How can married couples cope with bipolar disorder? Discover 8 valuable relationship tips that have helped one couple manage this mental health condition and strengthen their marriage.

Maintaining Communication and Understanding in Challenging Times

Effective communication is crucial when navigating the ups and downs of bipolar disorder in a marriage. Tiffany and Mike, a couple who have been married for eight years, emphasize the importance of talking to each other about problem-solving strategies, even during periods of stability. This helps set the groundwork for how to handle escalating situations, such as when Tiffany needs to take some time alone to de-stress, as she did on Christmas morning.

Gregory Nawalanic, PsyD, a clinical assistant professor of psychiatry and behavioral sciences, stresses that while communication is vital, safety must always come first. If one partner is concerned the other could harm themselves during a manic or depressive episode, that should take precedence over the agreed-upon coping strategies.

Recognizing and Responding to Mood Episode Triggers

Knowing the signs and triggers of your partner’s bipolar episodes can help prevent or manage them more effectively. Depressive episodes may involve symptoms like depressed mood, loss of interest, and suicidal thoughts, while manic or hypomanic episodes can manifest as feeling abnormally upbeat, having increased energy, and making impulsive decisions.

Mike suggests trying to empathize with your partner’s experience, even if it’s uncomfortable for you, such as imagining what it feels like to be in an elevator or on a flight. This can help you better understand and support them during these challenging moments.

Developing a Personalized Coping Toolkit

Tiffany and Mike have created a designated “sanctuary” in their home, Tiffany’s bedroom, where she can go to relax and decompress when needed. This space is intentionally uncluttered and stocked with calming elements like essential oils, candles, and comfortable blankets. Tiffany uses this room to practice self-care activities like prayer, meditation, and yoga.

Establishing a personal space and routine can be an effective strategy for managing bipolar disorder symptoms and preventing escalation. Couples should work together to identify what coping mechanisms work best for their unique situation.

Seeking Professional Support and Guidance

While Tiffany and Mike have developed their own strategies for navigating bipolar disorder in their marriage, they acknowledge the value of seeking professional help. Nawalanic emphasizes that bipolar disorder does not have to be a limiting factor in a marriage, and that with the right support and coping techniques, couples can overcome the challenges.

Consulting with a mental health professional, such as a therapist or psychiatrist, can provide couples with tailored guidance on managing bipolar disorder and strengthening their relationship.

Embracing the Ups and Downs with Empathy and Understanding

Bipolar disorder can pose unique challenges in a marriage, but Tiffany and Mike’s experience demonstrates that with open communication, mutual understanding, and a willingness to adapt, couples can find ways to thrive. Nawalanic reminds us that every marriage faces challenges, and bipolar disorder is just one of many potential obstacles that can be overcome with the right approach.

By cultivating empathy, flexibility, and a shared commitment to supporting one another, couples can navigate the ups and downs of bipolar disorder and strengthen the foundation of their relationship.

Fostering a Supportive and Collaborative Mindset

Tiffany and Mike’s strategies for managing bipolar disorder in their marriage involve a collaborative approach. They constantly refine their coping methods, communicate openly about their needs and challenges, and work together to anticipate and prevent potential triggers.

This mindset of teamwork and mutual support is crucial for couples navigating mental health conditions like bipolar disorder. By approaching the situation as a united front, rather than viewing the disorder as a barrier, couples can build a stronger, more resilient relationship.

Embracing Self-Care and Personal Growth

In addition to their shared coping strategies, Tiffany and Mike also emphasize the importance of individual self-care. Tiffany’s designated “sanctuary” space allows her to engage in personal activities that help her manage her bipolar symptoms and maintain her well-being.

Encouraging each partner to prioritize their own self-care and personal growth can be a crucial component of navigating bipolar disorder in a marriage. By supporting one another’s needs and personal development, couples can build a stronger, more resilient foundation for their relationship.

Bipolar Disorder: 8 Relationship Tips for Married Couples

Tiffany Romito, 37, and her husband Mike, 41, were looking forward to hosting a party on Christmas Day for their friends and family this past year. But as their four kids were unwrapping their last gifts on Christmas morning, Tiffany — who has bipolar disorder — started to get anxious about the mess the wrapping paper was making, and everything she still needed to do to get ready for the party.

As her stress level rose, her patience evaporated, and she began to snap at her husband and kids.

After years of marriage, Tiffany and Mike had a system for handling the situation. Mike suggested that Tiffany spend a bit of time in a space she’s created for herself in their basement bedroom while he cleaned up the wrapping and toys with the kids and began party prep. Tiffany headed downstairs to the couple’s bedroom for some time on her own to relax.

Tiffany has made their bedroom a sanctuary to use when she needs to. She keeps it uncluttered, and stocks it with comfortable blankets, essential oils, and candles to help her relax. She uses the space to pray, meditate, practice yoga, and reflect in order to de-stress, and sometimes will also take a shower as part of her routine.

Tiffany was diagnosed with bipolar disorder about the time she and Mike met. In the eight years they’ve been married, they’ve worked together to troubleshoot how to anticipate conflict and strained moments, such as their Christmas morning experience, that can trigger Tiffany’s symptoms, and try to avert them.

Bipolar disorder can pose some extra challenges in marriage. Indeed, this mental health condition is associated with lower odds of ever marrying, as well as marriages that end in divorce more quickly, according to a review of studies on marriage and mental health conditions published in the July–December 2017 issue of the Industrial Psychiatry Journal.

But “for a marriage, bipolar disorder doesn’t have to be a limiting factor,” says Gregory Nawalanic, PsyD, a clinical assistant professor of psychiatry and behavioral sciences at the University of Kansas Medical Center in Kansas City, and the clinical director of psychology services at the University of Kansas Health System’s Strawberry Hill Campus. Dr. Nawalanic treats patients with bipolar disorder.

And even though there will be challenges, “that’s true of every marriage,” Nawalanic adds.

Tiffany and Mike say they’re constantly refining their strategies. But here are some tips that have worked for them.

1. Communicate — Even When Things Are Going Well

Talking to one another about ways to problem-solve when issues come up, especially during periods of stability, is critical, say Tiffany and Mike.

Nawalanic agrees. “That lays the groundwork and expectations for what is mutually agreed upon as acceptable and helpful in moments when things escalate,” he says.

A good example, Nawalanic says: If one spouse decides they need some brief alone time when a partner is having symptoms, as Tiffany did Christmas morning, a prior conversation about that choice can help the other spouse know it’s a coping strategy rather than an unexplained withdrawal.

Safety does come first, though, says Nawalanic. For instance, if one partner is concerned that the other could harm themselves during a manic or depressive episode, “that should take precedence over the agreed-upon retreat,” says Nawalanic.

2. Know Your Partner’s Signs and Triggers

Nawalanic says knowing what the start of a mood episode looks like may help prevent it or allow you to get help early.

A depressive episode may have symptoms including depressed mood, feelings of sadness and hopelessness, loss of interest and pleasure in normal activities, insomnia or oversleeping, changes in appetite, and suicidal thoughts or actions, according to the Mayo Clinic.

For a manic or hypomanic episode, symptoms may include feeling abnormally upbeat, jumpy, or wired, increased energy or agitation, exaggerated sense of self-confidence, decreased need for sleep, increased talkativeness, racing thoughts, and impulsive or risky decision-making, say Mayo Clinic experts.

The most important thing, says Mike, is to know what your partner’s triggers are and to try to put yourself in their headspace so you can understand the situation and help them. “If you see a trigger that could lead to an episode, then it’s important to think of something that makes you uncomfortable — say, flying or being in an elevator — try to understand what your partner is going through at that moment. Doing that lets you better help them in the situation,” says Mike.

Nawalanic says couples might even consider a word to use — say, “mistletoe” — to indicate they think their partner might be headed for an episode and to show their love and support, even though they may have to take some actions to protect their spouse.

3. Give Each Other Space

“It can be hard to put the other person first, or be the best version of ourselves,” says Nawalanic. “Sometimes each person in a couple, both with and without bipolar disorder, needs space where we can refill our personal emotional tank.”

Tiffany meditates and does yoga when she’s feeling stressed by a manic episode, and Mike knows to let her have some time alone and looks after the kids at these times.

And he also has a hobby and a space he can retreat to. He plays video games, especially when feeling stressed, which he finds relaxing. They try to end their “on their own time” with some conversation about why they needed time alone.

For example, on Christmas day after Tiffany spent time on her own, Mike went down to talk with her after a little while. Tiffany says that “having Mike come down in a peaceful, nonconfrontational way allowed us to have a meaningful conversation.”

4. Remember That It’s the Bipolar Disorder, Not the Person

Remember that bipolar disorder is not a choice for your loved one, Nawalanic says. If your spouse is having a mood episode, it’s important to work against the symptoms rather than the person.

When episodes occur, says Mike, “I remind myself that it’s not my wife, whom I love, who is acting this way, it’s the disorder that is taking over in the moment. Being patient and being conscious of what is happening and why helps us both then.”

That patience also requires realizing that hurtful words can also be part of the disorder. Mike says Tiffany can say things that are hurtful during a manic episode “but the worst thing I can do is to reciprocate, to say hurtful things as well, or start yelling back. ”

5. Take Time for the Two of You

Mike and Tiffany plan a date night at least once a month as a couple, sans kids. “Every couple has issues they deal with and deserves the joyous times of marriage as well,” Nawalanic says.

6. Learn as Much About Bipolar Disorder as You Can

Tiffany and Mike say they did their research, finding resources online about bipolar disorder so they would understand what was happening, treatment options, and how to handle situations. Nawalanic agrees, saying that seeking out information together as a couple can be a powerful way to get everyone on the same page.

7. Plan in Advance How You’ll Talk About Medication

If a spouse with bipolar disorder suddenly has symptoms, their partner might understandably want to ask if they took their medication. But that might sound accusatory to the partner having the symptoms. “It’s a hard question to hear,” says Tiffany, which is why how it’s asked is so important. “You don’t want to be made to feel irresponsible. ”

“I’ve learned to ask in a tone that says I’m concerned and not frustrated, such as ‘Was there something that kept you from taking your medicine today?” says Mike.

This is another example of an important conversation to have when moods are stable, says Nawalanic. He adds that even using a predecided code word or phrase — like, “Did Sally come over today?” — can help establish that you are concerned, rather than judgmental.

8. Have a Plan for Emergencies

Nawalanic says it’s critical to discuss what you’ll do during a serious episode, whether it’s simply being there for support, calling a physician, or even initiating a hospitalization. After the episode the couple should have a conversation about what happened and why.

Mike and Tiffany’s own plan for emergencies: If the situation escalates to a concern for Tiffany or anyone else in their family, Mike steps in to handle it, says Tiffany. “From calling the doctor to heading to the hospital if he thought that was necessary, we’ve developed that level of trust,” Tiffany says.

Tiffany and Mike make it a point to “reconnect” after an episode and talk about what happened, how each of them felt, and what else they might add to the plan, if needed.

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You, Me & Bipolar Disorder Makes 3: Marriage Tips

In sickness and in health, right? Well, mania and maybe episodes of depression, too, are putting your vows to the test. With the right tools, you can cope with whatever comes your way.

You and your spouse may have knock-down, drag-out verbal matches. They might go from feeling sad to feeling elated; from wanting loads of sex to having none; from having fun times filled with energetic activities to being unable to take out the trash.

Maybe they talk your ear off at one point, yet don’t speak to you for days at other times. Or perhaps they go from saving money to wild spending sprees.

This is what a marriage to someone living with bipolar disorder can look like.

Or, with transparency, strong mutual intimacy, and having routines and a solid treatment plan, it could look like a smooth-running train: Yes, there are departures and arrivals, but you’ll both know the signs, act accordingly, and keep things moving forward.

Bipolar disorder, previously called manic depression, is a mental health condition known for sudden or intense changes in mood.

Someone with bipolar disorder may experience highs — mania or hypomania — that involve high energy, an increased sex drive, impulsivity, agitation, and even anger or irritability. Some people may also have lows, known as depressive episodes.

There are three types of bipolar disorder: bipolar I, bipolar II, and cyclothymic disorder. Each type comes with its own set of similar symptoms, patterns, and cycling phases. A diagnosis may also include features or additional specifiers to better describe your spouse’s condition.

What might bipolar disorder look like? In an episode of mania, your partner may drive too fast or recklessly, overspend, act out sexually, or even become emotionally or physically abusive. On the other end, in a depressive episode they may be too depressed to get out of bed, work, or just perform everyday tasks around the house.

A small study in 2019 found a significant increase in marital distress among partners of people with bipolar disorder, including issues like:

• family finances
• career or job decisions
• household tasks

The good news is that if your partner is diagnosed with bipolar disorder and moves forward with treatment, you can work together to make your marriage healthy and successful.

Since people with bipolar disorder may have different types, severity, and particular features, each person’s condition will be unique.

For example, an analysis in 2009 observed how someone’s symptoms and condition can change in type and the length of episodes as they age.

Educating yourself on bipolar disorder can help you learn what to expect from your relationship and your partner’s mood episodes.

Being in contact with your spouse’s healthcare team is also a great idea, according to Nicole Nina, a therapist in Aurora, Colorado.

If your partner agrees to include you as a contact on their medical release forms and share information access, it can:

• provide 2-way communication between you and their treatment team, in case of emergency
• help you know their particular diagnosis so you know what to expect in general
• keep you in the loop on their treatment plan, therapy, and medication routine so you can be an advocate in their journey

Sasha Jackson, therapist in Brooklyn, New York, says that psychoeducation is crucial to helping your marriage.

Other ways you can help your spouse, yourself, and your marriage

Make a plan together

As a spouse, you may be the most in tune with how symptoms occur in your loved one. “Over time, you will likely be able to pinpoint when your spouse is getting ready to enter either a cycle of mania or a cycle of depression,” says Nina.

You may not be able to stop the cycle, but you can develop plans to ride them out together.

For instance, you can have a plan in place to prevent your partner from making large purchases or engaging in harmful behaviors when they’re having a manic episode.

You can also weather depressive episodes by helping them get their tasks completed or giving them a pass on the garbage or yard work when you know they’re not up for it.

Even just having plans in place for when an episode comes on can give you a sense of control and help you prepare.

Talk about impulsive and reckless behaviors

Since impulsivity and reckless behaviors can be symptoms of bipolar disorder that affect marital life, addressing them openly when your partner is in a stable state — called euthymia (you-thigh-me-uh) — can make a difference.

“Create a plan with your partner to help reduce damage from behaviors,” says Jackson. An example would be agreeing to limit access to credit cards if they have a history of impulsive spending or gambling when experiencing mania or hypomania.

Likewise, agree to opt for the passenger seat or a rideshare, or reschedule a long road trip if they have trouble with speeding or reckless driving during mania.

Don’t take mood changes personally

“It’s difficult to not take your partner’s mood dysregulation (depression, irritability, anger, or [ill-timed] happiness) as a personal attack,” says Jackson. “However, mood swings are a symptom of bipolar disorder and have to do with a chemical imbalance.”

Even though it’s hard, instead of taking it personally, communicate with your partner about ways you can help them cope and ways you’d like them to try and communicate their needs so they can avoid escalations like raised voices, the silent treatment, or personal attacks.

Ensure they have the resources they need

“Bipolar disorder is primarily managed through medication to stabilize the [mood],” says Nina.

If they ask you to hold them accountable, you can remind your partner to take their meds, keep their supply current, attend their therapy and medication appointments, and prioritize their health — eating right, exercising, and sleeping well. Lifestyle habits are known to help reduce severity of episodes.

Psychotherapy can also be a vital tool for managing the emotions that come with the condition.

Nina says helping your partner find the right therapist for them can ensure they have a trusted relationship with an objective party to help maintain and build on their progress.

Remember to enjoy time with each other

It’s easy to forget the pleasurable memories you’ve had with your spouse when managing health conditions takes so much of your time and energy. But it’s important to stay present, create space to enjoy each other’s company, have fun together, and continue to build your life.

“Every couple experiences highs and lows — spouses of those with bipolar disorder just get more heights and canyons to see,” says Nina.

Take care of yourself

Whether it’s a mental health or physical condition, taking care of a spouse, parent, or child can be taxing.

When supporting someone, you’ll want to have a self-care plan in place, where you put yourself first and make sure you get proper sleep, exercise, and downtime you need. Otherwise, you’ll burn out — or worse, feel resentful.

Choose activities that increase your energy and calm your emotions:

• Do an exercise you love like hiking, swimming, meditation.
• Find a hobby like reading or doing puzzles.
• Get away for me-time.
• Spend time in nature or with friends.

Ask for help when you need it

“Being in a relationship with someone who has bipolar disorder may be overwhelming at times,” says Nina. It’s OK — scratch that — vital to get an assist from online support groups, a therapist, or your spouse’s family if they’re privy to the diagnosis, whenever needed.

You may even consider marriage counseling to help you two meet the challenges and rise above them.

Marriage is less of a static institution and more of a living, breathing, organism: It grows healthy when we nourish and nurture it.

There may come a time when you need similar support, grace, and a proactive investment from your partner who’s also managing a chronic condition. Stay encouraged. A healthy bond is adaptable — physically, emotionally, and mentally.

People with bipolar disorder tell how to properly support them

March 30 is celebrated as Bipolar Day around the world. With this disease, it is important to monitor mood changes, which can be difficult to do alone. The founder of the Bipolar Association, Masha Pushkina, has collected stories of people who are helped by treatment partners.

At the initiative of public organizations bringing together scientists, doctors and activists, every year on March 30, World Bipolar Day is celebrated. The date chosen was the birthday of Vincent van Gogh, an artist who, according to researchers, was the embodiment of a “bipolar genius.”

With bipolar disorder, a person lives either in a state of high emotional uplift and excitement (mania), or in depression. According to world statistics, about 2% of people suffer from bipolar disorder in various forms. This means that in Russia there are at least three million bipolar people – this is about half of St. Petersburg.

In most cases, this condition responds well to medication. But, unfortunately, many do not seek help or do not know how to find it. Without treatment, the disease progresses and ultimately leads to sad consequences: loss of family, job, disability in general, and in almost every seventh case, suicide.

These consequences can be avoided. The peculiarity of bipolar disorder is that the onset of remission depends not only on the doctor and medications, but also on the behavior of the patient himself. Very often, bipolar people provoke seizures “with their own hands. ” The mood of people with BAD (bipolar affective disorder. – Note ed. ) is very unstable, the balance is fragile, and mania or depression can be “started” in dozens of ways: the psyche is easily shaken by psychoactive substances, alcohol, lack of sleep, too intense work, travel and even love. So, a short time after the next course of treatment with powerful drugs, the person again ends up in the hospital. And each new attack reduces the chances of a long remission, affects social status, and even more painfully – self-esteem.

The experience of people with mental disorders around the world has proven that you are much more likely to cope with difficulties when you are supported by people who understand your problems and condition, but do not look at you as a patient. As practice shows, such a person can be not only a partner or close relative. An old friend, and even a person with whom you have never met in person, can help you get through the darkest times. Masha Pushkina, especially for Afisha Daily, spoke with several bipolar people about those in whom they found their support. The result is a story not about illness, but about friendship and trust, which can defeat even madness.

Yana, 31 years old

Housewife, collects books and is fond of confectionery

Purposefully, I didn’t find out about the ways of support anywhere, everything turned out quite naturally. I have been sick for 15 years. The first person who looked after me was my best friend, and now it’s my husband.

When my hypomania (a mild degree of mania, which is characterized by a constantly high mood. – Approx. ed. ) accelerated into a full-fledged mania (this state is also characterized by a one-sided attraction to some topic, sometimes accompanied by delirium. – Note ed. ), it became clear that I needed to be looked after. A friend began to pay attention to repetitive patterns of behavior in one phase or another, and we decided together to find out what helps in such cases. I think my friend was afraid to take responsibility for my condition, but she turned out to be generous and selfless. When I got married, a friend passed this knowledge on to her husband, and he already supplemented it, based on his own experience. The husband initially knew with whom he connects his life. He says it didn’t scare him.

I have obsessions during my manic episodes. My husband does not argue with me at this time, but he also does not feed them, trying to redirect my stormy energy in a different direction. You can’t argue, because the result will be the opposite: I will finally get stuck on the idea, I will consider that I must prove it at all costs, even if the whole world is against me, and there are enemies and conspiracies around. If this does not help, the husband agrees to discuss all these things, but at the same time tries to slow down their implementation by offering to draw up a specific and detailed plan. Sometimes it takes me a long time.

For example, I always want to move somewhere. Right now, and why aren’t we packing our things yet? My husband tries to make me write down what are the pros and cons of different cities, what attracts us to them. As a result, I sit for hours on different forums, make lists, think about how we will arrange our life, calculate the budget for different countries of the world. There is also a manic passion for travel, but after preparation, we usually implement these plans. And many years ago, in a fit of mania, I bought an apartment – with a mortgage, with hellish payments. Then it took a long time to resolve this situation, but, fortunately, everything worked out well.

My husband began to chart my mood. I also manage it, and we check the results so that they are objective. Quarrels due to the fact that the husband takes on the role of the elder often arise in the manic phase (never in depression). Then I become very suspicious, any attempts at control cause rage. But now the husband has learned from experience, so he does not react to attempts to unleash a conflict. With obvious attacks of rage and auto-aggression, he uses holding therapy (long strong hugs. – Note ed. ). We have seen this in autistic children, this is how their parents influence them.

When I’m depressed, he doesn’t comfort me because it’s pointless, but he tries to give reasonable arguments that this period has always ended and this time will also pass soon. We look at mood charts for the past months, discuss the duration of the attacks: two weeks have already passed and, judging by past experience, it should get better in a couple of weeks.

Such support from the husband helps in many ways. When I was being treated by two doctors, taking all the medicines, I didn’t have such support, everything was very bad. Over time, I stopped disappearing from home in a manic state and inflicting serious injuries on myself. All my super-ideas remain on paper in the form of graphs and tables, I don’t even have time to start putting them into practice, so that later I don’t have to deal with the consequences with the whole family.

Alisa, 27 years old

Biologist

To be honest, I don’t always find understanding from my healthy environment, I often faced condemnation, devaluation of problems. But from a person who has a similar experience, you won’t hear “don’t invent”, “you can’t feel so bad”, “take a walk and it will pass”.

It just so happens that my best friend also suffers from bipolar disorder. I did not look for support in specialized communities where patients communicate, we met by chance. My friend is much older, he has much more life experience, and he was able to become a real mentor for me. Not once did his actions worsen my condition – I hope that he can say the same about me.

When I’m on the rise, I feel uncomfortable when he tries to slow me down and reduce my passions. But as soon as this state passes and I again take a sober look at the situation, each time I thank him for trying to stop the revelry and disgrace. My friend himself is currently not being treated, but he never imposed his position on me, and when I turn to doctors, he supports me in this.

I told the doctor about this source of support – he is all for it. Before meeting a friend, I had suicidal attempts, but during the entire time of our communication I never tried to say goodbye to life. When you know that there is a person who will understand everything and share warmth (while even my own family repels me), that there is a place where you can come in any condition and where they will accept me without unnecessary questions and teachings, this is a source of great strength. and hope.

When I was expecting my second child, I was depressed. My husband did not yet fully understand the features of the disease and did not want to admit obvious things – this added problems, and my emotional state became extremely difficult. It seems that only thanks to the participation of my friend, I did not do anything to myself and successfully endured the pregnancy. The child was named after him.

Sergey, 49 years old

Freelancer

At the height of the depression, I was looking for any available support and ended up in an online group of anonymous debtors (people who have taken on large loans). One of the participants drew attention to my condition and said that I urgently need medical help. Despite the fact that she lives in the USA, we began to communicate regularly via Skype. Olga literally brought me to the hospital and helped me prepare for the treatment.

Americans are a pragmatic people, many young and healthy people have folders with wills and instructions in case of their death. They also approach mental difficulties calmly and thoroughly. It is common practice for the patient to draw up detailed instructions in advance. In the United States, there is a practice of issuing Treatment Agreements for people with mental illness (Treatment Contract). This document is needed so that family, friends and doctors recognize the symptoms of deterioration in time and take into account your experience and wishes in the treatment. Typically, such a document contains: a list of trusted people; signs of a normal state; signs of an approaching episode; symptoms of mania and depression; actions that trusted people should take to help a person get better and keep him from destructive acts; plan of action in case of an emergency (for example, a suicide attempt).
who and what will be done in case of his hospitalization, so that he can be treated without anxiety for household chores.

In a period of severe depression, there is a struggle inside a person between the craving for death and the desire to live – and many external things can outweigh in one direction or another. Every clue is important to help you get out. It is very difficult for one to cope with all this.

I madly didn’t want to go to the hospital and wouldn’t have made up my mind myself, until the last I hoped that somehow everything would go away on its own. But under the supervision of a friend, I drew up a preparation plan: warn the customer at work, arrange to look after my cats. Reported to her about every step. But then he could no longer simply “escape” [from hospitalization], because he felt obliged to both her and the doctor. During depression, one’s own life has no value, but the people dear to me, the promises made to them, do.

At the most difficult moment, Olga became my “outer brain”, which told me what to do when I didn’t understand anything myself. After I was discharged from the hospital, I turned to four friends for support. Usually we call each other once a week, I tell what my condition is. It is important not only to chat online, but also to hear the voice, you can understand a lot from it. Friends immediately pay attention, if I suddenly disappear and stop calling, then something is wrong.

I think it is possible to find such a person if you set yourself such a goal. Take a closer look at people in support groups, religious or other communities – those who understand what compassion and mutual assistance are. This must be an internally mature person, ready to take responsibility for you in a difficult situation. If this person has similar problems, then he will better understand your experiences. For this reason, relatives are far from always suitable: they themselves can panic, seeing how bad you feel, choke you with their anxiety, overprotection.

It is necessary to establish the frequency of communication and observe it. And of course, in no case should you parasitize on someone else’s kindness. The support system works when you yourself take responsibility for your life, and do not outweigh it completely on another.

Anna and Valeriya, 21 years old

Students

Anna: After a major depressive episode four years ago that almost ended in a suicide attempt, I started looking for information on [support]. I managed to find a guide in English for relatives and friends on how to behave with such a person. I have sent this list to all my friends so that they have an idea of ​​what is happening to me. For the past few years, Lera has been monitoring my emotional state on a daily basis, and if, in her opinion, it goes beyond the norm, she tells me about it. Lera just asks every day how I’m doing, and if she sees that I’m reacting strangely, she wonders if something happened. At first, it was very difficult, because, in principle, I did not like to regularly share personal experiences. But by regularly receiving feedback, I can imagine the dynamics: do the pills help, how long do the side effects last, does the depressive phase go into a moderate and severe degree, do I lose my critical thinking during hypomania.

Valeria: We gradually established a very trusting relationship. Anya studied the topic of bipolar disorder up and down, and I read the articles that she sent me. The diagnosis did not change anything for me, because it remained the same. After that, we already discussed some formalities (for example, who to call in case of an emergency).

Anna: I asked Lera to watch for hypomanic manifestations in which I lose an adequate assessment of my actions: impulsive night walks, alcohol begin.

Valeria: My friend is a very responsible and conscious girl who takes care of herself, her health and her wallet. Before buying something expensive, she asks for my advice – and then we are already sorting out the situation. We can entrust accounts to each other and not worry. I also know where and to whom to run in cases of exacerbation.

Anna: I react badly to prohibitions and reminders of illness. Yes, I periodically have to turn to relatives for help, change treatment or take long breaks, but I expect mutual respect so that they don’t look at me through the prism of the disease.
When the mood is unstable, harsh phrases like “the disease speaks in you”, “these are not your real emotions” cause persistent rejection, even when they are true. The line between accepting a loved one’s illness and identifying him with a diagnosis for healthy people is extremely thin. Therefore, those who were able to grope it deserve great respect.

Anna: In the last year, I go to see the doctor with my parents. When the doctor notices that I may not be able to do it alone, she duplicates the instructions and advice for them. I, in turn, am a friend. The doctor has repeatedly emphasized that the change of episodes is more noticeable from the outside.

Valeria: We don’t have any kind of hierarchy in relationships, so there is no pressure when one makes decisions for another. This is not eating each other’s emotional resources, but complementing and supporting.

Anna: The main danger in a relationship with a person with a serious illness is to fall into codependency. This format is equally bad for both the “controller” and the “subordinate”. Unfortunately, I have been in such relationships before. It is worth maintaining mutual respect and treating each other as equals. Illness should not dominate a relationship. In difficult episodes, it temporarily comes to the fore, but you should always remember that you are not a disease.

Anna: I have memory problems: I don’t remember some episodes. In such cases, I can ask Lera for help. If you remember the last weeks, then these are regular reminders to call the doctor. In mixed episodes, this becomes an acute problem, because I can suddenly change my mind or forget. Against the backdrop of a severe episode, I may develop psychosis, and this is the most dangerous thing in the disease. Thanks to our format, I manage to avoid such exacerbations almost always.

The advantages of observation from a loved one are an early response and the fact that he knows the patient’s usual behavior very well and can notice even small changes. The main disadvantage is that normal friendly communication risks turning into constant monitoring of symptoms. Not every mentally healthy person is able to remain within the boundaries of reason.

It is important to agree in advance, before an attack, what is an undoubted sign of a worsening condition (for example, persistent insomnia), and what you do not need to pay special attention to (for example, loud indignation at something that you do not like). In a difficult situation, often a loved one begins to behave not as an equal, but as a “healthy” and “knowledgeable”. Not all relationships stand this test.

There is also a variant of “buddy” (when two people with mental disorders look after each other. – Note ed. ) – it is good precisely because it is the true request of the patient and more equal relations without mixing roles. But I don’t know the buddy support system.

To choose a person you can rely on in a critical situation, take a closer look at your surroundings. Above all, a high level of trust is needed. Your assistant should be open to nonjudgmental and open dialogue and at the same time emotionally stable and resistant to stress.

Support is essential for every person – very often we as mental health professionals need it. And with bipolar disorder, this problem is especially acute. At the initial stages, those closest to you often ignore the presence of the disease, and friends advise you to either “pull yourself together” or, conversely, “relax”, sometimes with the help of alcohol. When it becomes obvious to everyone that the “condition” will not go away on its own, urgent hospitalization is already required. The saved patient receives the “stigma”.

Psychiatrists then make it the responsibility of the uninitiated next of kin (parent or spouse) to monitor any changes in the patient, and they really try to do so. At the level of “laughing out loud – hypomania has begun, upset – depression.” As a result, psychiatrists begin to treat quite normal human emotions based on complaints from relatives… and the circle closes.

For this to change, mental health literacy must play a major role. Relatives, in order to be able to help, need to understand well what is happening with a loved one. In many, including state clinics, groups for training relatives either already exist or are being created.

The support of loved ones in case of emergency is especially important. In deep depression or mania, a person is not able to independently control his behavior, this decision is made by relatives, sometimes without his consent. In the case of bipolar disorder, this should be the last option when all others have been exhausted.

BAD – bipolar disorder. What it’s like to live with bipolar disorder, how people with bipolar disorder feel – the story of a person with bipolar disorder – March 30, 2022

In bipolar disorder it is difficult to understand where the personality ends and the illness begins

Collage: Philip Sapegin / E1.RU

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M or just bipolar: under such names, the people know a disorder that affects an average of five to eight people out of a thousand. There are many myths about him, including quite ridiculous ones. On Bipolar Affective Disorder Awareness Day, Ekaterina Bormotova, a journalist from the Network of City Portals, tells how to live with this diagnosis .

A few years ago I was diagnosed with a “fashionable” then already diagnosis – F31. Translated from medical into Russian, this means “bipolar affective disorder.” Many thanks to the doctors for choosing such a pleasant term for the name of my illness, because earlier, back in Soviet times, it was called “manic-depressive psychosis” – you must admit, it’s scary.

But the pleasant term has a downside: few people take the illness with that name seriously. “Manic-depressive psychosis” sounds impressive, and bipolar is something about teenagers who have not decided on their mood. At least that’s how it is perceived by many. And it didn’t help at all when I was diagnosed. Not at all.

I was 27 when I first came to the regional psychiatric hospital. She called an ambulance herself: I was at home alone and felt that now I can do something with myself. My consciousness seemed to split in two: some part of me wanted to end this life, but the other part understood that it should not do this. It’s very scary. Imagine that you are locked in a room with a killer and must persuade him not to kill you. Now imagine that this room is your mind and the killer is you.

By that time I had already seen a psychiatrist, the doctor thought that I had recurrent depressive disorder. He was partly right: depression is part of bipolar. But the second part of it is mania.

People often don’t understand the difference between depression and bad mood. I have a simple explanation: depression is running in water. You do everything that you do on land, you strain your muscles in the same way, you apply the same efforts, but because of the resistance of the water you cannot get the same result. To follow this analogy, mania is weightlessness. Your efforts are not hindered by gravity, you barely push off the ground and fly, not run.

Movie and book protagonists usually say, “I always knew there was something wrong with me.” I never thought so. I was convinced that all people live and feel the same way as I do, they are just stronger and cope, and I always do some stupid things and spoil everything. Even in our youth, my future husband said that I needed to see a psychologist. Of course, I didn’t think so. Later, when we got married, he started talking about a psychiatrist, but I was convinced that everything was fine with me. In the end, I went to the doctor only after the divorce, and he found I was depressed. And a year and a half later they brought me to the eighth kilometer (of the Siberian tract, the address of the psychiatric hospital. – Note ed. ).

There were twenty people in the hospital room. No bedside tables, no TV, no flowers on the windows – only beds with white sheets, I’m wearing a hospital nightgown, a toothbrush and slippers from personal items. This is called the “observation chamber”, newcomers enter there. It sounds creepy, but when you realize that the alternative is death, the choice is obvious. Then those who are not dangerous to themselves and others are transferred to other wards, where you can already have personal belongings, but still you can’t use the phone or, for example, embroider.

The number of suicides in Russia and the world is decreasing every year, but still remains at a high level

org/Person”> Infographics: Vitaly Kalistratov / Network of city portals

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I left the hospital after a month and a half and told about my illness on social networks. I know some people thought it was overkill and some people thought I was a hero for coming out with an open face, but let’s be honest, I had no choice. At work, they knew what hospital I ended up in, and the journalistic community is compact, one way or another people would know that I was in a madhouse. It was easier to tell myself than to catch meaningful looks and fight rumors when I wanted to change jobs.

Then a new life began. Because of one of the drugs, I gained 20 kg, slept 16 hours a day and did not want to leave the house. I was lucky that I could work remotely, my parents supported me, but even so I was forced to get into debt. I can’t imagine how people with my diagnosis cope with work at this stage, it’s very difficult: due to antipsychotics, absent-mindedness appears, cognitive functions weaken, and communication skills are lost.

Books and films about bipolar often reveal the problem of accepting treatment – many people find it difficult to come to terms with the fact that they will have to take drugs for the rest of their lives, which also cause side effects. But they don’t say anything about losing yourself. Here you live for 27 years and think that certain character traits are characteristic of you, and then you find out that, perhaps, these are not character traits, but a disease.

How to understand where you end and the disease begins? How to understand that it was you who wanted to hitchhike, get a cat, move to another city or get married, and not sick thoughts influenced your decisions? Do you love Aivazovsky in general, or did you just see his canvas in mania, when all feelings are aggravated to the limit? I am in several patient communities, and this is what really worries a lot of people.

The good news is that you can live with it. Over time, the body gets used to the drugs and ceases to give very harsh side effects. Some drugs are a thing of the past and are used only during periods of exacerbations, some doctors find a replacement if they complain about unpleasant effects. They picked up a good working scheme for me, with which I can live a full life: work, communicate with people, help loved ones. But, of course, there are exacerbations.

An exacerbation does not start all at once, it develops over several days or weeks. It is very important to notice this at the very beginning, otherwise there will be problems – from quarrels with loved ones to losing a job and debts. Debts… Damn money in mania is spent like it’s not yours. Even before I was diagnosed, I had to mess with it terribly. You know, I would forbid giving people loans without an examination by a psychiatrist. At the very least, it would save me from a number of problems. Fortunately, I never had large sums or property, so I lost a little.

In exacerbations, I offended people, made people fall in love with me, let people down, destroyed important connections, made new dubious ones, behaved disgustingly and defiantly, did things that I really regret and will regret all my life. And I don’t want that ever again. If for this you need to take pills for life, I’m ready.

I am very lucky with my close people. Almost no one abandoned me after I told about my diagnosis, although I know that many patients experience this. It was a little difficult to explain to some close people why I agreed to the treatment – they told me: “You don’t need it, I know you, everything is fine with you, you are normal.” Relatives and friends often persuade patients to stop taking medications, because with the drugs they become “strangers”. But it’s not. I am convinced that with treatment we do not lose ourselves, we find ourselves. It just takes time sometimes. Sometimes this time is measured in years.

I think that being a person with bipolar disorder is not as difficult as living with such a person. My loved ones are forced to constantly remember that my behavior may be due to illness. My mother often asks questions that can annoy an adult. I say that I fell in love, baked a cake or hung out at a bar until five in the morning, and I see wariness in her eyes: she is afraid that this is mania, which will invariably be followed by depression.