What Bipolar Does to Relationships, and How to Help

Having bipolar disorder or a bipolar diagnosis is a tough road, both for folks diagnosed and for the people who love them. The disorder is a highly prevalent illness—among the top most common mental health disorders in the U.S. and the sixth leading cause of disability in the world—so it's likely you already know someone who's been diagnosed.

Defining bipolar

A mental health disorder characterized by extreme fluctuations in mood, energy and activity, bipolar disorder affected an estimated 2.8 percent of the American population in 2017. Almost 5 percent of people will be diagnosed at some point in their lives. It's equally prevalent in men and women, and has a median average onset age of 25 years old.

Just to interject an important point of interest before continuing, it might be helpful to note that a person can be diagnosed with bipolar disorder after one manic episode and may never have another one, and just as well may never meet the criteria for a major depressive episode again.

There are multiple forms of this condition with different degrees of emotional highs (mania or hypomania) and lows (depression), which is the reason bipolar disorder used to be classified as a "manic-depressive" illness. Highs reflect racing thoughts and rapid speech, extreme energy and little need for sleep, inflated confidence and reckless behavior. Lows are associated with sadness, irritability, changes in appetite and sleep, difficulty concentrating, reduced self-esteem and suicidal thoughts.

The exact cause of bipolar is unknown, but it's thought to be linked to changes in neurotransmitter (the brain's chemical messengers) levels, as well as heredity and psychosocial elements. Risk factors include stress, drug or alcohol abuse and family history of the disease.

The disorder reduces life expectancy by an average of 9.2 years, and 15 percent to 17 percent of sufferers take their own lives.

Fortunately, treatments—including mood stabilizers, anti-anxiety medications, antidepressants and therapy—are effective for 80 percent of sufferers, both to minimize symptoms and allow them to maintain a normal life. Research indicates that 9 in 10 bipolar people taking medication are satisfied with their treatment and say it improves their outlook on life and ability to cope with the illness. Maintaining a regular sleep schedule and good sleep hygiene are also very important things to help someone with bipolar disorder avoid triggering mood swings.

Patient-to-patient support groups are especially helpful, improving treatment compliance by 86 percent. Still, living with bipolar can be tough, both for those affected and those who love them.

Challenges for loved ones

Having bipolar disorder makes it difficult for a person to stay on top of tasks, particularly during depressive episodes, and that can lead to problems at school, work and home.

Relationships can be difficult to form and maintain if symptoms aren't well managed—the disorder can easily result in unintentional offense or emotional harm to a partner. If you love someone who has bipolar, you may struggle with their mood swings, or have feelings of guilt, resentment, anger or helplessness.

If the relationship is romantic, your sex life can be challenging, as they're likely to be very interested in sex during manic episodes and not interested at all during depressive ones—and it can be hard not to take that rejection personally.

A parent with bipolar may not be able to fulfill responsibilities, and the stress of caring for a child can trigger episodes that can be very frightening for the children. As a side note, kids born to a parent with bipolar have a 15 percent to 30 percent chance of developing it themselves.

You're important, too

It's essential that you meet your own needs and set boundaries. Let your loved one know what works for you and what doesn't. If something is troubling you, don't feel the need to tiptoe around them. Instead, find ways to gently express yourself in a nonthreatening manner and place, explaining where you're coming from and what you're feeling.

Take time out for yourself—practice self-care and relaxation, see friends, continue with hobbies and/or join a support group, such as the NAMI Family Support Group. You don't have to do this completely on your own.

Keep in mind bipolar symptoms don't define the individual, nor are they their fault. There will be elements of the disorder that are out of your control as well as the person with bipolar, but many issues are improvable. One of the most important elements of successfully dealing with bipolar as a loved one is communication. It is essential to be open and honest about how you both feel, addressing issues early, and speaking calmly and with respect. Make sure you're a part of their treatment, where appropriate. That can help keep you informed and ensure effective collaboration on disorder management. Consider asking to attend appointments with doctors and therapy sessions. Perhaps seeing a relationship counselor together could also help keep the conversation constructive.

Don't suffer in silence alongside someone with bipolar. Work together as a team to minimize their symptoms, manage the problems you face, and keep life uplifting and moving forward.