You can have a healthy relationship with someone who has bipolar disorder. But if the relationship is unhealthy and either person sees red flags, it may be time to consider ending the relationship.

People with a diagnosis of bipolar disorder experience extreme shifts in mood that can result in manic or depressive episodes. Without treatment, these shifts in mood can make it difficult to manage school, work, and romantic relationships.

It may be difficult for a partner who hasn’t been close to someone with bipolar disorder to understand certain challenges.

While bipolar disorder may present challenges, it doesn’t define your partner.

“Mental illness does not mean a constant state of debilitation, but rather there could be episodes of more difficult times,” said Dr. Gail Saltz, clinical associate professor of psychiatry at the New York-Presbyterian Hospital Weill-Cornell Medical College.

“Even if there is a period of more struggle, the goal would be to get them back to a stable state and maintain that.”

The disorder also has positive aspects. People with bipolar disorder may exhibit “high creativity, at times, high energy, that allows them to be original and thoughtful,” said Dr. Saltz. She noted that many CEOs have bipolar disorder and share these attributes.

While the disorder has no cure, treatment can effectively manage symptoms and help to maintain stability. This can make it easier to carry on relationships and to promote long, healthy partnerships.

However, it’s also possible for a relationship to be unhealthy even when one partner’s bipolar symptoms are effectively managed. Some people may face challenges that make it difficult to be in a relationship.

Here are some things to consider if you’re thinking of ending a relationship with a partner who has been diagnosed with bipolar disorder.

It’s possible to have a healthy, happy relationship with someone living with bipolar disorder. However, there may also be specific indicators that suggest taking another look at the relationship.

Dr. Saltz said that several signs may indicate an unhealthy relationship, particularly with a partner who has been diagnosed with bipolar disorder:

  • feeling that you’re a caretaker in the relationship
  • experiencing burnout
  • sacrificing your life goals, values, and needs to be with your partner

Your partner stopping their treatments or medication could also be a cautionary sign for the future of the relationship. Also, as with any relationship, you should never feel that your partner is putting either you or themselves in danger.

Unhealthy signs go both ways. A person diagnosed with bipolar disorder may see red flags from their partner, too.

“A partner who is stigmatizing and very negative about mental health issues, which is unfortunately fairly common, may be a difficult partner to have,” said Dr. Saltz.

“They may be often condescending or dismissive of you, [saying things like] ‘You don’t really have bipolar disorder,’ [which can] undermine your treatment,” she added. For a partner diagnosed with bipolar disorder, this may be a time to take another look at the relationship.

There are several things you can try to preserve the relationship.

First, remember why you’re in the relationship. “You probably got involved with this person and picked this person because there are lots of things that you like and love about this person,” said Dr. Saltz.

She suggested educating yourself about bipolar disorder to better understand the condition. It also helps to learn to recognize signs of depression or hypomania so that you can advise your partner to talk with their healthcare provider if needed.

Dr. Saltz also recommended encouraging your partner to continue treatment and taking any prescribed medications.

“Sometimes, when people have been stable for a while, they’re sort of like, ‘Oh, I don’t think I need any of this anymore.’ Usually that’s a bad idea,” she said.

Dr. Alex Dimitriu, founder of Menlo Park Psychiatry & Sleep Medicine, said that you can also support your partner by offering “gentle, nonjudgmental supervision and guidance” and encouraging healthy behaviors.

These behaviors include:

Additionally, he suggested that your partner identify three trusted people to check in with (you may be one) if they’re feeling off.

“Let those people then provide an average sort of score, and say, ‘Hey, yeah. ‘You are a little hot-headed, or you are a little down,’ or whatever they may offer,” he said.

You should immediately reassess any relationship that has become threatening, and take care of your safety. Beyond that, if unhealthy signs continue or grow worse, it may also be time to think about ending the relationship.

When to say goodbye

Dr. Dimitriu advised against breaking up when your partner is having a manic episode.

“A lot of times, I think there’s nothing that you can say that will convince the other person [of] anything, if they’re really on the mania side,” he said.

“The biggest thing, I think, actually, is to delay the breakup if that’s happening and just have a cooling off period,” he added.

After that, “Don’t make big decisions unless your three [identified and trusted] friends have said that you’re in an even place. And that includes the relationship.”

Consider seeking support

If you do break up, Dr. Saltz recommended making sure your partner has emotional support, and if you’re able to connect them to a mental health professional, that would be helpful.

If you have the contact information of their therapist you may leave a message, although be aware that their therapist may not be able to talk with you due to the Health Insurance Portability and Accountability Act (HIPPA).

“You can leave a message with their therapist saying basically, ‘We’re breaking up, I know this will be hard, and I want to alert you to that,’” she said.

She also advised paying attention to any thoughts of suicide. According to a 2014 research review, around 25 to 50 percent of people with bipolar disorder will attempt suicide at least one time.

“If a person in any circumstance makes a threat of suicide, that is an emergent situation. You should take away any means that you’ve seen currently available for them to do that and take them to an emergency room,” she said.

“That’s a concern even if you are breaking up with them.”

Be understanding

You can attempt to be as supportive as possible during the breakup. Still, Dr. David Reiss, a psychiatrist with offices in Southern and Central California, said that some people may not be receptive because they feel rejected.

“They may not be capable of ‘working through’ a relationship ending in an effective way, and mature ‘closure’ may not be impossible,” he said.

“Be kind, but not overbearing, and realize that once you are ending the relationship, your kindness may not be welcome anymore, and that’s OK.”

“Don’t take it as a personal attack,” he added. “Acknowledge that how the other person reacts, and their ability to maintain even a superficial or polite relationship after a perceived rejection, may be inherently limited and beyond your control.

Do try to be compassionate, but be ready to have that compassion rejected without taking it personally.”

Any breakup is likely going to be difficult, especially if you had a long-term commitment to your partner. Dr. Reiss said that this situation may lead to feelings of guilt.

“If you start feeling guilty when the reality is that you had not made the commitment the other person implicitly expected, your guilt will trigger anger, depression, etc. in both yourself and in the other person and make it worse,” Dr. Reiss said.

He added, “Work through your own guilt as much as possible before, during, and after the breakup.”

It’ll also take time to heal. Dr. Saltz suggested doing your best to learn from any relationship that didn’t work. “It’s always good for you to review for yourself why you chose this person, what was the draw for you,” she said.

“Is that something that, in retrospect, you feel good about, or does it fit some pattern that hasn’t been good for you? Just try to learn from a relationship that didn’t ultimately last and understand more about yourself in that regard.”

You can absolutely have a healthy, happy relationship with a partner who has been diagnosed with bipolar disorder.

The condition may bring both positive and challenging aspects to the relationship, but you can take steps to support your partner and to help them manage their symptoms.

If you notice unhealthy signs in the partnership that aren’t improving, you may seek to break up. You may try to be supportive during the breakup, but don’t take it personally if they don’t accept your help.

As with any relationship, focus on learning from the experience as you move forward.