are real. For instance, they may hear or see things which aren’t really there and they may develop ideas and beliefs which don’t reflect reality and are delusional in nature. 

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Source: 123rf

Non-adherence to medication and self-medication

There are a number of effective medication options for bipolar disorder -  but non-adherence to medication is common2. There are a number of reasons for this including the fact that it can take a while to discover an effective medication, the side effects of some treatments, the nature of bipolar disorder itself, which leads to non-compliance once the condition improves and the difficulties many people with the condition face in their lives such as unemployment, addiction, or homelessness, which make adherence to treatment plans less likely. Many people with the condition seek to self-medicate, using alcohol or illegal drugs and living with someone who is using substances in this way is a deeply upsetting place to be in.

Whilst your partner may be loving, supportive, and kind, all of the above puts a considerable strain on you and on your relationship. It’s important to put into place coping strategies which support you, as well as your partner.

Recognise your needs as equal

It’s easy for you to lose a sense of your own needs when you’re the partner of someone who has a severe mental health condition. You may feel bad for being upset and depressed and compare yourself to your partner. Whilst it may be true that you don’t suffer the severity of symptoms experienced by your partner, you are still allowed to recognise your own anxiety, depression, or any other emotional difficulties which you are facing.

Care for yourself

Living with a partner who has bipolar disorder can place huge stress on you, possibly requiring you to meet demands you never even knew existed. You may find yourself entirely alone dealing with these situations and it is vital that you take care of yourself. If you put all your energies into someone else, you will become exhausted and ill yourself. You need to have some time away from your bipolar partner to focus on things which make you feel good, from exercising to socialising with friends. You need to recognise when your stress levels are becoming severe and ensure you have enough rest and personal space to provide the self-care you need.

Create a support network

Not everyone wants to know about mental illness – and it’s beyond the understanding of some people. However, there are people out there who may be in similar situations or who are understanding of your situation. If your partner is the only person you are close to, when they become hyper, depressed, suicidal, or psychotic, you’re left entirely on your own, dealing with an almost impossible situation. It is vital for your own emotional wellbeing to have people other than your partner who can provide you with emotional support. Living with a partner who has bipolar disorder can feel like living in a pressure cooker and you need some way of relieving that pressure through being able to talk openly to those who care about you. There are support groups that provide support for partners and their family and making use of online communities can also be helpful.

Keep yourself safe

Some of the behaviours associated with bipolar disorder – including risky sexual behaviour, psychotic episodes, and violent outbursts – can potentially place you in a position of danger. No matter how responsible you may feel for your partner’s wellbeing and how understanding you are, you must keep yourself safe. If you feel you are in a position of danger, take any measures you need to in order to protect yourself. This has to be your priority.

Set boundaries

It’s more than understandable that people may self-medicate and/or find it difficult to adhere to treatment regimes. However, if you and your partner are going to have a relationship which respects both your needs, you need to have boundaries about what is and is not acceptable. Draw this up together. You may need to create a boundary regarding drinking, non-adherence to medication, and other things you have noticed exacerbates their condition.

Draw up a plan of what works

Bipolar symptoms may be triggered by stress, tiredness, and other factors. It is important to sit down with your partner when they are feeling well and identify their triggers. What practical steps can you take together to help reduce the possibility of triggers and deal with the symptoms when they occur?

Bipolar disorder is not a condition that can be cured, but it can be well managed. It is possible for people to have successful relationships by being honest about their own needs and putting in the required effort.

References

1. Goodwin FK, Jamison KR.  Manic-Depressive Illness. New York: Oxford University Press; 1990. 

2. Jawad, I., Watson, S., Haddad, P.M. et al (2018) Medication nonadherence in bipolar disorder: a narrative review, Ther Adv Psychopharmacol, 8 (12): 349-363