Living With a Bipolar Spouse: What to Expect - Verywell Health

Bipolar disorder is a mental health condition that can cause significant mood changes. A person's energy levels, thoughts, feelings, and behaviors may be affected.

When a bipolar partner is unwell, they may struggle to function as they would when they are well. This can create problems and impact the quality of life partners have established. These challenges can cause strain in a relationship for the person with the condition, as well as their spouse. It's common for someone with bipolar disorder to hurt or offend their partner or be controlling.

Verywell / Julie Bang

When living with a bipolar spouse, understanding the condition, recognizing and discussing the needs of both partners, and creating boundaries to care for each other can help manage a partner's bipolar disorder.

Read on to learn about bipolar disorder, how it can affect a relationship, and ways to help a spouse living with the condition.

Bipolar Disorder at a Glance

Bipolar disorder is characterized by extreme mood fluctuations. Periods of mania (high energy, elevated moods), hypomania (elevated moods less severe than mania), and depression (states of sadness and hopelessness) can occur.

There are different types of bipolar disorder, including:

• Bipolar I: A person with bipolar I experiences at least one episode of mania or elevated mood for at least one week. They also usually experience depression for at least two weeks.
• Bipolar II: In bipolar II disorder, the person has at least one major depressive episode and at least one hypomanic episode (a less intense form of mania).
• Cyclothymic disorder: This is a milder form of bipolar disorder involving many "mood swings." It is diagnosed when symptoms of depression and hypomania persist for at least two years but do not meet the criteria for a diagnosis of bipolar I or bipolar II.
• Mixed states: Mania and depression symptoms occur within the same period of time that last a week or two, sometimes longer.
• Rapid cycling: Here, a person experiences at least four or more episodes of mania, hypomania, and depression within a single year.
• Unspecified: This is when the condition is characteristic of bipolar disorder, but does not meet the full criteria for any of the other specified bipolar spectrum disorders.

Treatment often includes a combination of medication and psychotherapy.

Every person with bipolar disorder has a unique experience of the condition. Being educated about symptoms and treatment options can provide insight into ways to better support a spouse with bipolar disorder.

Recognizing symptoms or patterns in their spouse's behavior allows a partner to support their spouse, determine the ways they can take care of themselves, and tend to the things that need attention in the life they've built together.

If Your Spouse Has Undiagnosed Bipolar Disorder

It's sometimes possible for a person to have bipolar disorder and be unaware of their condition, particularly during a manic episode. One reason is that symptoms may be confused with other conditions, such as ADHD, anxiety, substance use, and more.

If you believe your spouse might have undiagnosed bipolar disorder, you might notice the following behaviors.

Mania

• Elevated mood
• Inflated sense of self-esteem
• Easily distractible
• Agitation or irritability 
• Impulsiveness or engagement in risky behaviors (e.g., excessive spending)
• Lack of sleep

Depression

• Expressions of hopelessness 
• Periods of low mood or sadness
• Increased need for sleep
• Isolation and withdrawal
• Lack of interest in daily activities 
• Thoughts about death or suicidal ideation

If you observe some of these symptoms in your spouse, talk to them about what you're seeing and ask if they would be willing to seek help.

If they are open to the conversation:

• Inform your spouse about what you've noticed without being judgmental.
• Let your partner know that your concern comes from a loving and caring place.
• Ask them about how they've been feeling and if they've noticed changes in their mood as well.
• Listen to what they think and what this might mean for them.
• Inquire about their thoughts on seeking help.

If your spouse is open to seeking treatment, let them know they have your support. If they are not open, you can let them know you want to support them and ask how you best do so.

If Your Spouse Has Diagnosed Bipolar Disorder

Recurrent or extreme changes in mood can have a significant impact on the spouses of people living with bipolar disorder. There can be a level of unpredictability in the relationship that causes distress.

On the one hand, the partner experiencing the mood episode is affected by their symptoms, leading to changes in behavior and level of functioning. On the other hand, their spouse may feel responsible for their partner and the family, and may begin to feel burnt out.

These dynamics create challenges in marriages that can be difficult to overcome. Research indicates divorce rates are higher in couples in which one partner has the condition.

How Bipolar Disorder Affects a Marriage

For many people, getting married is a positive experience and aspiration. Being married provides an emotional connection and partnership in life.

However, every relationship has its challenges. When one partner in a marriage has bipolar disorder, the relationship can become complicated when they are unwell.

Communication

Communication between partners may not be as fluid when a partner is going through a manic or depressive episode. However, communication is crucial for understanding between partners.

Research shows that communication between partners and members of a bipolar spouse's care team can help manage their care and support the relationship. Additionally, research demonstrates that couples believe a level of emotional disclosure is vital to their relationships.

In a study where researchers interviewed the wives of patients with bipolar disorder, they uncovered that wives felt helpless, frustrated, and hypervigilant when their spouses were unwell.

Another study determined spouses have a hard time assessing the impact of bipolar disorder on their partners' lives.

Ultimately, bipolar disorder and the emotional impact it has on partners can weaken their communication.

Sex

A bipolar spouse's interest in sex can wax and wane depending on their mood and medication. Some medications can diminish a person's interest in sex, while an episode of mania can lead to hypersexuality.

Additionally, research suggests that during mania, a person may participate in risky behavior, such as having unprotected sex or cheating on their spouse.

Parenting

While being a parent can be rewarding yet taxing at times, for people with bipolar disorder, stressful situations can cause changes in mood. When they are unwell and unable to assist with family responsibilities, this can take a toll on the other partner.

Bipolar disorder is complex, and depending on a child's age and level of understanding, explaining to them what their parent is going through might be challenging. 

Financial Responsibility

Mania and impulsivity can lead to behaviors that can jeopardize a couple's financial health. Excessive spending, accumulation of credit and debt, and gambling have serious consequences for a couple's financial standing, and it can be hard to recover. 

Considering Your Spouse's Feelings

Compassion from both partners toward each other can go a long way in a marriage in which one spouse has bipolar disorder.

The partner with the condition may have feelings of guilt, shame, and fear because of the impact of a mood episode on the relationship. Meanwhile, the spouse's partner may experience a range of emotions, including anxiety, resentment, loneliness, or feeling stuck.

Learning how to take care of themselves and support each other can strengthen the relationship.

How to Help

There are many ways you can help a spouse with bipolar disorder:

• Educate yourself about bipolar disorder. Understanding what you and your partner are dealing with can help you cope and strengthen your relationship.
• Recognize that your partner is separate from the disorder. If your partner does or says something hurtful, reminding yourself it's the disorder causing the behavior can help alleviate your confusion or frustration.
• Talk to your partner about their experience with the condition, and identify patterns to be aware of. This can help you anticipate changes in behavior and how to cope with them.
• Ask questions, actively listen, and communicate honestly. Having empathy and allowing your spouse to be heard can strengthen your relationship.
• Work together to create a plan to support your family and household when your partner is unwell.
• Develop a plan of action when symptoms worsen (e.g., contacting the care team or seeking emergency services).
  
• Support your partner in seeking treatment and staying consistent with medication and therapy. Proper treatment can stabilize moods and support a healthy relationship.
• Encourage healthy daily habits (e.g., exercise, balanced meals, and good sleep hygiene). Research shows that people with bipolar disorder who have an unhealthy lifestyle have a worse course of illness.
• Consider couple's therapy. Going to counseling together can support open communication, help work through upset and frustration, and provide professional guidance for dealing with challenges.
  

Caring for Your Needs

You must also remember to take care of yourself:

• Cultivate self-care and coping skills. Self-care, such as exercising, healthy eating, good sleep habits, and spending time with friends and family members can help to manage stress and improve mental health.
• Set boundaries by expressing what is acceptable or unacceptable. Setting boundaries, such as not tolerating verbal abuse or participating in unhealthy behaviors can improve communication, support self-care, and potentially strengthen your relationship.
• Be clear about what will happen if a boundary is violated.
• Reach out for help if you need support or guidance. Individual therapy or support groups can be beneficial.
• Be gentle and compassionate toward yourself. Negative self-talk and blaming yourself are harmful to your self-esteem and mental health. Self-compassion has been shown to improve well-being.
  

When to Talk About Divorce

Sometimes a marriage doesn't work, and partners exhaust options that might help them reconcile. In such cases, the partners may want to consider divorce as an option.

Abuse

Due to stigma, people often associate violence with mental health conditions. The truth is that most people with a mental health diagnosis are not violent.

However, abuse can occur when there are extreme changes in mood or when drugs or alcohol are involved. Irritability and impulsiveness that accompany mania can lead to a dangerous situation. 

Abuse can appear in many forms, including emotional, physical, or financial, and determining the best course of action to protect oneself can be scary.

Leaving a dangerous situation cannot always happen immediately for safety or other reasons (e.g., finances, culture, religion). Once a person has resolved to leave a relationship, it can help to seek support about the safest way to exit.

Knowing When to Leave

Walking away from a marriage can be a difficult choice. It might feel like the time to leave if:

• The relationship feels consistently unhealthy.
• You are constantly taxed, burnt out, or unable to care for your own needs.
• You feel unsafe.

Alternately, the partner with bipolar disorder may be the one to decide the relationship is not beneficial for their well-being anymore. Some signs might be:

• They feel consistently judged or stigmatized by their partner.
• They feel their spouse doesn't support them.
• The relationship feels unsafe (emotionally, physically, etc.).

Seeking psychotherapy to help clarify these issues can be important for both partners in the relationship.

Summary

Living with a spouse who has bipolar disorder can be challenging. Engage in honest conversations about how you are affected and how you need support. No one is to blame for bipolar disorder, and spouses can learn to care for themselves and each other.

Alternatively, the relationship may not feel safe. In those cases, you should prioritize your own mental health and well-being and seek help.

Frequently Asked Questions

• The diagnosis of a mental health condition is not a red flag. Many people with various mental health conditions, including bipolar disorder, lead balanced and meaningful lives.

  When dating someone with bipolar disorder, if it appears they are not managing their symptoms, this may be an indication that something deeper is going on and they need to seek help.

• Rates of separation and divorce are higher in couples where one partner has bipolar disorder. Dating or being married to a person with bipolar disorder has challenges, and like any relationship, communication, understanding, and support can benefit the relationship.

  Partners should be clear about when it feels like a relationship is or isn't working for them. Strategies to enhance and improve the relationship are available through individual and couples counseling.

  However, the emotional impact of recurrent mood swings on either party can lead partners to feel like a relationship isn't healthy anymore. 

• Whether your partner has bipolar disorder or not, learning how to clearly communicate thoughts and feelings in a nonjudgmental manner helps couples in a few ways. They can identify and address the root of concern, listen and validate each other, and determine a course of action to move forward together.

  It can also be a good idea to decide whether or not it feels like the right time to have a conversation. If your partner is unwell or it doesn't feel like either of you is ready to have a productive discussion, don't proceed. Instead, take some time to process and cope individually, then come back together at a time that feels better for both partners.

• Honesty and communication are foundational to establishing trust. People often feel more confident in trusting or relying on others when they can have an open dialogue about the concerns and issues that may be affecting the relationship and how to tackle them.

  If you have concerns about trust, you might voice them and talk with your partner about how you can share responsibilities in your relationship. Set boundaries and ask for what you need. Hear your partner on this as well. Be clear about what you need to build trust between the two of you.

• A person can sometimes have bipolar disorder and not recognize it. The best way to gauge your partner's emotional state is to have an open and honest conversation about it. If you suspect that your spouse may be dealing with bipolar disorder, let them know your concerns and that you are there to help.

  Asking them about what they've noticed about themselves and their thoughts can be a great way to get insight into how they're feeling. Offer to help connect them with a mental health professional in order to take the next step.

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