Guide to Bipolar Disorder & Relationships And Five Ways

Her condition affects so much of her life that she tells anyone new she meets about it pretty quickly.
“In fact, it’s almost impossible for me not to. The way my life revolves around bipolar disorder symptoms, medications, side effects and just general coping, not mentioning it is like cropping out half my life,” Tracy said. “Additionally, I would much rather know that the person can’t handle it up front. If they can’t handle that I’m sick, they’re not the person for me and it’s best I find that out as soon as possible.”
The process of dating has had its share of heartbreak, and Tracy learned some pretty stark realities about her condition—that others may use it to their advantage by using her bipolar disorder against her. Still, Tracy is hopeful that she will find someone who can offer her the right kind of support, the kind that everyone needs.
“The best thing a person can do for me is provide loving support. It is best if they can be there, listen and share a hug,” she said. “Unfortunately, the person can never ‘fix’ my illness but by being there in a kind and loving way, they are helping me more than I can express.”

Disclosing Your Disorder

You don’t have to tell your newfound love interest about your condition on the first date.
You should, however, let the person know early in the relationship. If it’s a deal breaker for him or her, it’s better to get it out in the open right away. Besides, the best beginning to a successful relationship is an honest one.

As a general guide, in personal relationships, Dr. David M. Reiss, a psychiatrist in private practice and interim medical director of Providence Behavioral Health Hospital in Holyoke, Mass., recommends discussing the issue of the bipolar disorder when and if the relationship has reached a level of closeness or intimacy where there is talk of some type of commitment, such as exclusivity.
“I suggest preparing to discuss bipolar disorder in as unemotional terms and as much ‘plain language’ as possible,” he said. “No need to go into biochemical or psychodynamic explanations—unless a relationship has reached that level of intimacy/closeness.”

What to Expect

One of the biggest challenges bipolar disorder can create in relationships is the uncertainty and uneasiness of mood swings, Dr. Michael Brodsky, medical director of Bridges to Recovery, a residential treatment facility, said.
The low levels of enjoyment and withdrawal during the depression, and the inattentiveness and self-focused behavior during the mania can be discouraging to a partner, especially during the early parts of a relationship, Dr. Brodsky said.
During the mania, there is also a chance for a person with bipolar disorder to become promiscuous or hypersexual, but that isn’t a guarantee the person will.
Mania can also mean the person can be more spontaneous, creative, charismatic, inspirational, and energetic, Dr. Brodsky said.
The most important things a partner can have for someone with bipolar disorder is patience and tolerance, Dr. Brodsky said. A successful relationship involves a partner who is willing to tolerate uncertainty, learn to help the other person modify negative behavior, and is willing to let go of control.
“Trust is big,” he said. “They’re not going to be able to have the ability to control everything.”
When a partner becomes a partner in treatment, he or she can gain a better insight into how a person feels, how therapy affects them, or how to spot the changes in mood.

Make a Contract

You don’t have to sit down with a lawyer like you’re going through a prenuptial agreement, but you should set aside some time to make an agreement over things related to your bipolar disorder.
“Absolutely we are looking to come to an agreement and some ground rules,” Dr. Brodsky said. “Whether the contract is written or not is the least important issue.”
Some of these guidelines include guidelines for when a partner needs to intervene on potentially destructive behavior, and what a partner can do to enforce the contract, Dr. Brodsky said.
If you’re well in tune with your disorder and can feel the shift from mania to depression or vice versa coming, tell your partner. That’s when it’s important to stick to your contract.

There Will Be Problems

Every relationship has its problems, no matter how perfect it seems to be. A large part of relationships when one partner has bipolar disorder is distinguishing when a problem is a normal problem, or when it stems from something related to bipolar disorder.
Say, for instance, you have an argument over whose turn it is to do the dishes. That’s a normal problem. Tracy, like many other people with bipolar disorder, learned to distinguish what is a normal relationship problem, what is a serious problem, and when she’s being blamed for something. She’s learned when people use her illness as an excuse, and then it’s off to the curb with them.
“People will blame your bipolar disorder for their bad behavior. While with other illnesses it is much less acceptable to leave someone for, say, cancer, but it’s perfectly okay in some people’s minds to leave someone because of a mental illness,” she said. “And, for some, it’s perfectly okay to treat someone badly because of a mental illness too. And it’s also okay to blame every behavior you don’t like on your partner’s mental illness. What I wish I knew is that even though I never use my illness as an excuse, other people will.”

Five Ways to Create and Maintain Stability In Relationships with BPD Partners

The shock of being threatened with a knife by his twenty-three year old wife Charlene hit Jackson really hard.
He arranged a separation from Charlene to recover, and to begin to feel safe again. The toughest moments came when he wanted to hear her voice that had encouraged him so often. Growing up in a home with a devouring mother who put him down when he wanted to think and act on his own behalf, he was attracted to Charlene’s adoration and constant attention. Sure, she was volatile – calm and caring sometimes but insatiable and stifling at others. But now, he was seeing another side of her, and feeling as abused as he had when he lived at home with his parents.
Not long after the threatening incident that led to the couple separating, Jackson discovered that Charlene had been diagnosed with Borderline Personality Disorder (BPD). He was furious and felt he had been duped. Yet Jackson couldn’t stop wanting to talk to Charlene and meet up with her from time to time. He didn’t know how to get the more nurturing parts of Charlene that he needed to keep his confidence and spirit up,and how to be safe from her verbal and physical abuse.
Having a relationship with a BPD partner is like living in two worlds at the same time as Jackson discovered. It was heaven on earth when Charlene made him feel like he was the only thing in her world.  When she was feeling attracted to and attached to Jackson,  he was the ‘good’ guy. But when she was empty and desperate for him to fulfill the promise of being her idol, she would taunt him and nag at him until he focused solely on her. At those moments he was the ‘bad’ guy, withholding from her, making her feel as if she didn’t exist.

The Essential Relational Problems That BPD People Live With

Otto Kernberg gives a useful description of a  BPD person’s “splitting” defense in his book, Borderline Conditions and Pathological Narcissism . He describes how they split themselves up into empty/bad and full/good parts, and do the same to their loved ones. When Jackson was doing the dishes or working on an illustration for his client, Charlene felt empty and therefore made Jackson into the ‘bad’ guy. But when he was attentive and focusing on her, he was the ‘good’ guy, filling her up again.
It’s exciting for Charlene to put pressure on Jackson to walk out on himself and join her in her state of anxiety and emptiness. She wants him to blur the boundaries and become part of her. That’s so satisfying. But as soon as he needs to be his own person again, she gets enraged and threatens to hurt him.

Why Can’t People with BPD Stay Full and Remember That They are Loved?

BPD adults have missed out on two essential developmental experiences that affect all their attachments.

  1. They can’t feel you and hold you as a constant loving being in their mind’s eye. You are either ‘good’, ‘bad’ or ‘absent’!  It’s called a lack of object constancy. So when Jackson went for a walk with Charlene just before they were preparing dinner the night of the threatened attack, she felt him as the good person, present with her. But the moment he wanted to do something else while she was preparing the dinner he became the ‘bad’ person, abandoning her and making her empty again.
  1. They have trouble imagining your intentions and needs. It’s known as troublementalizing. According to this theory of BPD, put forward by Bateman and Fonagy in their book, Psychotherapy for BPD, when Charlene gets angry that Jackson wants to do something else as she prepares the dinner, she cannot imagine that he may need the rest room, or need to check messages on his work e-mail, or just need to read a trade magazine. She imagines only that he is tired of her and wants to get away – hence the rage and threats. Mentalization based treatment is very successful in helping people like Charlene control their extreme feelings by learning how to read the intentions of their loved ones.

Jackson and Charlene didn’t stay apart for long. They had short periods of separation and reunion in waves. He needed her to make him the center of her universe and a worthwhile person who was necessary to her life – all the things he never got from his parents. She needed him to make her feel that she was better than his mother and could provide him with support, ensuring that he would stick around. It became a co-dependent relationship. It’s on the foundation of co-dependency that many relationships involving a BPD person and a narcissistically wounded person (Jackson) survive.

Finding Stability

Introducing structure and predictability really helps couples like Charlene and Jackson.

  1. Make specific times to be together with no other intrusions for short spans, so that Charlene will ‘know’ she isn’t abandoned or unloved and start poking Jackson to attend to her. It helps with the difficulty she has with ‘object constancy.’ Spell out the details like from ‘6pm-6:30 pm is sharing our day together time. Jackson starts talking first and Charlene listens for 3 minutes, then vice versa.’ It may sound calculated but in my experience BPD partners use the entire time to either vent or dig at the other for information to prove loyalty. Structuring the talking-listening makes the encounter satisfying for both.
  1. Plan to do things together during those times that bring both of them together in a world called ‘us’ – so that Jackson doesn’t feel he has to give up his world to be engulfed by hers, and so that Charlene learns that other worlds exist that include her.
  1. Engage in regular and constant ‘check ins’ with each other – saying out loud what you are feeling and thinking in the moment. It works by giving feedback about what is going on inside Jackson so that Charlene doesn’t go to her usual abandonment story. Jackson’s saying things like, “I’m really tired after that walk!” will help Charlene appreciate that he doesn’t want to lie down because he is tired of her, but that his body needs a rest!
  1. Have a network of friends outside the relationship. Family relationships are bad for both parties, so friends and colleagues become crucial in helping the couple avoid co-dependency that fuels the cycle of instability.
  1. Encourage your BPD partner to write down their feelings while you are not in the same place together. So if Jackson is at the Gym and Charlene is doing laundry at home, she might get anxious that he is meeting someone new and won’t ever come home. Writing down those feelings at the time and then sharing them later is a very effective tool to control volatile feelings and discuss them later when reality proves the anxieties unfounded.

Writing the feelings down helps settle the turmoil and release it in a coherent manner. It engages the more rational part of the brain with the emotional centers and helps the BPD person to get grounded and then do a reality check. It’s much less likely that when Jackson comes back from the Gym, Charlene will attack him with her unprocessed anxiety and fear of abandonment.
In my experience of working with couples where one person has BPD and the other is narcissistically wounded (the common combination of attraction) they agree to these five core stabilizing suggestions and use it for a short while. As soon as stability is created, they abandon the scheme and the whole cycle of volatile emotions, safety-issues and fear become center stage again.
Dr. Jeanette Raymond is a licensed clinical psychologist with a private practice in Los Angeles. She is the Author of: Now You Want Me, Now You Don’t! Fear of Intimacy: Ten ways to recognize fear of intimacy, and ten ways to manage it in your relationship.

Leave a Reply

Your email address will not be published. Required fields are marked *