Family Support for a Depressed Bipolar Spouse

There are some diseases that extend their reach beyond the person affected and corrode the very family structure that helps the individual weather all storms. One such disease is bipolar disorder. With its rapid cycles of depression and mania, it can change the lives of those who live with the afflicted person.

One reason could be that bipolar disorder is sometimes not diagnosed in time, or even if it is, some people may shy away from accepting it and seeking help. The reasons for this could be social stigma as well. Nevertheless, one of the other reasons that could affect the whole family of the bipolar individual is the inadequate social support that the family receives.

Children of depressed bipolar sufferers tend to be ignored, and this could very well alter the fabric of their life. Even when the well spouse takes charge of the family, it can be frightening and can cause a lot of anxiety for the family.

What is needed is a holistic approach to treating bipolar depression, not just in the afflicted individual, but the entire family as a whole. Today, there are many support groups for families of people who suffer from bipolar depression. The internet is also a wonderful resource for those who need help regarding depressive bipolar disorder.

There are plenty of support websites where you can seek help not just for the afflicted person, but for the family as well. However, not many reach out and use these services. This is because of the lack of awareness regarding the help that is available to people.

If someone in your family has been diagnosed with bipolar depression, you will have to make it your prerogative to help that person. You cannot stay disconnected from this problem while someone you love or care for is undergoing mental trauma. While supporting the said person, however, you need to remember that you need support and help too.

Fear of social stigma for the person suffering from depressive bipolar disorder and his/her family can naturally affect the treatment process. The family of the person suffering from bipolar depression has to offer unhindered support, but in the face of all obstacles, this can be very difficult.

Immediate family, neighbors, and friends can create their own support system to help a family cope with a bipolar person. However, for this to happen, people need to be well informed about bipolar disorder and believe that a mental illness does not equate to a life of hopelessness.

Alcohol and Bipolar Disorder: What Are They Thinking?

Bipolar disorder affect the entire family, not just the afflicted person. Psychology Today magazine has estimates that the divorce rate among couples where at least one partner is bipolar is more than 90%.

Self-medication is a worrying aspects of bipolar disorder, and many diagnosed with bipolar disorder turn to alcohol. Both men and women with bipolar disorder are more likely to become alcoholics as compared to those without this condition.

Bipolar alcohol abuse often occurs because it can be one way to eliminate the symptoms of bipolar disorder, such as anxiety, depression and fear. However, this often backfires because as dependency on alcohol increases, the patient ends up with a dual diagnosis with debilitating symptoms.

Furthermore, alcoholism worsens bipolar symptoms, and it becomes more difficult to treat this condition because not only does alcohol complicate the symptoms, but it also makes it difficult to use certain medications that cannot be used with liquor.

According to a study by Oxford University and the Karolinska Institutet in Sweden and mentioned in www.bphope.com, “21% of patients with bipolar disorder and a diagnosis of severe substance abuse (alcohol or illegal drugs) were convicted of violent crimes, compared to 5% of those with bipolar disorder but without substance abuse, 5% among the unaffected siblings of bipolar patients, and 3% among general public control individuals.”

The question that arises for the partner of the bipolar alcoholic is whether it is worthwhile to save a marriage beset with this challenging combination of medical conditions. Certainly not every bipolar alcoholic spouse is violent, so this is not necessarily a question of spousal abuse.

But the 800-pound gorilla in the room is how long should well spouses endure the troubles in their marriages? Some spouses draw strength from their religion or marriage vows and see treatment for their sick spouse as “part of the package” they signed on for. Everyone knows bipolar alcoholics cannot control their bouts of mania and depression alone and frequently suck all the support and love they can get from their relationships—often without gratitude.

Well partners may often feel they are contributing the overwhelming amount of effort in their relationship–emotionally, physically and responsibly. The fact is that the bipolar alcoholic cannot control the negative symptoms and requires constant stimulation, love, support and reassurance to address both bipolar disorder and alcoholism.

A bipolar marriage is chock full of challenges most marriages don’t have. To have a success, both partners must acknowledge these challenges and work toward a compromise. The well partner cannot be the sole responsible partner for the success of the marriage. And the sick partner cannot “check out” of his marriage to through alcohol or participation in other risky behaviors. The patient may not be curable, but a successful marriage depends on the bipolar alcoholic making an effort.

Should I Divorce My Cheating Bipolar Husband?

Living with a bipolar husband is a challenging experience on its own. But when his mood disorder is compounded with infidelity, the situation can reach a crisis level.

Bipolar disorder is characterized by mood variations from mania to depression and there’s typically plenty of risky behavior in between. One of the worst is the connection between bipolar and cheating– adultery.

Even couples on the brink of divorce who are not facing bipolar issues often arrive there because of infidelity. It’s indeed hard to forgive these breeches of trust. But for bipolar husbands who cheat, the adultery for the spouse is like rubbing salt into an already open wound.

The first question that arises most often is…

“Should I allow my husband to get away with cheating on me because he blames it on his bipolar disorder?”

In other words, is a doctor-approved diagnosis of bipolar disorder a “get out of jail free” card for a cheating husband?

Does Society Condone Cheating from Bipolar Husbands?

Certainly, society has become more accepting of mental illness and there are plenty of public examples of bad behavior being blamed on a chronic mental condition.

Take, for instance, the recent case of New York Democratic Congressman Anthony Weiner who apologized for his inappropriate “sexting” behavior by announcing he was going for treatment of his undisclosed “condition.” Speculation about his diagnosis ranged from an obsessive sex addiction to a narcissistic personality disorder at the root of his scandal, and he ultimately resigned from office.

In another story, a banker was penalized with a milder sentence for an outrageous theft because he was found to be suffering from depression.

Many bipolar husbands and wives use their condition as an excuse to seek out extra-marital affairs during the manic phase. A heartfelt apology is many times enough for someone’s human frailties to be overlooked, excused or forgiven.

The dilemma is the confusion over morality vs. biology. If someone with a mental disorder cheats, lies or is unfaithful, it’s common for this behavior to be more exaggerated than in someone who cheats who is not mentally ill. For example, sex addicts are known to be controlled by their urges, as opposed to most of society who feels the impulse but uses introspection and morality to respond.

Why Do Some Wives Put Up with Bipolar Lying and Cheating?

Wives want to know: Should I hate the sin or the sinner? Should I divorce my cheating bipolar husband.

To answer these questions, you must evaluate how your spouse’s behavior impacts your sense of self-worth. How much you can handle the cheating, the lying and the adultery which is likely never to end because it’s compulsive. Are you are willing to go the distance and participate in your husband’s therapy? Is he even willing to go?

Since there is no cure for bipolar disorder, just management of symptoms, are you willing to take the plunge and live with someone who hurts you emotionally and continues to “get away with it” because they have a doctor-diagnosed excuse?

Why Is Bipolar Marriage Help Always About the Bipolar Husband or Wife?

I guess my article for today is more like a rant.

Why is it whenever you see an article or video for help with your bipolar marriage, the help is always about supporting your bipolar husband or bipolar wife? When do you get help for the marital challenges you’re facing?

PLEASE! Don’t everyone reading this rant leave me a comment on this blog post telling me how insensitive I am, how uncaring, how I don’t know what I’m talking about.

I absolutely do know what I’m talking about, and I commend Dr. Art Bowler on his fine advice in this video. Keeping a diary of your bipolar husband’s or bipolar wife’s mood swings is an excellent way to provide factual (as opposed to emotional) feedback to your spouse’s psychiatrist.

After all, you are living with your spouse everyday, while your spouse’s p-doc sees him in person only 50 minutes maybe–what?–twice a year (barring any emergencies, God forbid).

In a bipolar marriage, someone has to be the detail-oriented or focused person to keep track of important medical information. Typically, this falls into the pile of responsibilities the well spouse takes on. No problem.

But for those of us who have a bipolar husband or bipolar wife, doing all the “shoulds” recommended by doctors, psychologists, self-help books, friends and family, can result in a full-time job caring for your sick spouse. (Actually, some months it’s even more than a full-time job.)

My rant is not about whether you should be a caregiver for your bipolar spouse. Of course you should! That’s what marriage is all about, taking care of one another.

My rant is that no one ever gives any bipolar marital advice on how to help the well spouse in a bipolar marriage (only how to help the sick spouse!) With all the bipolar marriages out there, there must be a lot of proven tips that could really help couples trying to make a bipolar marriage work.

Let’s think past all the bipolar marriage barriers.

First of all, the psychiatrist is bound by doctor-patient confidentiality not to disclose any information to you without your bipolar spouse’s permission. That permission may or may not be forthcoming. So already, you’re operating half in the dark when you must make caregiver decisions that affect your entire family.

When things are as bad as they can be, and you have no spouse to discuss a problem with (because the spouse IS the problem), how can you be sure your decision making is as good as it can be? Where do you go for help?

Of course, getting your own counselor is not a bad idea. At least a professional will have some idea of the responsibilities you have and the multiple layers of consideration you face.

And sometimes a bipolar spousal support group can be helpful. You can find excellent bipolar support groups through NAMI. Unfortunately, many times they only have “general” bipolar support groups, so you end up meeting with those who have bipolar parents, siblings and children. Their life experiences are very different than getting support from another spouse of a bipolar husbands or bipolar wife.

Do you have any tips, forums or websites where you’ve found help for you to make your bipolar marriage run more smoothly? Please leave me a comment below with your advice.

How to Help Your Bipolar Spouse — powered by eHow.com

14 Questions To Ask Your Future Bipolar Husband’s Psychiatrist-Part 1

Contemplating marriage to someone with bipolar disorder? Your marriage will not be like any of your friends’ or family who do not have to deal with this extra relationship challenge.

Here are 15 questions to ask the psychiatrist about your future husband or wife if he/she has been diagnosed with bipolar disorder.

How can I participate in my future bipolar husband’s/wife’s therapy plan?
What are the potential long-term side effects of lithium and/or other psychiatric drug treatements?
Is there a chance that the medication prescribed now will become ineffective? If yes, what happens then?
How will other medications or alcohol affect my fiancee over time if he gets sick, has bad allergies or drinks too much?
What if the dosage on the medication(s) is too high? What does medicinal toxicity look like? Is a blood test twice a year enough to detect this?
Will my bipolar future husband or wife ever be “cured?” Will he/she ever be able to stop taking medication?
Are there other treatment options besides medication?
What are the bipolar disorder “warning signals” I should watch out for?
What are the risks to our marriage? What’s the worst that could happen? What are the chances of that happening?
Should we have children? What are the chances we’ll pass bipolar disorder to them? Is that an ethical consideration? Or a medical one?
Will bipolar disorder medication affect my future bipolar husband’s or wife’s ability to have children?
All things being equal, what percentage of a “normal” life can we hope to have together if he/she stays on a treatment plan?
How will bipolar disorder affect my future husband’s/wife’s ability to get medical insurance?
Does medical treatment for bipolar disorder shorten somebody’s lifespan or damage health or organs?
What should I be asking you about marriage to a bipolar husband or wife that I haven’t asked you yet?

Obviously, this is a lot of ground to cover with a medical professional. But even if it takes more than one session with your future bipolar husband’s/wife’s psychiatrist to get these questions answered, you’ll want to take your time in absorbing the enormity and ramifications of the answers.

No doubt you’ll want to discuss the answers with your future spouse, as well. Better to be informed as possible before you walk down the aisle than to be surprised with information you hadn’t considered after the wedding.

Bipolar Disorder Can Leave Permanent Emotional Scars on Husbands and Wives

“If recent research has taught us anything,” says Carol Jacobson, psychiatric social worker, “it’s that families also pay a price from bipolar disorder in the form of emotional pain, social isolation and stressed interpersonal relationships.”

Children may withdraw from the family unit, couples pull away or drift apart, individuals become isolated within their own families, she said. These situations leave scars on the family unit and affect the way family members deal with the needs, demands and often manipulations of the patient.

Husbands and wives can become overly involved or too distant, too permissive or too restrictive in an effort to gain relief from the bipolar husband’s or bipolar wife’s pathology or their own discomfort.

Jacobson offers 6 steps to prevent permanent emotional scarring:

Establish limits. Know what you are capable of giving. Don’t allow yourself to be pushed, forced, cajoled or intimidated into doing what you do not want to do. Giving more than you are willing to breeds resentment. Resentments are often then expressed inappropriately toward ourselves, the bipolar husband or wife or toward other family members.
Deal with your guilt and/or grief over your bipolar husband’s or wife’s illness. In other words, she advises, put the past to rest. Previous mistakes, angers, deficiencies cannot be changed. When you bring them up and berate yourself over them, you are left feeling helpless and angry. You cannot be reminded not to do this often enough, Jacobson says.
Forgive yourself your sins. If you don’t forgive yourself, you will continue to allow and excuse inappropriate behavior from your bipolar husband or wife. This leaves you open to “emotional blackmail,” which is extremely dysfunctional.
Do not tolerate inappropriate behavior. Illness is not an excuse for bad behavior, rudeness or manipulation. If your bipolar husband or wife is uncontrollable, seek immediate treatment or hospitalization. If you’re not sure if he or she needs treatment, ask yourself if you would accept this behavior from a non-sick family member. Far too often we excuse behavior from a bipolar husband or wife that we would never tolerate from anyone else.
Respect a bipolar husband’s or wife’s range of emotion, as you would anyone else’s. Living together in peace requires respect. A sick spouse can get well and may have normal periods of irritability, sadness and happiness. Keep your own anxieties and concerns under control and not label hbehavior “sick” because it disturbs you or brings back memories of previously ill times. Respond to today’s behavior honestly by dealing with what you see today.
Do not become an “in home therapist.” You may often find yourself spending time and energy talking about, thinking about, planning for or around the bipolar husband or wife and his/her problems. Don’t do this, Jacobson says. It is not healthy for you, your sick spouse or your family. The sick person has a qualified therapist or doctor. He/she needs the family to act as it would ordinarily. This teaches him/her through action and modeling what behaviors are appropriate for the greater world outside the home.

Jacobson says these 6 suggestions are easier to accomplish when you remember that you did not cause your bipolar husband’s or wife’s illness and your cannot cure their illness. But it is your choice to encourage health and responsible behavior.

Coping with a Bipolar Husband Is a Family Affair

With a bipolar husband in the family, sometimes avoidance is easier than communicating. That’s what Mary J resorted to with her bipolar husband. “His verbal abuse got so bad I just avoided him,” said Mary J. of her husband, who was recently diagnosed with bipolar disorder.

It’s not uncommon for wives of bipolar husbands, like Mary, to instinctively shut down all lines of communication rather than to address the negative behaviors that bipolar disorder causes. Unfortunately this can make a bipolar marriage situation worse by triggering more dysfunctional behavior.

Online research about bipolar disorder and, especially searching for help in dealing with a bipolar husband, was how Mary found the book, “70 Signs of Depression: Recognize and Cope with Your Loved One’s Clinical or Manic Depression.”

The book provided her with proactive tools for dealing with a bipolar loved one. “70 Signs of Depression gave me the knowledge, even the words to use, to start really helping my husband and our marriage get back on track,” she added (Mary’s full name has been withheld to protect her family’s privacy.)

Crafted from the hands-on knowledge of thousands of bipolar victims and their family members by Marlee Fisher, a best selling ghostwriter-turned author and Certified Faculty Member of NAMI, the National Alliance For the Mentally Ill, “70 Signs of Depression” takes readers into the minds of bipolar disorder sufferers by uncovering the illness’ 70 Signs, 4 Emotional Trip Wires and 2 Defense Mechanisms. It then provides proven step-by-step strategies and techniques to help co-manage each of them.

“The non-communication between Mary and her husband is all too common,” stated the author. Members of the medical and mental health communities endorse this book as a page-turning must-read for anyone with a bipolar spouse, family member or friend.

Fisher wrote her book to offer an easy-to-understand look inside bipolar disorder, alongside firsthand know-how from thousands of bipolar co-victims that readers can use to help themselves and their own ill loved ones immediately.

Then she details the step-by-step strategies and proactive techniques, including the exact words, that have already helped others deal with a bipolar loved one.

This book is based on the author’s personal experience as a bipolar co-victim, including her years of extensive research meeting with psychiatrists, M.D.s, psychologists and social workers; actively participating in NAMI support groups; serving as a NAMI faculty member and interviewing thousands of bipolar victims, their family members and friends.

The result is an in-depth and easy-to-understand look inside bipolar disorder, often written in its victims’ own words, that reveals valuable first-hand insights and expert hands-on knowledge.

Researchers Pool Resources in Largest Study of Genetic Factors Leading to Bipolar Disorder Episodes

For a long time now, researchers have suspected a genetic link to bipolar disorder. But they’ve not been able to find it conclusively.

In a new study, doctors pooled resources to create the largest genetic analysis of its kind to date for bipolar disorder and discovered machinery involved in the balance of sodium and calcium in brain cells as a root cause.

“Faced with little agreement among previous studies searching for the genomic hot spots in bipolar disorder, these researchers pooled their data for maximal statistical power and unearthed surprising results,” said NIMH Director Thomas R. Insel, M.D. “Improved understanding of these abnormalities could lead to new hope for the millions of Americans affected by bipolar disorder.”

Researchers supported in part by the National Institute of Mental Health, part of the National Institutes of Health, found an association between the disorder and variation in two genes that make components of channels that manage the flow of the elements into and out of cells, including neurons.

2 Proteins at Fault in Disrupting Ions that Regulate Neuron Firings

Doctors found that two proteins may be involved in disrupting the ions that regulate whether neurons can fire properly. “Finding statistically robust associations linked to two proteins that may be involved in regulating such ion channels — and that are also thought to be targets of drugs used to clinically to treat bipolar disorder — is astonishing,” said Pamela Sklar, M.D., Ph.D., of Massachusetts General Hospital (MGH) and the Stanley Center for Psychiatric Research at the Broad Institute of MIT and Harvard, who led the research.

Sklar, Shaun Purcell, Ph.D., also of MGH and the Stanley Center, and Nick Craddock, M.D., Ph.D., of Cardiff University and the Wellcome Trust Case Control Consortiuum in the United Kingdom and a large group of international collaborators reported on their findings online on Aug. 17 , 2008 in Nature Genetics.

In the first such genome-wide association study for bipolar disorder, NIMH researchers last fall reported the strongest signal associated with the illness in a gene that makes an enzyme involved the action of the anti-manic medication lithium. However, other chromosomal locations were most strongly associated with the disorder in two subsequent studies.

Bipolar Disorder Thought To Involve Many Gene Variants

Since bipolar disorder is thought to involve many different gene variants, each exerting relatively small effects, researchers need large samples to detect relatively weak signals of illness association.

To boost their odds, Sklar and colleagues pooled data from the latter two previously published and one new study of their own. They also added additional samples from the STEP-BD study and Scottish and Irish families, and controls from the NIMH Genetics Repository. After examining about 1.8 million sites of genetic variation in 10,596 people — including 4,387 with bipolar disorder — the researchers found the two genes showing the strongest association among 14 disorder-associated chromosomal regions.

Variation in a gene called Ankyrin 3 (ANK3) showed the strongest association with bipolar disorder. The ANK3 protein is strategically located in the first part of neuronal extensions called axons and is part of the cellular machinery that decides whether a neuron will fire. Co-authors of the paper had shown last year in mouse brain that lithium, the most common medication for preventing bipolar disorder episodes, reduces expression of ANK3.

Variation in a calcium channel gene found in the brain showed the second strongest association with bipolar disorder. This CACNA1C protein similarly regulates the influx and outflow of calcium and is the site of interaction for a hypertension medication that has also been used in the treatment of bipolar disorder.

The National Institutes of Health (NIH) — The Nation’s Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Bipolar Husband? Bipolar Wife? Should You Stay Married?

Should You Stay Married To Your Bipolar Husband or Wife?

By Elizabeth Atlas

Husbands, wives, girlfriends, boyfriends of partners with Bipolar Disorder are the overlooked and underserved mental illness support network of the Bipolar treatment world.

First, we are never secure about our own emotional needs. Are they more or less important the needs of our mentally ill spouse? If we choose to take care of our own needs first, we often suffer, then punish ourselves with guilt, then get angry toward our sick partner that he or she has caused us such misery.

But if we choose to put our partner’s emotional, physical and mental health needs ahead of ours-after all, he’s the sick one-our quality of life diminishes. Our choices are never easy and always agonizing.

True Marriage Partner or Bipolar Caregiver?

Second, husbands and wives are alone in coping with our spouses’ Bipolar Disorder (also known as Manic Depression). Besides managing doctor visits, medications, decisions on whether to hospitalize or not, “well” partners must fight for our relationships. The line between partner and caregiver is thin and often non-existent. It can make for a lonely and often devastating life.

You cannot share your feelings with your bipolar partner; he’s the sick one and the cause of your distress! Your parents are empty nesters; you can’t burden them with your problems. Your siblings have their own families to worry about. Unless mental illness runs in your friends’ families, they won’t understand what you cope with. Plus your bipolar husband or wife may not want you violating their privacy rights.

Why Do You Stay in Your Bipolar Relationship?

The pressure on us from friends, family and professionals is unrelenting. Those who ask, “Why do you stay in your relationship?” are not supportive. And neither are the ones that imply that it’s your duty to stay married to your bipolar husband or wife. Bipolar disorder runs roughshod over relationships. The divorce rate is three times higher in these marriages than in the general population.

Bipolar Suicide Rate

In my personal story, when I did find a “spousal support group,” there was one man (divorced) and 16 women. A third of the women’s husbands lived in their basements, couldn’t hold jobs and couldn’t contribute financially or emotionally to their family life. One third of the women were divorced from violent men who beat them or were emotionally abusive to them or their children (a common side effect of problems with bipolar medication).

The last third were widows-their bipolar husbands had committed suicide. (The suicide rate for bipolar disorder is 12 times higher than the “normal” population.) Everyone in the support group thought I was in denial for having a goal to stay married.

Why do you stay married to or in a relationship with a bipolar husband or bipolar wife?

Elizabeth Atlas is the author of “Married To Mania,” a book that helps spouses and partners be in relationships with someone with bipolar disorder. Her book teaches how to “live life on purpose,” despite the unfair hand you were dealt in love and marriage and despite the chaos and emotional mine field you must avoid everyday in a marriage to someone with manic depression (another name for bipolar disorder). Elizabeth shows how to construct a plan to take charge of your life and to retain control of your life’s goals, without getting caught up in the bipolar drama–no matter how much you love your bipolar spouse.

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