How can one reconcile bipolar disorder and life as a couple?

Romantic relationships are rarely simple. When one of the partners suffers from a psychiatric disorder, they demand so much the more communication and compromise to hold over time. In contrast to appearance, love and bipolarity are not so incompatible, provided certain requirements are met. How to lead a healthy married life? Dr. Isabelle, psychiatrist and general secretary of the French Psychiatric Association, informs us.

What is bipolar disorder?

Bipolar disorder, formerly known as manic-depressive psychosis, is one mood disorder characterized by phases of mania and depression, interrupted by phases of remission (where the mood stabilizes and becomes “normal”). “It must be distinguished from borderline disorder: in this case, the mood swings are numerous and occur during the same day. While in the classic form of bipolar disorder, the phases of deep depression and intense tension (mania) last several weeks,” the psychiatrist specifies. And to indicate:

During the phases of depression or mania, patients’ emotional and affective lives are disrupted: either it is off or it is totally aggravated. What seriously compromises the quality of vision in patients who are more likely to develop anxiety disorders, addiction and suicidal behavior.

Identify the depressive phase

The depressive phase is marked by great difficulty in feeling pleasure: anhedonia. “The feeling of love, joy and emotional life is very strongly affected. Patients no longer have a taste for life and their self-esteem plummets,” says Dr. Isabelle Secret-Bobolakis. They may show several of these symptoms:

  • -one depressed mood ;
  • -one loss of interest or pleasure ;
  • -one loss or increased appetite ;
  • from insomnia or vice versa hypersomnia ;
  • psychomotor retardation;
  • very severe fatigue (asthenia);
  • loss of self-esteem:
  • -one guilt important;
  • greater indecision;
  • dark thoughts, suicidal thoughts or thoughts.

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

Identify the manic phase

The manic phase is mainly characterized by hyperactivity, excessive euphoria and ideas of greatness. “In these phases, impulsivity and uninhibition take overs, which calls for all kinds of extravagance: Especially at the sexual level, but also at the economic level, e.g. through ruthless purchases “, warns the professional. The patient’s (or patient’s) consequences may also be confronted with some form of aggression. Patients may have several symptoms:

  • great euphoria ;
  • -one high self-esteem And sometimes megalomaniacal ideas ;
  • a reduced need for sleep;
  • great willingness to speak (logorrhea);
  • confused ideas or even a racing tank;
  • attention and concentration problems ;
  • -one hyperactivity (which can result in social, professional, academic, financial, sporting or even sexual over-investment);
  • risky behavior : forced purchases, speeding, unprotected or multiple intercourse, violent, harmful or even criminal acts, gambling, etc .;
  • from psychotic symptoms : delusions, hallucinations and destructuring of thoughts.

This Emotional instability inevitably has consequences for affective relationships, especially relationships. Especially since the disease experiences a delay in diagnosis and is therefore slow to be taken care of. Once diagnosed, bipolar disorder can be checked with mood-stabilizing drugs and to psychoeducational care.

Does bipolar disorder affect the ability to love?

When they are not in the manic or depressive phase, people with bipolar disorder are quite able to identify their feelings, feel and give love. Difficulty arises during acute phases, known as decompensation (manic and depressive phases).

People with bipolar disorder fall in love just like everyone else. They do not form particularly dysfunctional pairs, but the disease can end up creating difficulties, emphasizes Dr. Secret-Bobolakis.

When they take their treatment and ensure compliance with their follow-up, the patients are completely able to maintain a stable relationship. As in any couple, it requires communication, understanding and some sacrifice.

What negative consequences can bipolarity have on the couple?

Let’s face it, bipolar disorder weakens relationships, but also, more generally, socio-professional relationships. “Mood swings are not easy to deal with for either the patient or the partner. Unfortunately many unions end up in separation or divorce. Most often, the spouse can no longer cope and throws the towel in the ring, “the expert states.

Everything is not always black: Bipolar people often have generous, creative and sensitive personalities. But sometimes it is not enough to remedy it daily mental workload. The partner often lives in surveillance: he or she constantly keeps an eye on the warning signs (prodromes) of a manic or depressive attack. Added to this anxious expectation is the frustration, fear, and sadness of not being able to alleviate the symptoms of the disease. Not to mention the weight of everyday tasks that fall on him as soon as the patient enters a depressive phase (asthenia, anhedonia).

When the spouse becomes an obstacle

Another difficulty, and not least important: In the manic phase, the bipolar person may have recurring infatuations, commit infidelity, endanger the household economy, develop violent reactions, and so on. In some very rare cases, placement under guardianship (or even guardianship) is necessary because the patient enters a phase of denial of his illness and refuses to take his treatment. The spouse is then perceived as a brake, an obstacle that prevents spending, criticizes, does not support enough …

Are these relationships viable in the long run?

“It depends entirely on the quality of the care the patient receives (long-term follow-up, regular, supervised, if possible, by the same team),” the psychiatrist replies. prodromes of decompensation, then a couple and family life is quite possible with time. But keep in mind that bipolar disorder cannot be “cured.” He’s there for life. ”

How do you cope with a relationship when you suffer from bipolar disorder?

People with bipolar disorder need to adopt a very strict lifestyle in order to best control their illness:

  • get enough sleep;
  • limit stressors;
  • avoid alcohol, drugs and tobacco;
  • participate in regular sports activity;
  • adopt a healthy and balanced diet;
  • do not take medication (including antidepressants) without medical advice;
  • etc

The importance of monitoring and transparency

Bipolar people who want to enter into a romantic relationship must realize that they are suffering from a mental illness that requires regular therapeutic follow-up. To lead a healthy relationship, the most important thing is to learn to communicate with your 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, do not hesitate to meet with their relatives to ask all the questions necessary for your correct understanding of the disorder. “In most cases, bipolar patients have a good level of social-professional integration. They are often creative, original and charming people,” warns Dr. Secret-Bobolakis.

We may be seduced 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 knowing the other person and their history well, seeking education to better understand their illness, being flexible, attentive, patient, etc. You must also be able to clear periods of denial : “Often the bipolar patient in the remission phase thinks that he or she no longer needs care. Communication becomes difficult, dialogue often gives way to crying and blame. Relatives must then be able to count on support from trusted teams, in order to take care of the patient. ”, The specialist insists.

Is it dangerous to live with a bipolar person?

No, bipolars are not dangerous to those around them. Psychiatric illnesses are not dangerous in themselves. On the other hand, bipolar can put itself at risk : The risk of suicide in the depressive phase or of ill-considered decision in the manic phase poses a real danger. This is all the more true when the person is in the grip of addiction (alcohol, drugs, gambling, etc.), which can aggravate aggressive actions.

Do not hesitate to get help!

All “psy” diseases have consequences for the immediate consequence (parents, children, spouse, etc.). The life partner quickly becomes a “helper”: he or she provides moral support, emotional presence, treatment follow-up, 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, listened to and supported.

Bipolarity: what advice to live a quiet life as a couple?

As in any relationship, it is important to listen to each other, to understand each other and to 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.);
  • To express his feelings: to calm his love makes it possible to consolidate the couple in spite of the hardships;
  • Become aware of each other’s feelings and accept them without being offended.

When the disease takes up too much space in the relationship, it is important to discuss it with the health teams, possibly after couples therapy. Everyone needs to be aware of their role and their boundaries. Conclusion? Having a relationship with a person with bipolar disorder is not impossible, but it does require patience and stability.

A movie to watch to get ahead: Intranquillesdirected by Joachim Lafosse with Leïla Bekhti and Damien Bonnard (2021).

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