Q&A: How do I deal with my bipolar spouse?

Question: My husband is bipolar but he refuses to seek treatment. I want our marriage to work, but the strain on our relationship is becoming too much to bear. Any suggestions as to what I should do?

Answer: 

Bipolar disorder is a serious and extremely complex psycho-physical condition. Causes can include genetic, environmental and medical factors, as well as poor life choices. For these reasons, optimal treatment consists of a combination of physical, psychological and spiritual intervention and support. In most cases, appropriate medication (usually mood stabilizers and antidepressants) is indispensable, along with Christian counselling for the sufferer, his spouse and sometimes his family. 

Protecting yourself and your family

If, as you say, your spouse is unwilling to submit to this kind of treatment, your response will have to focus primarily on the need to protect yourself and the other members of your family from the negative fallout of his poorly informed choices. This could mean a number of different things: "tough love," intervention, possibly even a temporary separation, designed to "force a crisis" in your husband’s life. Without detailed information we really aren’t in a position to suggest a more specific plan. 

Support and set boundaries

One of the best books available on the subject of depression, mental illness and bipolar disease is Dr. Paul Meier’s Mood Swings. In it, Dr. Meier suggests that you nurture, support and encourage the bipolar sufferer while simultaneously maintaining realistic expectations and setting appropriate boundaries. Such limits will depend on your individual situation. They might include:

• Taking away all credit cards.
• Assuming legal control over banking privileges.
• Taking away car keys during a mood-swing episode.
• Insisting on hospitalization (in spite of resistance) whenever the sufferer is out of control. Obviously, this may require the intervention and physical assistance of a group of friends.

There's no shame in getting help

Meanwhile, both you and your spouse need to understand that there is nothing sinful or shameful about seeking professional psychological and medical assistance in cases of genuine bipolar disorder. It’s an affliction that arises directly from an imbalance between three important chemical neurotransmitters which function to control depression and euphoria within the brain: serotonin, dopamine, and norepinephrine. As such, it’s a problem that can and should be dealt with medically. There are many other diseases associated with similar chemical imbalances – for example, diabetes, migraine headaches, cancer and thyroid disease – but few carry the social stigma that is often attached to bipolar disorder. As you’re probably aware, many uninformed people draw a connection between this particular disorder and the sufferer’s moral and spiritual character. This is a dangerous misunderstanding that needs to be corrected. Here again Dr. Meier has written a book that can be extremely helpful in dispelling some of the more common myths and misconceptions about bipolar disorder. It’s called Blue Genes and it can be ordered via Focus on the Family Canada’s online store. 

Find support for yourself

You are in a difficult position, and you need all the outside help you can get. We’d strongly encourage you to seek out the fellowship of a support network, possibly through your church or a special interest group. You should also consider the option of procuring the assistance of a registered Christian counsellor, with or without your husband’s willing participation. Focus on the Family Canada’s counselling staff is available to discuss your situation with you over the phone. They can also provide you with a list of referrals to qualified family therapists in your area. Simply give them a call Monday through Friday between 8 a.m. and 4 p.m. Pacific time at 1.800.661.9800. They’ll be more than happy to assist you in any way they can.