Bipolar disorder is characterized by extreme mood swings. These can range from extreme highs (mania) to extreme lows (depression). Episodes of mania and depression often last for several weeks or months. Follow this article and explore more about bipolar disorder and what it is like being in a relationship with someone who is bipolar.
Bipolar disorder is a brain disorder that causes changes in a person’s mood, energy, and ability to function. People with bipolar disorder experience intense emotional states that typically occur during distinct periods of days to weeks, called mood episodes. These mood episodes are categorized as manic/hypomanic (abnormally happy or irritable mood) or depressive (sad mood). People with bipolar disorder generally have periods of neutral mood as well. When treated, people with bipolar disorder can lead full and productive lives.
People without bipolar disorder experience mood fluctuations as well. However, these mood changes typically last hours rather than days. Also, these changes are not usually accompanied by the extreme degree of behavior change or difficulty with daily routines and social interactions that people with bipolar disorder demonstrate during mood episodes. Bipolar disorder can disrupt a person’s relationships with loved ones and cause difficulty in working or going to school.
Follow this article to learn more about what is bipolar disorder and what is it like being in a relationship with someone who is bipolar?
Table of Contents
What is bipolar disorder?
Bipolar disorder is a mental health condition marked by extreme shifts in mood. The National Institute of Mental Health describes the main symptoms of bipolar disorder as alternating episodes of high and low mood. Changes in energy levels, sleep patterns, ability to focus, and other features can dramatically impact a person’s behavior, work, relationships, and other aspects of life.
Most people experience mood changes at some time, but those related to bipolar disorder are more intense than regular mood changes, and other symptoms can occur. Some people experience psychosis, which can include delusions, hallucinations, and paranoia. Between episodes, the person’s mood may be stable for months or years, especially if they are following a treatment plan.
Treatment enables many people with bipolar disorder to work, study, and live a full and productive life. However, when treatment helps a person feel better, they may stop taking their medication. Then, the symptoms can return. Some aspects of bipolar disorder can make a person feel good. During an elevated mood, they may find they are more sociable, talkative, and creative.
However, an elevated mood is unlikely to persist. Even if it does, it may be hard to sustain attention or follow through with plans. This can make it difficult to follow a project through to the end. Bipolar disorder is a mental health condition that causes extreme shifts in a person’s mood and energy level.
A person with bipolar disorder may experience periods with an extremely elevated or irritable mood (called manic episodes, or mania) as well as episodes of depression. These shifts are more severe than the normal changes in mood that affect everyone. They can involve impaired thinking and behavior, and can affect your ability to function day to day.
Bipolar Disorder is distinguished from Major Depressive Disorder by the presence of manic or hypomanic episodes. It is distinguished from Schizoaffective Disorder by the absence of psychotic symptoms (such as delusions, hallucinations) during periods of stable mood.
Bipolar Disorder is really a spectrum of disorders. Bipolar I disorder is characterized by a history of at least one manic episode, and (usually) depressive episodes. Bipolar II disorder is characterized by hypomanic episodes alternating with depressive episodes. Cyclothymia is characterized by highs which fulfill some but not all criteria for hypomania and lows which fulfill some but not all criteria for depression.
What are the early signs of bipolar disorder?
This serious mental illness affects about 6 million women and men in the U.S., according to the Depression and Bipolar Support Alliance (DBSA). And it can be harrowing and dangerous for people around them. In the manic phase, sufferers often don’t think anything’s wrong. They’re hyper-energized and brimming with confidence. But they’re not as invincible as they feel. Eventually, people almost always make a big mistake, such as a foolish investment or an ill-advised affair. Recognizing the mania and depression signs of bipolar disorder is the first step to getting help. Here’s what to look for:
- Unusually upbeat, outgoing or irritable mood
- Racing thoughts and speed-talking
- Boundless energy
- Impulsive and self-destructive behavior
- Decreased need for sleep
- Inflated sense of self-worth
Unusually upbeat, outgoing or irritable mood:
During a manic phase, some people feel euphoric, others talk nonstop and some develop a hair-trigger temper. The key is that their mood is a radical departure from the norm. A person who’s usually a reasonable individual may suddenly become impossible to live with.
Racing thoughts and speed-talking:
Besides speaking quickly and jumping between ideas, a person in a manic phase may also be easily distracted — one reason mania is sometimes mistaken for ADHD. Unfortunately, the primary treatment for ADHD is stimulants, which can trigger severe symptoms in someone with bipolar disorder.
The extremely energetic behavior common in the manic phase often leads to rushing around and taking on new projects, however ill-advised. If the sufferer is also easily distracted, he’ll jump to new tasks before completion.
Impulsive and self-destructive behavior:
Spending sprees, flagrant affairs or risky investments can all signal bipolar disorder if they’re out of character and part of a larger pattern of symptoms.
Decreased need for sleep:
Sleeping only a few hours a night could be a sign of bipolar disorder – as well as depression or anxiety. People with insomnia typically feel very tired during the day. Someone in a manic episode may never feel exhausted.
Inflated sense of self-worth:
An exaggerated sense of your power, knowledge or importance is common in the manic stage, such as believing you have a special relationship with God. It’s a feeling of being invincible and doing no wrong.
What are the different types of bipolar disorders?
Like many other conditions, bipolar disorder is not one-size-fits-all—though, in general, the mental illness causes unusual shifts in a person’s mood, energy, and behavior, it does so to various extents. Bipolar disorder symptoms can range in severity and duration depending on the type of bipolar someone has. Treatment may also vary among the various forms of bipolar disorder.
- Bipolar I disorder
- Bipolar II disorder
- Rapid cycling bipolar
- Cyclothymic disorder
- Bipolar with mixed features
- Unspecified bipolar disorder
Bipolar I disorder:
Bipolar I is the most severe form of mental illness. To be diagnosed with bipolar I, someone has to experience a major depressive episode for at least two weeks, plus a manic episode that lasts for seven days (fewer, if the patient is hospitalized for the symptoms). People with bipolar 1 disorder may also experience psychosis, hallucinations, and delusions. People with bipolar I are also more likely to be hospitalized for their symptoms than those with other types of bipolar disorder.
Bipolar II disorder:
Like bipolar 1 disorder, bipolar 2 disorder (or bipolar II disorder) involves episodes of depression. But rather than full-blown manic episodes, people with bipolar 2 experience what’s known as hypomania. It’s the same symptoms as mania, but the severity and duration are less than with bipolar 1. Usually, people experience milder symptoms of mania for four consecutive days, and people generally don’t go to the hospital for them.
Rapid cycling bipolar:
You may be told you have bipolar 1 or 2 ‘with rapid cycling’ if you’ve experienced 4 or more depressive, manic or hypomanic or mixed episodes within a year. This might mean:
- You experience episodes of mania or hypomania, followed by episodes of depression.
- You feel stable for a few weeks between episodes. For example, you may cycle between manic episodes and stable periods.
- You experience episodes that last months, weeks or days.
If you have bipolar disorder, you may experience rapid cycling at certain times in your life and not others. Currently, rapid cycling is not officially considered a separate type of bipolar disorder. More research is needed about rapid cycling and how best to treat it.
Cyclothymic disorder, also called cyclothymia, includes hypomania and depression. But the hypomania is not severe enough to be mania, and the depression symptoms aren’t severe enough to be major depression. Otherwise, you’d be classified as bipolar 2. Usually, people with cyclothymic disorder experience milder symptoms for a longer duration—for example, two full years with a few depression symptoms and a bit of hypomania. Cyclothymia is usually treated with mood stabilizers.
Bipolar with mixed features:
“Mixed features” refers to the occurrence of simultaneous symptoms of opposite mood polarities during manic, hypomanic or depressive episodes. It’s marked by high energy, sleeplessness, and racing thoughts. At the same time, the person may experience hopeless, despairing, irritable, and suicidal feelings.
Unspecified bipolar disorder:
Unspecified bipolar disorder includes symptoms of both depression and mania that don’t meet the criteria for a clinical diagnosis. You may have a few symptoms of depression and mania, but not the full diagnostic criteria based on the duration of how many symptoms you have. So there are some bipolar symptoms there, but not enough to diagnose any of the other three types.
What are the mood episodes in bipolar disorder?
All forms of bipolar disorder involve mood episodes—sometimes known as mood “swings” or mood cycling. As the name suggests, the condition involves two poles or periods of low mood and elevated mood. The three specific mood episodes seen in bipolar disorder include:
- Depressive episodes
- Manic episodes
Depressive episodes are known as the “low” period of a person’s bipolar disorder. A person must exhibit one or more of the following symptoms nearly every day for at least two weeks, and those symptoms must significantly impair their daily life.
- Feeling very sad, “down,” empty, worried, or hopeless
- Feeling slow or restless
- Sleep issues (trouble falling asleep, waking up too early, or sleeping too much)
- Weight gain or increased appetite
- Talking slowly
- Difficulty concentrating, making decisions, or performing simple tasks
- Lack of interest in activities
- Decreased sex drive
- Unable to experience pleasure (anhedonia)
- Thinking about death or suicide
What distinguishes bipolar disorder from depression are episodes of mania or hypomania. In order to be diagnosed with bipolar disorder, a person must have experienced at least one episode of mania or hypomania, in addition to depressive episodes the following are symptoms of mania:
- Feeling elated, “up,” “high,” or elated
- Feeling touchy or irritable
- Decreased need for sleep
- Loss of appetite
- Talking fast or rushed
- Racing thoughts
- Risky behaviors, such as substance abuse, spending money, or reckless sex
- Feeling unusually important, talented, or powerful
Hypomania includes similar symptoms to mania, but according to Dr. Potash, the symptoms aren’t as extreme and they’re shorter in duration. For example, someone with hypomania might experience elevated mood for four days rather than an entire week. In general, bipolar mood episodes typically last for months before shifting. Some people experience rapid cycling, in which they shift from high to low mood (or vice versa) over the course of days or hours.
What can cause bipolar disorder?
No one knows exactly what causes bipolar disorder. Research suggests that a combination of factors could increase your chance of developing it. Following are some of the causes of bipolar disorder:
- Childhood trauma
- Brain chemistry
- Stressful life events
- Family links
- Drugs and alcohol
Some experts believe that experiencing a lot of emotional distress as a child can cause bipolar disorder to develop. This could be because childhood trauma and distress can have a big effect on your ability to manage your emotions. This can include experiences like:
- Sexual, physical, or emotional abuse
- Traumatic events
- Losing someone very close to you, such as a parent or career
Evidence shows that you can treat bipolar symptoms with certain psychiatric medications which act on the neurotransmitters. These are the ‘messenger chemicals’ in your brain. This suggests that bipolar disorder may relate to functional problems of the neurotransmitters. While some research supports this, no one knows for sure how these neurotransmitters work. And we don’t know whether problems with these are a cause of bipolar disorder, or a result of it.
Stressful life events:
You may be able to link the start of your symptoms to stressful experiences or situations in your life. Some people also find that stress can trigger a mood episode. Or it may make symptoms feel more intense or difficult to manage. Things that can cause stress include:
- A relationship breakdown
- Money worries and poverty
- Experiencing trauma
- Losing someone close to you
- Being abused, bullied or harassed, including experiencing racism
- Feeling lonely or isolated
- Lots of change or uncertainty
- Feeling under pressure while working, studying or looking for work
- Big events, such as weddings or holidays
If you experience bipolar disorder, you’re more likely to have a family member who also experiences bipolar moods and symptoms. But they might not have a formal diagnosis. This suggests that bipolar disorder can be passed on genetically through families.
But this doesn’t strictly mean that there is one ‘bipolar gene’. Family links are likely to be much more complex. For example, researchers think that social factors can also trigger experiences of bipolar disorder symptoms. And family members can be an influential part of your environment as you grow up.
Drug and alcohol:
Using these can cause you to experience symptoms similar to mania, hypomania or depression. It can often be difficult to distinguish the effects of alcohol and drugs from mental health symptoms. Some studies suggest that using certain recreational drugs can increase your risk of developing bipolar disorder. But the evidence is very limited.
How can you manage your life with bipolar disorder?
Although it’s usually a long-term condition, effective treatments for bipolar disorder, combined with self-help techniques, can limit its impact on your everyday life. Following are some of the tips through which you can manage your life well with bipolar disorder.
- Nurture yourself with exercise
- Reach out to others
- Create little rituals
- Stay on a strict sleep schedule
- Have a treatment toolkit
- Don’t self medicate
- Don’t get complacent
Nurture yourself with exercise:
One of the early signs of bipolar disease was an exercise addiction. It can destroy your body: you developed osteoporosis and suffered joint damage. A fitness practice that is a blend of dance, martial arts, and healing arts. While before you used exercise to numb yourself, this form of activity helps you feel more centered and alive.
Reach out to others:
It’s important that you stay connected and don’t isolate yourself. The more you withdraw and pull away from others, the more likely your mood changes will go unnoticed, which jeopardizes your health. Social connections help so much with bipolar because having empathy and understanding from others can make it easier to manage. Join a book or outdoor activity club. Or volunteer. Doing good for others can help alleviate depression.
Create little rituals:
Small rituals — even just taking pills at a prescribed time and place — can provide a sense of calm that helps lower anxiety. Around 8 each evening, for example, you sit in your favorite chair and sip a cup of chamomile tea. It’s a point of certainty in a very uncertain life. The more detailed the ritual, the better. This way, if a crisis happens, the rituals act as known spaces of safety to which the person can return.
Stay on a strict sleep schedule:
Sleep is key to managing bipolar disorder. In particular, it’s important to have a consistent sleep-wake schedule. People with bipolar disorder are very sensitive to changes in circadian rhythms, so just going to bed or waking up an hour or two later can exacerbate symptoms. We’ve all heard the stories about the college student with bipolar who pulled an all-nighter to finish a paper and ended up in the hospital 3 days later.
Have treatment toolkit:
Create a treatment plan that also includes daily, weekly, and monthly items for both managing your condition and self-care. Sometimes you can do it all, and everything feels under control. But other times, You can’t even complete your daily requirements, like feeding yourself or performing basic hygiene. This signals to your husband that you may need help picking up prescriptions or making doctor appointments.
Don’t self medicate:
A lot of people who have bipolar disorder turn to marijuana to try to manage symptoms. That’s a big mistake. Here’s why: It contains THC, a psychoactive compound that makes you feel high. But the bipolar brain has a lot of trouble regulating chemicals such as dopamine or serotonin. Throw some THC into the mix, and you run a real risk of triggering a manic or depressive episode. It’s better to create a natural high through activities like regular exercise.
Don’t get complacent:
Oftentimes, when bipolar treatment works, patients let their guard down. They start to miss medication doses and don’t show up for therapy sessions. But consistency is key for the successful management of bipolar disorder. It only takes one or two skipped pills or therapy appointments to unravel all the progress you’ve made.
What is it like being in a relationship with someone who is bipolar?
The shifts in mood associated with bipolar disorder can cause extreme changes in behavior. During manic episodes, a person with bipolar disorder can have an unusual amount of energy and may not be able to sleep. When experiencing depressive episodes, a person with bipolar disorder can seem tired and sad. They may not want to go out or do things.
These major shifts in mood can make communicating and socializing difficult. While the symptoms of bipolar disorder can be managed with medication and psychotherapy, they can still take a toll on relationships, perhaps especially romantic ones. If you have bipolar disorder, you may already be familiar with the impact your condition can have on a romantic relationship.
You may feel nervous about starting a new relationship and finding the “right” time to tell your partner you have bipolar disorder. These concerns are understandable, but it’s important to keep in mind that you can have a healthy romantic relationship. For the best chance of success in a new relationship, be sure to communicate openly and follow your treatment plan.
There are certainly challenges in any romantic relationship, but bipolar disorder can make things especially difficult in various aspects of life:
It’s common for people with bipolar disorder to desire frequent sex during manic or hypomanic phases. Your partner may initiate intimacy much more than normal, or masturbate or use pornography more frequently than usual. Those with bipolar disorder may also engage in risky behaviors such as unprotected sex or extramarital affairs while manic. During episodes of depression, your partner may avoid sexual contact altogether. This can be confusing or feel like rejection, especially if your partner recently desired lots of sexual activity during a manic or hypomanic period. Many medications for bipolar disorder can also lower sex drive.
Your partner’s ability to perform well at work can be affected by bipolar disorder. Severe mood swings, along with manic symptoms such as poor judgment and impulsivity, or depressive symptoms such as low energy and disinterest make it tough to find and maintain a job. Stressors at work may also trigger or exacerbate your partner’s symptoms. If your partner can’t hold down a job, this could put more pressure on you to provide financial support until their illness is well-managed.
Many people consider parenting the most stressful (albeit rewarding) job of their lives. But any kind of stressor — good or bad — has potential to trigger manic or depressive episodes for people with bipolar disorder. In addition, the erratic behavior associated with bipolar disorder can be confusing and scary to children, who look to parents to provide stability. Helping your partner get and maintain treatment to control symptoms is crucial for providing a safe and secure home for children.
How can you make bipolar relationships work?
It takes effort to keep any relationship strong, but it can be especially challenging when your partner has bipolar disorder. Doctors offers these recommendations:
- Go to couples counseling
- Get involved with treatment
- Practice self care
- Communicate feelings
- Asking about triggers
Go to couples counseling:
Couples counseling is essential for working through upset over a bipolar partner’s actions. It’s common for someone with bipolar disorder to hurt and offend their partner. When someone is first diagnosed, there are often relationship issues that need to be addressed. Couples counseling can help you:
- Understand that there’s an illness involved in the hurtful behavior.
- Forgive the behavior that happened during an altered mood state.
- Set boundaries with a partner about maintaining treatment.
Get involved with treatment:
Ask if you can be involved with your partner’s treatment, which may include occasionally going to the psychiatrist together. Being a part of your partner’s treatment has multiple benefits, including:
- Gaining a better understanding of the illness.
- Providing additional insight for the psychiatrist.
- Learning to spot signs of impending episodes.
- Alerting the psychiatrist about mood changes.
Even if your partner hasn’t signed off on you exchanging information with their psychiatrist, you can still report worrisome signs (the doctor just won’t be able to tell you anything). This gives the doctor a chance to make quick medication changes that may help your partner avoid being hospitalized.
Practice self care:
Self-care gets a lot of buzz these days, but nowhere is it more important than when you’re caring for someone with a serious illness such as bipolar disorder. It’s essential to dedicate time to your own physical and mental health, whether that’s going to a support group, talking to a therapist or attending a yoga class. Being in a healthy relationship with someone with bipolar disorder requires not only careful management of their illness, but also setting aside time to take good care of yourself.
High or low periods may be emotional for both partners. For this reason, open communication is crucial. A partner should explain how the behavior of a person with bipolar disorder makes them feel, without judging them or stigmatizing the condition. Talking openly can be a powerful way to reduce the negative impact that certain behaviors may have.
Asking about triggers:
Triggers are events or circumstances that could disrupt the mood state of a person with bipolar disorder. This could increase their risk of experiencing a manic or depressive episode. Triggers could include dealing with a stressful work scenario, not getting enough sleep, or missing doses of medication.
Not everyone with bipolar disorder will have triggers, but if they do, they may have learned about them through their own experience with the condition. Asking about personal triggers can help someone support their partner when those events or circumstances arise or help them avoid triggers. However, many mood changes can occur without triggers.
Having a diagnosis of bipolar disorder does not mean that a person will have relationship problems. However, without effective treatment, bipolar disorder symptoms may cause relationship tension. By sticking to a good treatment regimen, a person with bipolar disorder may have long periods with few or no symptoms.
All relationships require empathy, communication, and emotional awareness. These qualities help a person be a supportive partner to someone with bipolar disorder. People with well-managed bipolar disorder can build healthy, long term relationships. While taking these steps can benefit your relationship, bipolar disorder may still occasionally cause strain in a relationship — even if both of you know what to expect.
That’s not unusual. But keep in mind that whether you have bipolar disorder or are dating someone with the condition, it’s possible to establish and maintain a healthy and fulfilling relationship. Keys to success include maintaining an open line of communication, making sure the person with bipolar disorder follows their treatment plan, and getting support when you need it.