How to reconcile bipolar disorder and life as a couple?

Romantic relationships are rarely easy. When one of the partners suffers from a psychiatric disorder, they have: the more communication and compromise last over time. Contrary to appearances, love and bipolarity are not so incompatible, provided certain requirements are met. How do you lead a healthy married life? dr. Isabelle, psychiatrist and general secretary of the French Federation of Psychiatry, explains.

What is Bipolar Disorder?

Bipolar disorder, formerly called manic-depressive psychosis, is a mood disorder characterized by phases of mania and depression alternating with phases of remission (where the mood stabilizes and becomes “normal”). “It must be distinguished from BPD: in this case, the mood swings are numerous and occur on the same day. While in the classic form of bipolar disorder, the phases of deep depression and intense agitation (mania) last for several weeks,” he said. to the psychiatrist. And to indicate:

During the phases of depression or mania, the emotional and affective life of patients is disrupted: it is either extinguished or it is totally aggravated. Which seriously compromises the quality of vision in patients, who are more likely to develop anxiety disorders, addictions and suicidal behaviour.

Identify the depressive phase

The depressive phase is characterized by great difficulty feeling pleasure: anhedonia† “Feelings of love, pleasure and emotional life are very strongly affected. The patients no longer have any meaning in life and their self-esteem plummets,” says Dr. Isabelle Secret-Bobolakis. They may exhibit several of these symptoms:

  • a depressed mood
  • a loss of interest or pleasure
  • a loss or increased appetite
  • by insomnia or, conversely, a hypersomnia
  • psychomotor retardation;
  • very severe fatigue (asthenia
  • loss of self-esteem:
  • a guilt important ;
  • great indecision;
  • dark thoughts, suicidal tendencies or thoughts

The risk of suicide is high at this stage! If a bipolar person is depressed and has suicidal thoughts, it is an absolute psychiatric emergency: the patient must be protected from himself and hospitalized, the psychiatrist emphasizes.

Identify the manic phase

The manic phase is mainly characterized by hyperactivity, excessive euphoria and grandiosity. “During these phases impulsivity and disinhibition take overs, which encourages all kinds of expression: especially sexually, but also financially, for example through reckless purchases”, warns the professional. The patient’s entourage can also be confronted with a form of aggression. Patients can show various symptoms:

  • great euphoria
  • a a lot of self confidence and sometimes megalomaniac ideas
  • a decreased need for sleep;
  • a great willingness to speak (logorhoe
  • confused ideas or even a racing thought;
  • attention and concentration problems
  • a hyperactivity (which can result in social, professional, academic, financial, sporting or even sexual overinvestment);
  • risky behavior : compulsive shopping, speeding, unprotected or multiple sexual intercourse, violent, abusive or even criminal acts, gambling, etc.;
  • by psychotic symptoms : delusions, hallucinations and destruction of thoughts.

This one emotional instability inevitably affects affective relationships, especially couple relationships. Especially since the disease experiences a delay in diagnosis and is therefore treated slowly. Once diagnosed, bipolar disorder can be controlled with: mood stabilizers and to psycho-educational care

Does Bipolar Disorder Affect the Ability to Love?

When not in the manic or depressive phase, people with bipolar disorder are quite being able to identify, feel and love their feelings. Difficulties arise during acute phases, the so-called decompensation (manic and depressive phases).

People with bipolar disorder fall in love just like everyone else. They don’t exactly make dysfunctional pairs, but the disease can cause problems, Dr. Secret Bobolakis.

When they undergo their treatment and ensure their follow-up, patients are complete able to maintain a stable relationship† As with any couple, it requires communication, understanding and some sacrifices.

What negative effects can bipolarity have on the couple?

Let’s face it, bipolar disorder weakens couple relationships, as well as, more generally, socio-professional relationships. “Mood swings are not easy to deal with, both for the patient and their partner. Unfortunately, many unions end in divorce or divorce† Usually the husband can’t take it anymore and throws in the towel,” notes the expert.

Not everything is always black: bipolar people often have generous, creative and sensitive personalities. But sometimes that’s not enough to make up for it daily mental load. The partner often lives in hypervigilance: he or she constantly watches for the warning signs (prodromes) of a manic or depressive attack. Added to this terrifying expectation is the frustration, fear, and sadness of not being able to relieve the symptoms of the disease. Not to mention the heaviness of the tasks of everyday life, which come to him as soon as the patient enters a depressive phase (asthenia, anhedonia).

When the husband becomes an obstacle

Another difficulty, and not the least important one: in the manic phase, the bipolar person may have recurrent crushes, commit infidelity, endanger household finances, develop violent reactions, etc. In some very rare cases, placement under guardianship (or even guardianship) necessary, because the patient enters a phase of denial of his illness and refuses to undergo his treatment. The spouse is then seen as a brake, an obstacle that prevents, criticizes, insufficiently supports the spending of money…

Are these relationships viable in the long run?

“It all depends on the quality of care the patient receives (long-term follow-up, regular, if possible supervised by the same team), the psychiatrist replies. If the patient is well cared for and that he and his environment are accustomed to recognize the prodromes of decompensation, then a couple and family life in time is quite possible. But keep in mind that there is no “cure” for bipolar disorder. He’s there for life.”

How do you manage a relationship if you suffer from bipolarity?

People with bipolar disorder must adopt a very strict lifestyle to best control their disease:

  • get enough sleep;
  • limit stress factors;
  • avoiding alcohol, drugs and tobacco;
  • participate in regular sports activities;
  • following a healthy and balanced diet;
  • do not use medicines (including antidepressants) without medical advice;
  • and so forth

The importance of monitoring and transparency

Bipolar people who want to enter into a romantic relationship must realize that they suffer from a mental disorder that requires regular therapeutic follow-up. To lead a healthy relationship, the most important thing is to learn to communicate with his or her partner about his or her past experiences, feelings, and fears. Thus, he or she will be less confused during a mood episode.

What should I do if I am in a relationship with a bipolar person?

If you are in a relationship with a bipolar person, don’t hesitate to meet with their caregivers to ask any questions necessary for an understanding of the disorder. “In most cases, bipolar patients have good socio-professional integration. They are often creative, original and charming people,” warns Dr. Secret Bobolakis.

We may be tempted at first, but we need to be aware of the issues to support all mood swings!

Maintaining an emotional relationship with a bipolar person requires a good knowledge of the other person and their history, seeking education to better understand their illness, being flexible, considerate, patient, etc. You must also be able to deal with periods of denial : “In the remission phase, the bipolar patient often thinks that he or she no longer needs care. Communication becomes difficult, dialogue often gives way to yelling and blame. Next of kin must then be able to count on the support of trusted teams to care for the patient. “, insists the specialist.

Is it dangerous to live with a bipolar person?

No, bipolar people are not dangerous to those around them. Psychiatric diseases are not dangerous in themselves. On the other hand, bipolar people can put themselves at risk : the risk of suicide in the depressive phase, or of an ill-considered decision in the manic phase, is a real danger. This is all the more true when the person is in the grip of addictions (alcohol, drugs, games, etc.) that can exacerbate aggressive acts.

Don’t hesitate to get help!

All “mental” illnesses affect the immediate environment (parents, children, spouse, etc.). The life partner quickly becomes a “helper”: he or she provides moral support, emotional presence, follow-up of treatment, etc. A place that is not always easy, because we do not all have the same psychological or medical skills. It is therefore important to feel surrounded, heard and supported.

Bipolarity: what advice to lead a serene life as a couple?

As in any relationship it is important to listen to each other, understand each other and be present for the other. Some tips for maintaining a peaceful relationship with your partner:

  • Communicate on both sides;
  • Give time for reflection and adaptation to the other;
  • Focus on stability (geographical, temporal, etc.);
  • Expressing your feelings: reassuring your love makes it possible to consolidate the couple despite the hardships;
  • Become aware of the other person’s emotions and accept them without taking offense.

When the illness takes up too much space in the relationship, it is important to discuss this with the care teams, possibly after couples therapy. Everyone should be aware of their role and their limits. Conclusion ? Being in a relationship with someone with bipolar disorder is not impossible, but it takes patience and stability.

A movie to watch further: The Intranquilesdirected by Joachim Lafosse with Leïla Bekhti and Damien Bonnard (2021).

Leave a Comment