Mood symptoms in bipolar I disorder can make everyday interactions a challenge — for the person living with the condition and for their family members. But there are steps you can take to maintain your relationships.

Family relationships can be complex for anyone. At times, you may experience natural conflict and adversity. If you or a loved one has a mental health condition such as bipolar I disorder, however, family tensions can become even more complicated.

Bipolar I disorder can cause extreme mood shifts from episodes of mania to episodes of depression. It can be treated with a combination of medication and psychotherapy.

But sometimes, even if you’re following your treatment plan, symptoms of bipolar disorder can affect those closest to you. Hurtful statements, harmful behaviors, and seemingly self-centered actions can be difficult to ignore, even if your family understands you’re living with a mental health condition.

Involving family in your bipolar I disorder care and learning how to ask for support can help you maintain and improve relationships with your loved ones.

The symptoms of bipolar I disorder can cause a ripple effect, emotionally, physically, and even financially, to those closest to the person with the condition.

Emotional impact

The emotional impact of bipolar I disorder on family can be diverse.

Dr. Colleen Mullen, a licensed marriage and family therapist from San Diego, California, says mood episodes continually test the emotional resilience of family members.

She explains that, during mania, high energy and high risk or sabotaging behaviors can be exhausting because the family will often engage emotionally, trying to get the person with bipolar I disorder to “calm down” or not act on their impulses.

Family members may also be affected by the person’s most intense episodes. A person with bipolar I disorder may pick arguments, lash out for no reason, or belittle others.

During depressive episodes, family emotional fortitude may continue to be tested as they worry about their loved one’s safety, particularly if they’re experiencing suicide ideation.

Over time, this constant emotional strain can lead to burnout or a lack of empathy, especially if comments and behaviors come across as uncaring or cruel.

Physical impact

Because bipolar I disorder is a psychological condition, its physical effects on family are often overlooked.

“The daily stress of feeling emotionally tired and worrying about your loved one’s behavior can cause somatic, or physical, symptoms,” Mullen says. “For instance, if your loved one gets depressed and they express suicidal thinking, you may suddenly develop a chronic stomachache or a backache.”

Other physical challenges may be more extreme. Impulsivity and risk-taking during manic episodes, such as driving recklessly, can put everyone’s well-being at risk.

Financial impact

Bipolar I disorder can make it difficult to maintain steady employment, and people may go periods without pay due to time off.

During mania episodes, people with bipolar I disorder may engage in compulsive shopping, gambling, or other major spending.

“This can literally change a family’s financial status overnight depending on just how severe the mood-related symptoms presented themselves,” points out Louis Laves-Webb, a licensed clinical social worker from Austin, Texas.

Family estrangement

Laves-Webb explains mood disorders such as bipolar I disorder can create behaviors and emotions that can be unstable, intense, and potentially dangerous.

“This can easily lead to a lack of relationship trust, significant hurt feelings, and a lack of empathy over time,” he says.

To prevent this, family members or entire family systems may choose to cease contact with their loved one with bipolar I disorder, which Laves-Webb indicates is their way of feeling safe, establishing boundaries, or dealing with the challenge.

The longer severe mood symptoms go on and the more interpersonal relationship damages they cause, the more likely estrangement is to happen, he adds.

It’s not always easy to ask your family for support if you live with bipolar I disorder. You may not fully understand what you need from them, either.

Dr. Alecia Greenlee, a board certified adult and consult liaison psychiatrist from Campbell, California, suggests involving your family in your treatment process to help them understand bipolar I disorder, the treatment plan, and what to do in the event of an emergency.

She says that discussing mood episode warning signs can be important in promoting family empathy.

If a person is entering an episode of mania, for example, and says something snappish, understanding it’s just an emerging symptom of mania and not a personal attack can help family members cope.

Mullen also recommends being clear about what might help during a mood episode. She suggests using statements like:

“It’s also really important that if I say anything that may result in hurting myself or anyone else that you call for help. I’ll need you to do that even if I tell you not to or get mad at you for doing it. I know it’s the best thing for me at that time.”

If you need help now

If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

If you or someone you know is experiencing suicidal thoughts, help is available 24/7. You can call 988 in the United States to reach the Suicide and Crisis Lifeline, or visit the Suicide and Crisis Line’s website to talk with someone.

Was this helpful?

Bipolar I disorder may present interpersonal relationship challenges, but there are things you can do to help fortify your family connections.

Greenlee, Mullen, and Laves-Webb recommend:

  • seeking bipolar I disorder treatment and involving family
  • educating your family (and yourself) on bipolar I disorder
  • taking medications as directed
  • openly communicating about the challenges you face with bipolar I disorder
  • setting and agreeing on boundaries, such as limiting access to finances
  • creating safety plans or safe words family members can use if they feel unsafe
  • participating in outside support networks — for you and your family

Overall, the experts agree that family involvement in treatment is paramount to maintaining healthy relationships.

“This can be an opportunity to understand how [bipolar disorder] has impacted these relationships,” Greenlee states. “If children are involved, then it may provide them with the understanding that the behaviors they have witnessed are not their faults.”

While bipolar I disorder is treatable, symptoms of the condition can sometimes affect those closest to you. This can wear on emotions, cause physical distress, and potentially put family finances on the line. But open communication, mental health education, and support services can help you maintain your interpersonal relationships.