Author: Melissa Howard
Understanding bipolar disorder (BD) as a couple is not just managing a diagnosis – it’s about building a life together with greater compassion, flexibility, and love. As this blog is a follow up to my candid Q & A with my spouse, the sequel is a collective of actionable tools we have discovered along our journey to help better manage my BD and its effect on our marriage. Education is the foundation: when both partners learn about bipolar disorder’s symptoms, treatments and patterns, they create a shared language to talk about mental health openly and within a safe space. How mental health appears in each relationship will present differently – the same way BD symptoms are unique to each individual living with the disorder. Recognizing individual triggers, tracking mood shifts, and noticing subtle non-verbal cues become vital skills, allowing early intervention before small problems escalate. Open and honest communication – even when it’s hard – helps couples face the impacts of mania and depression in marriage, from emotional intensity to shifts in intimacy and trust. Working together means embracing the reality that bipolar disorder is something you navigate as a team, not alone. The following is a curated list of personal key points that my spouse and I have utilized throughout our evolving relationship. Understanding and managing bipolar disorder as a couple appears differently than understanding BD individually. For myself, I have to put bipolar disorder first to minimize any potential episodes – by default, so does my spouse.
Understanding Bipolar Disorder as a Couple
Educate Together: Both partners should learn about bipolar disorder—how it affects mood, energy levels, and behavior. Understanding that symptoms are not personality flaws but part of an illness helps reduce blame and resentment.
Recognizing Triggers: Every couple should work together to identify what triggers mood episodes and how to manage them proactively. My spouse can recognize a heightened mood shift coming on before I can identify it. I believe this is because hypomania/mania can feel good in its initial phase. With depression, I am more self-aware; therefore, I’m the one initiating the conversation as well as asking for more support. I have learned to minimize my triggers, but there have been times when life has thrown me those unexpected curve balls that have triggered symptoms of mania or depression. It is important to note that not all triggers are negative. They can come in the form of but are not limited to, a new job, transitioning homes, adding an additional member to your family, graduation, or even the start of a new relationship. It does not have to be a life-changing event. It only has to alter your day-to-day life or interrupt your structured routine to create a mood shift.
Tracking Mood Patterns: Some couples find it helpful to use mood-tracking apps or journals to spot early warning signs of mania or depression. For my spouse and I, we are both aware that the seasonal changes that occur during daylight savings time can trigger mood shifts. Autumn initiates a down curve for me, while spring often creates a heightened sense of happiness. I am hypervigilant during these two periods of the year as they both have triggered episodes in my past.
Communication is Key
During Stability: Have open conversations about boundaries, needs, and expectations when both partners are in a calm, balanced state.
During an Episode: Try to approach mood swings with compassion, not criticism. Instead of saying, “You’re acting irrational,” reframe it as “I see you’re struggling—how can I support you?” Initially, this approach was challenging for my spouse because, for the better part of our relationship, I had been euthymic. When I experienced my most acute episodes of mania/psychosis and then depression fourteen years ago, my spouse had no idea that a BD episode could be so destructive. My symptoms of mania were infuriating, while those of depression were frustrating. Up until that point, my spouse’s level of understanding was in its infancy, and because I was experiencing an episode, I could not rationally explain my symptoms or what was happening to me. I had explained my experiences with past episodes however, there was no preparing him for the episode that evolved fourteen years ago. During that time in our life, there had been an avalanche of triggers that left me vulnerable to a BD episode. I was unable to manage all of the life changes with a young family. My spouse and I learned valuable lessons from that time, the most important being that communication and reaching out for support during the initial symptoms are essential for my maintenance and stability.
Non-Verbal Cues: Sometimes, when words are difficult, having signals or codes to express when one partner is feeling overwhelmed can be helpful. I’ve often used an arm squeeze and a nod toward the door when I’ve hit the end of my tolerance in challenging environments.
The Impact of Mania and Depression on Marriage
Mania’s Effect: During mania, one might experience impulsivity, overspending, hypersexuality, irritability, or grandiosity, which can strain trust. Having safeguards (like joint financial management or check-ins) can help prevent damage to the relationship. My spouse and I check-in with each other, however, when issues have risen without a joint solution, we follow up with our couple’s therapist who provides a safe space when we discuss uncomfortable issues.
Depression’s Effect: Withdrawn behavior, loss of interest in intimacy, and feelings of worthlessness can create emotional distance. The non-bipolar partner may feel rejected or helpless. During episodes of depression, intimacy is the last thing on my mind. My spouse has felt emotionally and physically dismissed by me. This is an issue that has also evolved with age and menopause. There is a level of understanding between the both of us, however, the impact can be damaging if the subject is not addressed on a regular basis.
Supporting Each Other: Instead of pushing a struggling partner to “snap out of it,” gently encourage professional help with the offer of attending appointments together to show unconditional support.
Navigating Conflict & Emotional Intensity
Setting Boundaries: Establishing boundaries around what is and what isn’t ok during mood episodes (e.g., no verbal attacks, taking space when needed) prevents harm to the relationship.
Dealing with Guilt: After an episode, guilt can be overwhelming. A healthy marriage allows for forgiveness, accountability, and moving forward without dwelling on past mistakes. This perspective of a “healthy marriage” is subjective. I speak from a space of personal experience when I say I know how damaging bipolar episodes can be to a relationship, and there are circumstances where the healthiest choice is for a couple to separate for self-preservation. In my circumstance, my marriage would not have survived if we did not go to couple’s therapy.
Couples Therapy: Seeing a therapist familiar with bipolar disorder can provide tools to navigate challenges and strengthen emotional connection.
The Role of the Non-Bipolar Partner
Avoiding the Caregiver Trap: While support is crucial, the non-bipolar partner shouldn’t become a full-time care-giver at the expense of their own well-being.
Maintaining Their Own Support System: Whether it’s therapy, support groups, or friends, having outside support helps prevent burnout.
Encouraging Treatment, Not Enforcing It: Encouraging stability (medication adherence, therapy, healthy routines) is good, but trying to control the bipolar partner’s choices can create resentment.
Keeping the Love Alive
Prioritizing Intimacy: Mood swings can impact sex drive, but open discussions and adjustments can help maintain intimacy and emotional connection.
Finding Joy Together: Shared hobbies, humor, and new experiences strengthen the bond beyond the challenges of mental illness.
Celebrating Small Wins: Recognizing progress—whether it’s managing an episode better, practicing self-care, or simply getting through a tough week—helps reinforce the partnership.
Thriving as a couple where one partner lives with bipolar disorder requires a commitment to ongoing growth, patience, and connection. Navigating conflict with empathy, understanding emotional intensity without personalizing it, and seeking support like couples therapy can help withstand the turbulence that sometimes arises. The non-bipolar partner plays an important role in providing stability and compassion, but it is equally important that their needs are acknowledged and supported as well. Above all, keeping the love alive – through humour, affection, shared dreams and small daily acts of kindness – reminds both partners that their bond is stronger than any diagnosis. With dedication, mutual respect, and trust, couples cannot only survive bipolar disorder but find deeper meaning and intimacy in their journey together.
The content of the International Bipolar Foundation blogs is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician and never disregard professional medical advice because of something you have read in any IBPF content.
