By Wendy Kagan
For Melanie, 46, being married almost 20 years to a partner with bipolar disorder has been a roller coaster ride. Lately, with her husband hit by a new depressive episode, it’s a steep and harrowing downhill descent. “When he’s depressed, it breaks my heart, and I miss the man I married,” says Melanie (not her real name), a marketing executive and mother of two boys. “It’s like taking care of three children instead of two.”
Keeping your relationship strong through bipolar disorder is not easy. Though firm statistics are not available, many experts say that marriages with a bipolar spouse are two to three times more likely than the national average to end in divorce. But there’s a lot that couples can do to maintain and strengthen their relationship when a partner has bipolar disorder.
Commit to a “treatment contract” with your spouse or partner.
The most important thing that a bipolar spouse can do is stick to a medication regime that is effective and sustainable, says Edith Shapiro, MD, a psychiatrist based in Englewood, NJ. “It is essential to have the right maintenance medication, to have medical support, and the support of families,” says Shapiro. That means, first, finding a medication regime that works; pharmacogenomics, the study of how genes affect a person’s response to drugs, and genetic tests like GeneSight can help reduce the trial-and-error process by identifying the right medication faster. Then, couples can create their own treatment contract that includes actionable items for the bipolar spouse, such as taking medication without fail and attending regular doctor appointments.
Invite your partner to become an active participant in your treatment plan.
Thinking of your spouse as a partner in care can bolster not just your relationship but also your outcome if you’re dealing with bipolar disorder. “Patients do better when they have a support structure in place,” says Shapiro. When possible, invite your partner to come with you to doctor appointments and therapy sessions to keep their involvement active.
Stay informed and keep abreast of the latest science about bipolar disorder.
Both the bipolar and the non-bipolar partner can deepen their understanding of the condition by asking questions at doctor appointments and by reading books and articles. “Understanding bipolar through the psychosocial model, there is a biological predisposition, including genetic markers that we are beginning to understand,” Shapiro says, “and there is also the personality of the individual patient, as well as the social aspect or the support system.” By learning together about aspects like these, you can deepen your partnership while possibly exploring new solutions.
Use stable periods to heal and strengthen your relationship.
During healthy, stable periods with a remission of symptoms, couples have an opportunity to rebuild their bond, which may have weakened during a depressive or manic episode. Use these times to talk about any issues that came up during a period of illness. Just as important, use these stable times to plan fun activities such as dates and family travel together. Then, do what you can to keep the stable period going as long as possible through maintenance medication and other treatments. “If we can control the symptoms, a person with bipolar disorder can have relationships that look like anyone else’s,” Shapiro says.