Relationships in Bipolar Disorder

Introduction:

Bipolar disorder affects a person’s thinking, feelings, and behavior. Affected individuals exhibit extreme highs and lows in their mood. Because of this, relationships are affected, and trust and communication may be lost. This condition can be effectively treated, and relationships may be maintained effectively.

What Is Bipolar Disorder?

Bipolar disorder is a condition in which there are unusual shifts in a person’s mood, energy, activity levels, and concentration. This condition was previously called manic depression.

Extreme mood swings characterize this condition and involve emotional highs (mania or hypomania) and lows (depression). Among those affected by bipolar disorder, in the case of depression, they may feel hopeless, sad, and lose interest or pleasure in most activities. When the mood is mania or hypomania, they may feel euphoric, full of energy, and unusually irritable.

These changes may occur in episodes. They may occur rarely or multiple times a year. Some of them may develop symptoms of this condition in between the episodes. Some may not get any symptoms in between the episodes. There are different types of bipolar disorders. These include,

• Bipolar I disorder.
• Bipolar II disorder.
• Cyclothymic disorder.
• Other types.

Bipolar disorder may be seen at any age, but it can be diagnosed among teenagers or early twenties. In this condition, the affected individuals may struggle to maintain more than daily functions. This condition affects relationships, too.

How Are the Relationships in Bipolar Disorders Affected?

In any relationship, the ups and downs are considered normal. When one person has bipolar disorder, the other person in the relationship may feel stressed and tired. Over time, the relationship may be affected. Challenges faced in a relationship with bipolar disorder include,

• Intimacy: Individuals with bipolar disorder may like to have frequent sex during the manic or hypomanic stages. These may tend to initiate intimacy much more than normal, masturbate, or use pornography more frequently than usual. They may exhibit unusual behaviors like unprotected sex or extramarital affairs while manic. During depression, these individuals may avoid sexual contact altogether. This may make the other partner confused or feel rejected. Many medications used for bipolar disorder also tend to lower sexual drive.

• Work: Bipolar disorder may affect the ability of a person to work well. Symptoms of mania, like poor judgment or impulsivity, and symptoms of depression, like low energy and disinterest, make it difficult to find or maintain a job. Stressors at work may trigger the symptoms of bipolar disorder.

• Parenting: Many feel that the act of parenting is very stressful. Stressors related to parenting can trigger manic or depressive episodes. Erratic behavior may confuse and scare children of parents affected by bipolar disorder. To provide safety for children, it is necessary to get the person treated.

• Self-Sacrifice: Research has found that partners of bipolar disorder have to give up their leisure time and self-care to attend to the needs of the affected person. If the couple has children, the other partner has to take greater responsibility for the children and the home.

• Difficulty Relating: The partner of an affected person may face hard times and may not be aware of how to react to the symptoms. These situations may make the partner feel lonely, powerless, and angry.

• Physical Health: The other partner’s health may be affected, and they may suffer muscle pain and insomnia.

• Ultimate Impact: All these factors lead to emotional distancing that affects the relationship. This may, in turn, affect family and social contact. They lose trust in the relationship.

Internal struggles with bipolar disorder include,

• Self-Stigma: The person affected faces challenges in creating a relationship. This is due to self-stigma (internalized stigma) leading to self-created isolation. In self-stigma, there is the internalization of negative messages received by a person regarding mental conditions. This creates low self-esteem. Feeling bad about themselves may lead to social isolation.

• Routine: The routine affects the relationship of an affected person with others. Individuals with mental health conditions rely on routine for illness.

These may include

• Sleeping early.

• Sleeping for long hours.

• Having meals on time.

• Not to skip exercises.

Maintaining a strict routine may make them avoid nighttime gatherings, parties, and other events.

Mood Change: The symptoms of mood disorder affect relationships.

How to Manage Bipolar Disorder and Their Relationships?

Relationships need to be nurtured properly. To maintain a healthy relationship with an individual with bipolar disorder, one needs empathy, communication, and self-awareness. These include,

• Learning About the Condition: Reading about the condition from trusted sources can help the partner understand their experiences.

• Asking About the Triggers: Knowing and avoiding the triggers that may worsen the situation or condition.

• Asking About the Behaviors: Knowing about the behavior during normal episodes may help the partner know and distinguish between the normal behavior and the symptoms of bipolar disorder.

• Supporting Treatment: Knowing and discussing the treatment aspect may help reduce the anxiety among the affected partner.

• Creating a Support Plan: Planning activities, making useful contacts like trusted relatives and therapists, and adjusting the routine may help. A support plan may help partners cope with high or low periods.

• Practicing Self-Care: Partners of a person with bipolar disorder must practice taking care of their mental health. This helps to improve the relationship.

Self-care strategies include,

• Sharing about the relationship issues with a close friend or family member.

• Involving in a favorite hobby.

• Consult a therapist for help.

• Not to depend only on the partner for support.

• Practicing relaxation techniques like meditation or mindfulness.

Other important things include,

• Counseling: Therapy that includes both partners in the counseling may help to understand each other.

• Additional Treatment: Getting treated is very important for bipolar disorder and maintaining relationships.

Treatment options include,

Medications:

• Antidepressants: These should be used very carefully, as they may trigger bipolar disorders.

• Lithium: It is a mood stabilizer and hence can be used effectively to counteract the high and low episodes.

• Second-Generation Antipsychotics (SGAs): These are used along with mood stabilizers for emotional regulation.

• Anticonvulsants: This is one more mood stabilizer that can be used.

All these medications should be used only when prescribed by a psychiatrist. Once started, these medications should only be stopped if under the supervision of a psychiatrist.

Psychotherapy: This therapy is useful in changing negative thoughts into positive ones. Cognitive behavioral therapy helps achieve this.

Psychoeducation and Family-Focused Therapy: Learning about the condition benefits both partners in a relationship. This helps understand the disease and how to cope with it. It helps to recognize the problem quickly.

Electroconvulsive Therapy (ECT): This sends electronic impulses to the brain. It is rarely used. It is useful for short-term treatments, especially when other treatments do not work.

Conclusion

Bipolar disorder is a mental health disorder that affects the mood of a person. This leads to a distortion of the relationship. Relationships can be maintained by knowing and understanding the condition and treating it well. Hence, it becomes important for both partners to know about the condition, how it affects relationships, and how to manage it.