Bipolar Relationships: How To Care for and Cope With a Bipolar Partner

Feelings of stress, isolation, and rejection are common among those involved with a bipolar patient, but outside support and education can help.

If you're involved with someone with bipolar disorder, the romantic relationship may be exciting, exhausting, and stressful. Bipolar disorder does not only affect the person with the disorder. It can also affect their partner and their relationships.

The episodes of depression and mania that bipolar people experience—which can lead to emotional withdrawal, out-of-the-blue accusations and outbursts, spending sprees, and everything in between—have been shown to induce stress, sexual dissatisfaction, and money worries in their partners, as well as depression.

Depressive phases, during which the partner with bipolar feels hopeless and sad, can drag their partner down, too.

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The Impact on Relationships

"Mental illness is, on some levels, a contagious disease," David Karp, PhD, a professor of sociology at Boston College who has studied interpersonal dynamics within bipolar couples, told Health. "It brings out very strong negative emotions and feelings of isolation in the partner, who struggles so hard to separate the illness from the patient."

Relatively few studies have been conducted on the effects of bipolar disorder on relationships, but the research is nearly unanimous that the disorder tends to cause both practical and emotional difficulties for couples.

In a 2021 review of previous studies published in Medicina, the study authors describe the negative impacts of bipolar disorder on the lives of the partners of persons with bipolar disorder to include self-sacrifice, caregiver burden, emotional impact, and health problems. There are also negative impacts on the relationship which can include volatility in the relationship, stigmatization, dissatisfaction with sexual life, and lower rates of childbearing.

Authors of a 2017 study published in Industrial Psychiatry Journal wrote people with bipolar disorder have higher rates of divorce, lower fertility rates, and poorer marital adjustment among persons with the disorder, as well as their spouses too. Previous studies suggest the presence of sexual dysfunction among one-third to half of persons with bipolar disorder receiving lithium.

A Team Effort

Many people enter into relationships with a person living with bipolar disorder unwittingly, thinking it will be smooth sailing, Adele Viguera, MD, a psychiatrist at the Cleveland Clinic who works with bipolar couples seeking to start a family, told Health. "Maybe they meet the person when the person is hypomanic, not realizing that mood can change," Dr. Viguera said.

Divorce and separation are common in relationships involving bipolar disorder, but according to Dr. Viguera, such relationships don't have to be destructive and separation is hardly inevitable. Both parties have to participate in its success, however.

"Taking care of bipolar disorder is a team effort, involving the two people and a psychiatrist or other mental health professional," Dr. Viguera said. While she would never speak to a spouse without her patient's consent, such open communication empowers both parties to make treatment decisions that lead to a healthier relationship.

Mental health professionals aren't the only ones who can lend a hand. The stigma of mental illness can make couples hesitant to look elsewhere for help, but Dr. Karp emphasized that extended family members and trusted friends can all provide invaluable support.

"Spread it around a little bit," Dr. Karp said. "People need support systems. By keeping the illness a secret, people place an additional burden on themselves." Dr. Karp also recommended that anyone who cares for someone with bipolar disorder find a support group in their area.

Dr. Karp also urged people with partners living with bipolar disorder to remember what Dr. Karp called the "four Cs": I can't control it; I didn't cause it; I can't cure it. All I can do is cope with it.

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