Samantha Turner, 36, and her partner Alex, 39, were excited to host a Thanksgiving dinner for their relatives and close friends this year. As their three children were enjoying the festive parade on TV that morning, Samantha — who has bipolar disorder — started to feel overwhelmed by the noise and the tasks she still had to manage for the dinner.
As her anxiety escalated, her patience dwindled, and she began to get irritated with Alex and the kids.
Over their ten-year relationship, Samantha and Alex have developed strategies for managing such situations. Alex suggested that Samantha take some time for herself in a special retreat they set up in their attic. While Alex entertained the kids and handled the kitchen preparations, Samantha went upstairs to her peaceful nook.
This area is designed as a calm space where she can unwind. It is neatly organized, equipped with cozy pillows, scented candles, and soothing music to help her relax. Samantha often uses this spot for quiet reading, gentle stretching, or simply to take a moment to breathe and center herself.
Samantha was diagnosed with bipolar disorder shortly before she and Alex became a couple. In the decade since, they have learned how to spot and mitigate potential triggers that might upset Samantha, like their Thanksgiving morning incident, and they work proactively to prevent them.
Bipolar disorder can introduce additional challenges into a marriage. Research suggests that individuals with this mental health condition are less likely to marry and more likely to experience divorces, as highlighted in a study review from the July–December 2017 issue of the Industrial Psychiatry Journal.
However, bipolar disorder does not have to restrict a marriage, according to Gregory Nawalanic, PsyD, a clinical assistant professor of psychiatry and behavioral sciences at the University of Kansas Medical Center, and the clinical director of psychology services at the University’s Strawberry Hill Campus. Dr. Nawalanic, who specializes in treating patients with bipolar disorder, believes that while challenges are inevitable, they are a part of every marriage.
Tiffany and Mike acknowledge that they continuously refine their coping strategies. Here are some effective tips they’ve shared.
Communicate — Even When Things Are Going Well
The couple emphasizes the importance of discussing problem-solving strategies during stable periods, which they believe is essential.
The clinical psychologist supports this approach, noting, “This establishes a clear understanding and sets expectations for agreed-upon behaviors that are beneficial when situations intensify.”
He provides an example: If one spouse needs a moment alone during the other’s symptomatic phases, as the wife did on Christmas morning, discussing this in advance helps the other spouse recognize it as a coping mechanism rather than an unexpected withdrawal.
However, safety is paramount, the psychologist points out. For instance, if there’s a concern about potential self-harm during a manic or depressive episode, immediate safety concerns should override any previously agreed-upon strategies.
Know Your Partner’s Signs and Triggers
The psychologist emphasizes the importance of recognizing the onset of a mood episode to potentially prevent it or seek early intervention.
According to the Mayo Clinic, a depressive episode might include symptoms like a depressed mood, feelings of sadness and hopelessness, loss of interest in usual activities, sleep disturbances, changes in appetite, and suicidal thoughts or behaviors.
For a manic or hypomanic episode, symptoms can include feeling unusually upbeat, restless, or irritable, increased energy or agitation, an inflated sense of self-confidence, reduced need for sleep, heightened talkativeness, racing thoughts, and impulsive or risky decision-making.
The husband notes that understanding your partner’s triggers and trying to empathize with their experience is crucial. “If you notice a trigger that could lead to an episode, consider a personal anxiety-inducing situation, like flying or being in an elevator, to relate to what your partner might be feeling. This understanding can significantly improve your ability to assist them,” he explains.
The psychologist suggests that couples might even adopt a safe word, such as “mistletoe,” to signal a potential onset of an episode and to express their support and love, even though protective measures might be necessary.
Give Each Other Space
“It can be difficult to always prioritize the other person or to consistently be our best selves,” says the psychologist. “Sometimes, both partners, regardless of whether they have bipolar disorder, need their own space to replenish their personal emotional reservoir.”
The wife finds solace in meditation and yoga during stressful manic episodes, and the husband understands the importance of giving her this space, taking care of the children during these times.
The husband also has his own hobbies and retreats. He finds playing video games particularly soothing when stressed. They make it a point to discuss their experiences after spending time alone.
For instance, after the wife had some alone time on Christmas Day, the husband joined her later for a calm and nonconfrontational discussion. The wife appreciates these moments, stating, “Having him approach me in a peaceful manner enabled us to have a meaningful conversation.”
Remember That It’s the Bipolar Disorder, Not the Person
The psychologist stresses that bipolar disorder is not a choice for the affected individual. It’s crucial to address the symptoms rather than the person during a mood episode.
The husband explains, “When episodes occur, I remind myself that it’s not my wife, whom I love, who is behaving this way, but the disorder that is manifesting. Being patient and aware of what’s happening and why is beneficial for both of us.”
This patience also involves understanding that hurtful remarks may be symptoms of the disorder. The husband notes that his wife might say hurtful things during a manic episode, “but the worst response I could have is to retaliate or to start yelling back.”
Take Time for the Two of You
The couple makes it a point to schedule a date night at least once a month without the children. “Every couple faces challenges and equally deserves to enjoy the happier moments of marriage,” the psychologist notes.
Going on occasional date nights can offer several benefits for couples. First, it provides an opportunity to reconnect and spend quality time together away from daily responsibilities and distractions. This can strengthen the emotional bond and enhance communication. Date nights also allow couples to relax and enjoy each other’s company in a different setting, which can rekindle romance and intimacy. Additionally, such outings can serve as a reminder of the reasons they fell in love, helping to maintain a healthy and vibrant relationship.
Learn as Much About Bipolar Disorder as You Can
The couple emphasizes the importance of educating themselves about bipolar disorder, seeking out online resources to better understand the condition, available treatments, and effective management strategies. The psychologist concurs, noting that gathering information together as a couple can significantly enhance understanding and cooperation.
Plan in Advance How You’ll Talk About Medication
Discussing medication can be sensitive, especially if a spouse with bipolar disorder is experiencing symptoms. Asking about medication might sound accusatory and make the partner feel irresponsible. “It’s a hard question to hear,” acknowledges the wife, highlighting the importance of the manner in which the question is asked. “You don’t want to feel like you’re being irresponsible.”
The husband has adapted by asking in a way that conveys concern rather than frustration, such as, “Was there something that kept you from taking your medicine today?”
The psychologist underscores the value of having these discussions when both partners are in a stable mood. He suggests that using a pre-agreed code word or phrase, like, “Did Sally come over today?” could be a gentle way to broach the subject, emphasizing concern over judgment.
Have a Plan for Emergencies
The psychologist emphasizes the importance of having a clear strategy for handling severe episodes, whether that involves offering support, contacting a doctor, or initiating hospitalization. Afterward, it’s crucial for the couple to discuss the episode to understand what happened and why.
The couple has established an emergency plan: if a situation becomes serious, the husband takes charge. “From calling the doctor to deciding if hospitalization is necessary, we’ve developed that level of trust,” says the wife.
They also make sure to “reconnect” after an episode to discuss what occurred, how each felt during the incident, and whether any adjustments to their emergency plan are needed.
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