This article first appeared on Your Tango and has been republished with permission.
No matter how strong your marriage or relationship may seem, when mental illness rears its head, none of the generic dating, relationship and marriage advice out there can quite capture how to handle things when your boyfriend, girlfriend, husband, wife or significant other is diagnosed. Knowing which questions to ask the person you love in the face of their own mental health struggles, however, can make all the difference in the world for you both.
I was diagnosed bipolar disorder II in 2014.
Before that time, I had no idea what bipolar disorder was or the stigma that surrounds it and other mental health conditions and issues, much less that I had it.
Since then, I've learned that bipolar disorder, formerly known as manic depression, is a type of mental illness "that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks." The exact causes aren't yet known, but the generally agreed upon risk factors include brain structure and functioning (including physical changes to the brain which may or may not be caused by trauma), genetics and family history.
There are four basic types of bipolar disorder — bipolar I disorder, bipolar II disorder, cyclothymic disorder, and other specified and unspecified bipolar and related disorders. For the purposes of this article, we will look at just the first two.
- Bipolar I: characterized by periods of behavior fueled by mania preceded or followed by periods of deep depression.
- Bipolar II: similar except the depressive episodes may be preceded or followed by hypomanic, but not manic episodes. Hypomania is similar to, but less than severe than, mania.
I was unhappily married at the time of my diagnosis, and my marriage only got worse thereafter. Neither one of us had any awareness of how to manage our relationship and keep the love alive, especially in the midst of uncovering the existence of my illness.
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I have since divorced and started dating again. As I remain determined not to allow this disease to destroy my next relationship, I am upfront and open with any men I meet about what it's like to have, and to be in a relationship with someone who has, a variation of this particular condition.
If you are someone who is dating, in a long-term relationship with or married to someone who has been diagnosed with a form of bipolar disorder, or if you suspect they may have this mental health condition, there are certain questions t’s important to ask in order to maintain a healthy relationship.
Here are five important questions to ask the person you love when they've been diagnosed with bipolar disorder.
1. What does feels like when you are depressed?
For many people, understanding what it feels like when someone is clinically depressed is a tough thing to do. Unless you struggle with depression yourself, you just can’t fully understand what it means to move through the world struggling with hopelessness and dread, what it feels like to carry a 100 lb weight on your shoulders at all times as you struggle to do what other people do so naturally.
For me, my depressive episodes have been deep and long.
I could go days, weeks or months feeling deeply depressed. During those times, the prospect of getting out of bed in the morning to go to work or hang out with my friends filled me with an overwhelming sense of hopelessness and dread. I hated my life and wished I was dead. Doing even the most basic tasks seemed insurmountable.
For me, being depressed was destroying my life. For my husband, who couldn't understand what I was going through, I am sure it was horrible in its own terrifying way. I wish that I'd had both the words and the opportunity to explain to him what I was going through. I truly believe that if he had understood what my depression looked like, he could have understood and learned how to support me, and I could have learned how to support him in return.
Asking this first question of the person you love is the first step towards a far better life for you both.
2. What does it feel like when you are manic?
Manic episodes in bipolar I and II are quite different, and the difference is important to understand.
With bipolar I disorder, imagine what it feels like to drink WAY too much coffee. Your heart beat races, your mind can’t sit still, your impulses are impossible to deny, and your sense of what is and is not appropriate is gone. You spend too much money, drive your car too fast and have a grandiose (i.e., larger than life) perception of who you are in the world.
My grandfather had bipolar I disorder, and during one of his manic episodes he bent a metal fire stoker in half. During another, he ripped iron bars out of a wall. He would hole himself up in the Ritz Carlton and drink Coca-Cola for days straight, entertaining a different woman each night.
With have bipolar II disorder, you experience hypomanic episodes, which are less severe than, but similar to, the manic episodes experienced by people with bipolar I.
When my hypomania sets in, it is to a far lesser degree than my grandfather's mania. become productive and hyper-focused. I can finish a 1000 piece puzzle in about 5 hours. I do drive my car fast and I have to watch my spending, but I am rarely driven to feats of strength or other extremes.
Asking your boyfriend, friend, husband, wife or significant other to explain what their own mania looks like opens the door for them to help you understand the particular effects this disorder has on them. Understanding makes accepting it possible, and with acceptance, comes support for you both.
3. What can I do for you when you are in crisis?
When you have a loved one who is in crisis, who is suddenly either manic or depressed, or rapidly cycling back and forth between the two, it's quite common to desperately want to help and feel absolutely helpless at the same time. What kind of help can you give? What if what you think would be help is actually NOT helpful at all?
For me, when I am in crisis during a hypomanic or depressive episode, there are a few things I know that I need. I need to take care of myself. I need to eat healthy food. I need to keep my brain occupied and myself busy. I need to exercise. I need to be intimate with my partner.
And I need my partner to acknowledge that I am depressed. To have my partner ignore my depression and pretend like it’s all okay makes it all worse.
I also need my partner to gently point out to me that he is seeing signs of depression or hypomania if I am not seeing it, which sometimes happens. I need him to be willing to give me space to be alone. I need him to understand that I am not in control of what is happening, and to allow me to ride it out as I know best.
I need my partner to remember that I am still me.
The person they love is still in there and has only stepped away temporarily. With time and effort, I will be back, so please, I need my partner to be patient with me.
Most importantly, I need him to notice if I can’t ride it out I will need extra help, and I need him to help me get it.
What your partner needs may be quite similar or quite different. The only way you will know is if you ask them this question. And the only way they will know what you need as well is if you share that, too.
4. What should I NOT do when you are in crisis?
Just as important as understanding what the person you love needs you to do during a manic or depressive episode is understanding what they need you NOT to do during these times.
As stated above, I need the crisis identified, and I need to know that my partner acknowledges and accepts what's happening.
What I don’t need is to be "fixed."
I don’t need to be reminded about how great my life is when I am depressed. I don’t need to be told to suck it up and that I can "choose" to be happy. I don’t need to be told to relax when I am hypomanic and on a productivity spree. And I certainly don’t need to be treated like a child who has had too much sugar.
I also don’t need to be berated for my moods and made to feel like a loser. If I am annoying my partner, he should tell me as much and then leave, as opposed to sticking around, getting frustrated and taking that frustration out on me. I do much better dealing with this on my own than I do when I have to help someone manage their own mood as well.
Find out in advance what your partner feels is entirely not at all helpful from you during their own periods of mania and depression so you can avoid unnecessary fighting for both of your sakes.
5. Who can I call if you aren’t getting better?
I spoke to a woman the other day who was inspired to get help for her mental illness after she heard me speak. I asked her if she knew where to start and she said NO.
It’s important that your partner know what resources are available for him or her to help you deal with your illness if it gets out of your control.
Who is in your support system? For me, my number one support has always been my doctor. I share that doctor’s number with my partner in case it’s necessary for them to reach out for help. I also encourage them to reach out to certain friends who have been through this with me before and who know what works and what doesn’t.
Having others to go to for help and knowing that there is support out there for both of us should we need it lightens the load on my partner and on myself.
I truly believe that if you are going to choose to love someone with bipolar disorder, it is essential that you have a comprehensive understanding of what this particular mental illness looks like, as well as an acceptance of the fact that your partner will live with this disease for the rest of their life.
My bipolar disorder doesn’t control me, but it does rear it’s ugly head from time to time. That my partner accepts this and is willing to do what needs to be done in order to support me through it is essential part for us to sustain healthy relationship.
So, ask questions. Understand what you are getting into.
If you can't fully accept your partner’s condition, perhaps being in a relationship with them isn’t a good idea for either of you.
And thank you for reading this article and trying to understand what bipolar disorder really looks like. Understanding this disease is an important thing in this world, and you are making it happen.