Marriage presents challenges to the healthiest of partners, so many people wonder how couples manage when one spouse suffers from a mood disorder. Millions of people are affected by bipolar disorder, a mood disorder that can cause frustration, worry, irritation, and anger for both partners in marriage. With appropriate treatment, people with bipolar can enjoy meaningful, successful lives. If you're married to a person with bipolar, you can keep your marriage flourishing by teaming up with your spouse in the management of his or her symptoms.
What is Bipolar?
Bipolar is a brain disorder that is highly influenced by environmental stressors. Bipolar I and bipolar II are two of the main types of bipolar conditions. Although people with bipolar II often suffer from more chronic depression, experts consider bipolar I to be the more severe condition because it can include episodes of extreme mania along with hallucinations and delusions. Bipolar II sufferers experience the unusual highs of hypomania and the lows of depression. The symptoms of hypomania can include a decreased need for sleep, distractibility, rapid speech, excess energy, reckless behavior, and irritability.
Marianne and Roy
Marianne and Roy had been married for eight years. Marianne struggled with mood swings and, after the birth of their second child, had been diagnosed by her doctor with bipolar II. Sometimes she was lethargic and pessimistic, and at other times she was agitated and had so much energy she stayed up all night.
Roy was growing tired of her mood swings. He was upset when Marianne talked so rapidly it was hard to interrupt her, and he often found himself tuning out. Sometimes he felt anxious when Marianne abruptly became angry. He would think to himself, "This is not the woman I married. It's like she's someone else."
During an episode of hypomania, Marianne would stay up until 3 a.m. working at the computer. Her need for little sleep irritated Roy because he couldn't get the rest he needed. He also longed for Marianne to go to bed with him at a regular time so they could be close. Although Marianne's high cycles typically only lasted a few weeks and were decreasing in frequency with the help of her psychiatrist, her episodes of depression were more chronic and required well-developed positive coping skills for her to manage her condition.
When Marianne was depressed she had a hard time getting out of bed in the morning — she seemed to have nothing to look forward to and nothing that she wanted to do. She mostly noticed the negative thoughts floating through her head such as "I just don't have the energy for anything; I just want to stay in bed" or "Things will never get better; I‘m going to lose my husband and my family." This type of exaggerated, distorted thinking is typical of depression. Fortunately, cognitive behavioral therapy (CBT) has proven effective for helping people develop more forward-moving thinking patterns.
Roy often worried about his wife when she was depressed, but sometimes he felt angry. He would think to himself, "Why can't she just snap out of it? She sounds like such a victim." Through reading, Roy learned that moving through a depressive cycle often required a serious effort from Marianne, but it was something she could breakthrough. He was relieved to learn that there were some concrete things he could do to help. I highly recommend the following two books, both written by Julie A. Fast and John D. Preston, Psy.D.: "Loving Someone with Bipolar Disorder," and "Get It Done When You're Depressed."
One thing we know for certain about depression is that exercise helps. Any type of exercise will do, but aerobic exercise is especially helpful to get your metabolism going, produce feel-good endorphins, and manage stress. Choose something you might enjoy and start with 10 minutes a day, gradually working up to at least 30 minutes a day. Of course, check with your physician before embarking on any exercise program, and pick a physician who exercises.
Roy encouraged Marianne to walk with him two or three days per week. This was doubly beneficial: it helped Roy stay fit, and it enhanced their relationship by enabling them to have fun together. They often walked to their favorite coffee shop, enjoyed a cup of coffee, and hiked back home. Afterward, they felt relaxed, invigorated, and ready for a productive day. It was much easier for Marianne to keep busy crossing things off her list after she had done some exercise.
Action is crucial when a person is depressed, and nothing is more important than a plan. Over a quiet dinner together, help your partner break a task down, lay out a schedule, and come up with a reward you can share. Just talking things out with your depressed spouse can have an energizing effect.
Target Distorted Thinking
Marianne regularly indulged in some distorted thinking that only deepened her depression. Roy was able to help her by periodically targeting these common types of thought distortions:
1. All-or-nothing thinking. Marianne often thought to herself, "I'm always going to be depressed." Of course she had periodic episodes of depression, but the belief that she was "always" going to be depressed was inaccurate.
2. Poor-me thinking. Marianne sometimes felt sorry for herself and thought, "If only depression didn't run in my family, I'd have a life." People with depression aren't victims — they can learn to manage their condition and have successful lives and flourishing marriages.
3. Fortune telling. Marianne made assumptions about Roy such as "I know Roy will leave me if I keep getting depressed." This type of thinking isn't based in reality: Roy loved Marianne deeply, and he'd never considered leaving the marriage.
Roy had an agreement with Marianne that he'd pull on his ear when he heard distorted thinking from her, and then she could stop and focus on what she was thinking. With this habit, she became more conscious of her thoughts instead of being dragged down by what are typically automatic negative thoughts.
Give Some Praise
Telling your spouse you admire his or her strength and giving positive attention can make a world of difference. Roy couldn't read Marianne's mind, so she practiced asking him for hugs and attention when she needed them.
Let It Be
When partners don't like each other's behavior, they often resort to lecturing, which usually backfires instead of creating positive change. As long as you have clearly expressed your feelings, thoughts, and wants, just letting things be for a while and accepting the situation can sometimes motivate change.
Think About the Good Things
Remember all of your spouse's good qualities. It's easy to forget about these when you're in the middle of a disruptive episode, but keep in mind that your spouse is not the disorder. A spouse with bipolar requires support, exercise, a healthy diet, positive thinking, and often, medication. When these conditions are successfully treated and you make yourself part of your spouse's care team, you're both on the path to a thriving marriage.