Useful information for consumers suffering with bipolar disorder

Talk therapy: 7 ways to help your partner help you

By Judy Eron, LCSW

 Bipolar disorder is such a tricky illness: a person can be so well, and then suddenly so "not well." As a therapist, I assist people with bipolar in making a plan of action—and enlisting a spouse, trusted friend, or relative in co-creating such a plan—for managing things when the going gets tough. 

Here are seven ways you can help your trusted person know how to be a partner with you in your illness.

1. Make a written agreement

Sit down with your chosen person and a pen and paper. Explain that you need a partner to help you manage your bipolar, and that this will require the two of you to work out details together.  Make certain that your person trusts you and your judgment when you are well, and is willing to take this on with you.

2. List your unique early symptoms  

Both mania and depression can be managed more easily if they are recognized before they intensify.  Make a list of the personal ways in which your illness manifests itself in its early stage. For example, you might both realize that when you are starting to get depressed, you play certain music.  Or, that when you are becoming manic you feel the need for more air and wish to keep the window open when you sleep. Tell your partner what you would like him/her to do when you show any signs that you are edging toward depression or mania.

3. Get on the same page about medication

Make certain that you and your partner have an understanding about medication and its role in your well-being. You know that the temptation is strong to discontinue medication when you are doing well, and that this can lead to trouble. Your partner needs written permission from you to contact your therapist or doctor if you stop taking medication without your doctor's knowledge. 

4. Include your partner in your therapy

Since you have chosen a special person to trust with these agreements, it is important that your treatment people have some familiarity with him or her. Decide together how often your partner will be included in your meetings with your therapist and your prescribing doctor. This might range from every meeting to far fewer times, but should be no less than twice a year.        

5. Specify when your partner may reach out

Agree which behaviors besides medication non-compliance give your partner de facto permission to contact your therapist or psychiatrist outside of regularly scheduled meetings. Be precise about these behaviors, such as not sleeping at night, uncharacteristic aggressiveness or belligerence, or major loss of interest in your usual pursuits.

6. Make a video

Record yourself on video reading the written agreements you and your partner have made together.  State in your own words that you know if your illness flares up, you will not want to follow through with these agreements, but that you give your person permission to follow through on what the two of you have written.    

7. Urge your partner to become informed

There is an abundance of information available. Strongly request that your partner attend local support groups and family education courses available through mental health associations. Your trusted person needs a mixture of education, support, and direction, and you need him/her to be as informed as possible.

While you are well, remind yourself that bipolar is "an illness that tells you that you don't have an illness." Being realistic about the tricky nature of bipolar and staying vigilant with a plan, combined with medication and therapy, can make a big difference in the control you have over bipolar and in enjoying life fully.