Bipolar4LifeSupport

Living with a husband or wife who has bipolar disorder can be difficult. Try these tips for coping with the inevitable mood swings.

If you’re married to someone living with bipolar disorder, you already know it’s a rough ride sometimes. The mood swings can make your days together sometimes exhilarating and other times frustrating. Yet you and your bipolar spouse can beat the dire statistics that predict the end of many of these marital unions.

New Orleans resident “Mary” has been married to her husband for 25 years. Almost halfway through their marriage, he was hospitalized at age 42 and received a diagnosis of bipolar disorder. The diagnosis was not surprising due to a strong family history — but it helped to clarify the situation, says Mary, age 51.

“The diagnosis made it easier, because you know the reason, but it doesn’t change anything. It is a roller coaster. You can have months that are perfectly fine and then all of a sudden it will come from nowhere,” she says.

Mary says she knows the statistics showing higher rates of divorce and abuse in marriages that include one spouse with bipolar disorder. She describes her husband as a “rapid cycler” (“On a day to day basis you never know what it’s going to be,” she explains) and says there are many days and weeks when she is tired, frustrated, and wondering why she is still married. After so many years of marriage and successfully raising a daughter together, she has developed a philosophical and compassionate view of her husband and her relationship.

Coping with Bipolar Spouse Mood Swings

Here are some tips for surviving and thriving in your relationship:

• Breathe. When things are tough, take a deep breath and step back. “It’s a disease — it’s not the person. So you try to remember that,” advises Mary.
• Build support. Caring for someone with a disease can keep you focused on his needs, but you also need your own sources of support. Joining a support group for family members of bipolar patients can help. Working with your own therapist may also be a good idea. Support from understanding family and friends is also invaluable. Mary has never joined a support group — and says she probably could have benefited from one — but she does find support in her friends.
• Get away. Mary says part of what keeps her sane is her job, for which she occasionally travels. Despite the fact that her business trips often coincide with times when her husband stops taking his medications, she values her time away. At home, when her husband’s moods are out of control, Mary acknowledges, “I try to avoid him.”
• Laugh. Whether you can insert humor into the situation and get a good response is highly individual, but Mary says this tactic works for her. “I try to make him laugh, to get him out of it,” she says.
• Enforce meds. Mary has made it clear to her husband that taking his medication is non-negotiable. “If you can keep them on the meds, you’re okay. It’s a fight. It’s like having another child,” she says. If he refuses to take his meds (as he often does when he is manic), she leaves, even if only to spend the night at a friend’s house to make her point. That usually gets him back on track.
• Recall your love. There are hard times in marriage to a bipolar spouse, acknowledges Mary. But she prefers to see the man she fell in love with, even when his moods are unpredictable.
• Know (or grow) your philosophy of marriage. Mary believes in the commitment she made when she married her husband. “You know, I married a man for better or for worse. I did not marry a disease.” While she acknowledges bipolar disorder is difficult, she also notes, “The person I fell in love with is still there. Would I want someone to leave me? I don’t think so,” she explains.
• Look for triggers. “When your spouse is in a stable or more favorable mood, pay close attention to what environmental triggers precipitated and are maintaining the stability. Often there are specific environmental stressors or soothers — including relationship issues — that influence mood swings. Use the soothers to help maintain the mood that both of you are desiring,” advises marriage and family therapist Tracy Todd, PhD, based in Alexandria, Va.
• Ask. Despite the mood swings, your spouse can tell you what he needs. “Have an honest discussion about what is helpful to your spouse when he is in an undesirable mood. Incorporate ideas, plans, and strategies so that there can be a minimization of harmful effects,” advises Todd.
• Keep talking. There may be days and weeks when it is not easy, but communication is essential. “Communication during and between mood swings is critical to managing the accompanying stressors,” says Todd.

Ultimately, Mary’s experience has given her a unique depth of compassion, both forfamily members whose loved ones have bipolar disorder and for people who live with bipolar disorder. “[I’ve said before] that I would hate to be in his head — I can’t even imagine how he feels,” she says.

Suicide is not inevitable for bipolar children, but must be taken seriously. Learning about the risk factors and signs of suicide among bipolar kids can help parents plan a prevention strategy.

No parent wants to think about a child committing suicide, yet suicide is the third-leading cause of death for teens between the ages of 15 and 19. The harsh reality is that bipolar children and teens have a greater risk of suicide and attempted suicide than their peers. Up to 50 percent of these children and teens may attempt suicide. Knowing what signs to look for and how to respond is essential to safely shepherding bipolar kids into adulthood.

The average age of bipolar disorder onset is 18, but symptoms of the disorder can appear much earlier (before the age of 10). These early symptoms, even without an official bipolar disorder diagnosis, are correlated with an increase in substance abuse, risky behaviors, and suicidal thinking.

Knowing the Risk

Understanding your child’s risk for both the disease and extreme symptoms will help you plan to decrease the risk of suicide. Risk for developing bipolar disorder increases if there is a family history of bipolar disorder and depressive disorders, because the disease has a strong genetic component. If you are not sure whether bipolar disorder is in your family, know that a family history of suicide or attempted suicide also puts your child at risk for suicide.

If you or the child’s other birth parent has bipolar disorder, your child has a 50 to 60 percent risk of developing a mood disorder. Unfortunately, a diagnosis of bipolar disorder is linked to a significantly increased risk of suicide or attempted suicide, which is why parents should be concerned about their child’s symptoms.

Factors that increase the risk of suicidal thinking in bipolar kids include:

• Early sexual abuse
• Early parental neglect
• Early onset of bipolar symptoms
• Recent stressful events, such as divorce, loss of a loved one, or the end of a relationship
• Recent release from hospitalization
• Suicide of someone close to them, people in their community, or a celebrity

Signs of Suicidal Thinking or Risk

It would be helpful for parents if bipolar children could turn on a neon sign the moment they start to consider suicide. However, the signs are rarely that obvious. Instead, knowing whether your bipolar child is at risk for suicide may come down to a combination of gut instinct and close observation. Here are some of the signs to watch for (many of which are also signs of depression):

• Withdrawal from friends and family
• Sudden changes in appetite or sleep habits
• Doing worse at school
• Aggression
• Irritability
• Talking about or writing about suicide or death
• Calling himself a bad person or implying you or others will be better off without him
• Hopelessness
• Desperation
• Feeling overwhelmed
• Substance abuse (drugs or alcohol)
• Starting to give away toys or possessions, cleaning up, and organizing as if putting affairs in order
• Mood suddenly improves after a depression

What You Can Do To Prevent Suicide

There are a number of ways you can help your bipolar children prevent suicide and cope better with their disease. Here are some ideas:

• Get a diagnosis. Young people are often diagnosed many years after their symptoms first appear. If you have a family history of bipolar disorder or suicide and your child shows any symptoms — such as cycling moods, periods of irritability or high energy, or depression — the first step to prevent suicide is to get a diagnosis quickly and begin treatment.
• Stay open. Be alert for signs and symptoms and talk to your child about what you see. Some parents are afraid to bring up suicide, but it is actually better to ask directly whether your child is considering suicide.
• Family-focused therapy. Family therapy has been shown to be very helpful for bipolar kids and adults. It has been shown to keep moods stable for longer and also provides education for both the patient and his family about bipolar disorder, mood triggers, and other relevant factors. This type of therapy may also improve conflict within your family and benefit everyone.
• Therapy to address early abuse. If early sexual abuse, parental neglect, or other types of abuse are a part of your child’s history, therapy that emphasizes his current safety from these threats may help keep his moods stable.
• Support medication. Effective treatments exist for depression and unstable moods. Work with your bipolar child and her doctors to find ways that effectively keep her on her medications and maintaining stable moods.

If you are concerned that your bipolar child is about to commit suicide, take these steps:

• Put all potential weapons or tools of suicide (such as pills) out of this reach.
• Do not leave him alone.
• Call his doctor.
• Call 911 in an emergency.
• Call the National Suicide Prevention Hotline (1-800-273-TALK) to talk to a trained counselor.

The reality of suicide is terrifying for any parent, but there are concrete steps you can take to try to prevent this tragedy. Talk to a trained mental health professional for more ideas about how to help your bipolar child.

Bipolar children face certain issues and challenges at school. Find out what accommodations are mandated by law for young bipolar children and bipolar teens in the classroom.

School can be stressful for all children, but for children and teens with bipolar disorder, the stresses of the educational process can be overwhelming. The challenges that bipolar children face on a daily basis contribute to their risk for school failure. Bipolar children may be sleepy from medications, have difficulty concentrating or making transitions, or have other learning disabilities.

Young bipolar children and bipolar teens are protected by two federal laws. First, the Individuals with Disabilities Education Act (IDEA) requires schools to identify students with special needs and provide needed educational service from K–12 until age 22. Next, under Section 504 of the Rehabilitation Act of 1973, schools must make necessary academic adjustments for students with learning impairments. Additionally, individual states have various laws regarding what school systems need to do to fulfill bipolar children’s requirements for educational assistance.

When applying the intent of these laws, schools and parents need to realize that every child is unique. “There are some more common approaches that can be used in an education setting,” says Nanci Schiman, MSW, program director of the Child and Adolescent Bipolar Foundation in Evanston, Ill. “But flexibility and open communication are key in managing the bipolar child.”

Just as each student responds somewhat differently to teaching methods and styles, the same is true for a child with bipolar disorder. Some of the more common accommodations that a school can make include:

• Extending time to take tests
• Reducing homework and allowing flexible due dates
• Providing the student with a place to go to regain composure or take a break
• Allowing unlimited access to water (important for children taking certainmedications) and unrestricted bathroom breaks
• Alerting the child and parents if there will be unexpected changes in a school day’s routine (for example, a substitute teacher, fire drill, field trip, or upcoming test)

Schools need to be proactive in anticipating issues that may arise as a result of unresolved problems that the bipolar child is experiencing. If the child is socially isolated or shy, teachers should take steps to prevent any bullying or teasing from the other students. The school staff can also foster a more positive environment by being patient and ignoring minor negative behaviors while encouraging positive ones. Teachers should also stay calm during difficult situations and be a model of desired behavior.

Disciplining the Bipolar Child

Schools are also governed by laws such as IDEA and Section 504 when it comes to disciplining students with bipolar disorder. “It’s important to look not just at the behavior but at the circumstances behind the behavior, the environment in which the problem occurred, and the events leading up to the undesirable behavior,” says Schiman. “Often, problematic behavior occurs when a child does not have the appropriate tools to cope with a situation.”

For example, a bipolar child may be emotionally immature or have problems with impulsivity, anger, mania, or depression. Other times a child may be trying to save face in front of peers so as not to cry, scream, or act in some socially unacceptable way. The more that the school staff can work to address behavioral problems by looking at the root cause, the better the chance the child will replace these behaviors with more appropriate responses.

How Parents Can Help the Education Process

“Parents need to be advocates for their children,” says Schiman. It is helpful for parents to learn about their child’s disorder, know their child’s educational rights, and communicate regularly with school staff in a non-adversarial way to foster collaboration for what is best for the child. Parents can also help the staff to understand the disorder, what works best for their child, changes in medications, or behavioral strategies that work at home. Schiman adds that open communication is the key.

“Human beings are manipulative by nature, and we manipulate our environment to adapt to ever-changing situations,” says Schiman. “A child with bipolar disorder will manipulate the environment based on what skills they have.” A bipolar child’s intent is not to cause trouble, but rather to cope with a situation that causes him stress or anxiety. By understanding the challenges presented by bipolar disorder, and accommodating the child’s needs as necessary, both parents and teachers can give the child a road map to success at school.