how do you deal with a bi-polar spouse?

i am haveing a hard time in my marrage and i believe he is bi-polar, what do i do?

Hi Jina:

Thanks for writing. Has he been diagnosed as bi-polar, or is he just displaying behavior that seems like it could be bi-polar?

I would be interested in knowing a little more about what you’re dealing with. Has this popped up all of a sudden or has he been dealing with this for a while now? Can you tell me more about what’s happening?

I think the first thing to do is to find out if he indeed is bi-polar. If he’s not interested in therapy, this could be tough. I’d avoid telling him he is bi-polar, even if you have a hunch. I’d say something like, “Honey, I love you. I have noticed that you’ve seemed more stressed lately, and that stress might be making you more angry or moody. Am I getting it right?” Just get the dialogue started, letting him know that you’re on his team. Sound like something you might want to try?

I look forward to hearing from you~!

Hi Jinarenee. I can sympathize – someone near and dear to me is married to someone who struggles with bipolar disorder and some days, it’s really a struggle.

I think it will be helpful to sort out the two issues: (1) we need to figure out if he has bipolar disorder and seek treatment if he does, and (2) we need to look closely at your relationship and try to understand the negative cycle that is happening between the two of you.

With respect to bipolar disorder, making a diagnosis is something a professional should do. I agree with Joanna’s suggestion of encouraging him to check in with his physician for a check-up and to talk about how he’s feeling. If the physician has concerns about his mood or mental health status, he/she can refer him to a psychiatrist for an evaluation.

So that you can be well informed about bipolar disorder, here’s a bit more information:

As defined by the National Institute of Mental Health: Bipolar disorder is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated mood clinically referred to as mania or, if milder, hypomania. Individuals who experience manic episodes also commonly experience depressive episodes or symptoms, or mixed episodes in which features of both mania and depression are present at the same time. These episodes are usually separated by periods of “normal” mood, but in some individuals, depression and mania may rapidly alternate, known as rapid cycling. Extreme manic episodes can sometimes lead to psychotic symptoms such as delusions and hallucinations. The disorder has been subdivided into bipolar I, bipolar II, cyclothymia, and other types, based on the nature and severity of mood episodes experienced; the range is often described as the bipolar spectrum.

Knowing this, we can start to make some conclusions about whether or not someone we know or love might be suffering from bipolar disorder. Some mental health professionals use the mnemonic device DIGFAST to identify them. In general, for a diagnosis of mania, a patient must have experienced either euphoria with three DIGFAST symptoms or irritability with four of these symptoms:

D. Distractibility. This is the most common symptom, and it is usually characterized by the inability to pay attention to any activity for very long.

I. Insomnia in mania typically means having high energy and requiring less sleep. (This differs from insomnia in depression, in which the patient has low energy plus an inability to sleep.)

G. Grandiosity. Patients with this symptom have an inflated sense of themselves, which, in severe cases, can be delusional. Close to 60% of all manic patients experience feelings of being all-powerful. Sometimes they feel that they are godlike or have celebrity status.

F. Flight of ideas. Thoughts literally race.

A. Activity. The patient may show an increase in intensity in goal-directed activities, which are related to social behavior, sexual activity, work or school.

S. Speech. The patient may talk excessively.

T. Thoughtlessness. Excessive involvement in high-risk activities is present (such as unrestrained shopping, promiscuity). Mood disturbance may be severe enough to damage one’s job or social functioning or one’s relationships with others. Some patients require hospitalization to prevent harm to others or to themselves.

With respect to your relationship, after we have worked through any medical situations, such as BPD, it’s time ro re-evaluate how things are going between the two of you.

We know a couple of key things about couples who are struggling: (1) they are trapped in a negative cycle, where they seem stuck in the same hurtful spiral, and (2) the key to breaking the cycle is emotion!

The cycle is a never-ending feedback loop, where we make each other out to be the bad guy. Everyone feels hurt, unheard, and pushed away when we’re caught in a cycle/spiral. When we’re in the cycle, the more one of you attacks, the more dangerous you appear to be, the more we look for attacks, the harder we hit back. So we must break the cycle…..

There are two important steps you can take now to breaking the cycle:

First, realize that the cycle – not your partner – is the enemy. You are not each other’s enemy, you love each other. We are never more emotional than when our primary love relationship is threatened, so if both of you are acting in negative ways, that make lots of sense to me. You’re both hurt and upset.

Second, negative cycles always start when one person reaches out for the other and could not make safe emotional connection. We are really moved when those we love show their deepest emotions to us, but to do that, we have to feel safe.

So your goal is to identify your cycle, recognize how you impact your partner, then become a safer, more vulnerable person for your partner to open up to.

Please keep us posted on how things are going and let us know how we can best help. We’re here for you!

Warmly,
Dr. Kathy