Bipolar disorder, also known as manic depression, doesn’t only impact the person who has it. It affects everyone in their lives, from their spouse and children to their best friend. If you or someone you love has bipolar disorder, you know how challenging it is to maintain healthy connections. Fortunately, there are steps you can take to keep your relationships as strong as possible.

Bipolar disorder is a brain disorder that causes extreme changes in energy levels and mood. The cause is unclear. Genetics, brain physiology, and an imbalance in the brain’s neurotransmitters may play a role. Neurotransmitters are chemical “messengers” that send information throughout the brain and other parts of your body.

Everyone goes through highs and lows in life. Bipolar changes in mood go well beyond the norm. You endure life’s ups and downs to the extreme. This may wreak havoc on daily life and relationships. You alternate between manic and depressive states or experience both at once. Each state has distinct symptoms:

  • Mania: Manic episodes that include long periods (at least a week) of feeling unusually happy or irritable. You may participate in high-risk or impulsive behaviors.
  • Depression: Depressive episodes cause you to come crashing down and experience a long period (at least two weeks) of sadness. You may feel hopeless and lose interest in things you used to enjoy.

According to the National Institute of Mental Health, there are several types of bipolar disorder:

  • bipolar I disorder
  • bipolar II disorder
  • cyclothymia

Bipolar disorder presents unique challenges to everyone involved. If you have the condition, getting through each day may be all you can handle. There may not be anything leftover to give to anyone else. Your perception of what matters is affected. Your feelings about a person or situation may change day-to-day.

On the other hand, caring about someone with bipolar disorder has a unique set of challenges.

Romantic Relationships

Romance is difficult enough to maintain in normal circumstances. Romantic relationships for people with bipolar disorder may be particularly challenging. If you’re dating someone with bipolar disorder, it may be hard for you to understand their experiences. Relationships with people who have bipolar disorder may include dealing with and responding to self-destructive behaviors.

Stability and trust are key to a successful romantic relationship. Yet these are challenged in a relationship with someone who has bipolar disorder. To help maintain trust, it’s important to recognize that it’s the disease triggering negative behaviors, not the person.

Relationships with Family and Friends

For those who care about someone with bipolar disorder, sometimes you want to help, but have no idea how. You may enjoy their highs and dread their lows. For example, they may be a lot of fun when on a manic spending spree, but not want anything to do with you when a depressive episode strikes.

Make sure your loved one knows you care for them no matter what state they’re in. If they’re down, try to engage them in positive, low-key activities such as taking a walk or going out to dinner.

When a person with bipolar disorder is a parent, their children can be especially affected. Drastic changes in mood may be confusing and frightening to a child. If they don’t understand the physiological nature of the condition, some children may blame themselves or feel ashamed.

It’s important to educate children who have a parent with bipolar disorder about the condition. In some cases, they may benefit from therapy that helps them cope with their feelings.

Supporting Someone with Bipolar Disorder

These tips may help you be supportive of someone with bipolar disorder, no matter what the relationship:

  • Recognize that no one is to blame for the condition.
  • Remind them that their mental health condition is as real as any other medical illness.
  • Encourage them to seek professional help.
  • Accept their limits as well as your own.
  • Ask them how you can help day-to-day to relieve stress.
  • Learn about their medications. Make sure they take them as directed.
  • Recognize that stress and overstimulation may trigger episodes.
  • Know when to walk away. If they are combative or in the midst of an episode, it may not be the right time to confront them or have a serious discussion.
  • Be patient. There are treatments that help, but it may take time to find the right one.
  • With their permission, go with them to doctor appointments and therapy sessions. It’s critical you understand their condition as much as possible.
  • Take a break. In a relationship with someone who has bipolar disorder, caring for the person with the condition is often the focus. Don’t forget to take care of yourself by eating right, exercising, seeking therapy if needed, and giving yourself breaks.
  • Recognize manic and depressive symptoms and adjust your response accordingly.
  • Have a crisis plan in place that includes emergency numbers of therapists, doctors, and psychiatrists.

Helping someone stick to daily routines may lessen their episodes. According to a 2008 study, people with bipolar disorder have “more sensitive circadian clocks.” When the internal circadian clock is disrupted, bipolar episodes may occur. The study showed that behavioral therapy focused on regulating daily routines such as sleep habits, meals, and physical activity may help.

How you approach issues with someone who has bipolar disorder may mean the difference between a full-blown episode or a calmer reaction.

Therapy is helpful for all types of bipolar romantic relationships. According to the American Association for Marriage and Family Therapy, cognitive behavioral therapy may help someone with bipolar disorder. It aims to help control their symptoms, develop a crisis plan, and develop a relapse prevention strategy.

Family therapy teaches all family members, including the person with bipolar disorder, how to manage the condition. The goal is to help family members work together to monitor symptoms and help prevent relapse. Communication skills and problem-solving strategies are covered.

Couples therapy helps address the unique dynamics of bipolar romantic relationships. It encourages effective communication and accountability for both partners. It explores ways to build trust and deal with difficult feelings.

Keep in mind that individual therapy for the person with bipolar disorder is often needed in addition to couples or family therapy.

Navigating relationships with bipolar disorder can sometimes be a challenge. However, when done with care and understanding, it can be tremendously rewarding. Communication, compromise, and emotional support are key to building healthy connections with loved ones and friends. Don’t go it alone. Seek professional help if necessary.

All relationships stand a better chance if bipolar disorder is being treated. If you or someone special in your life has bipolar symptoms, contact your doctor. The faster treatment begins, the sooner you’ll be on your way to healing and healthy relationships.


I’m married and my significant other was recently diagnosed with bipolar disorder. He began to go to therapy immediately and insists we go together. I would hate to intrude on his sessions and meddle into his treatment too much. What should I do?

Anonymous patient


If your significant other is requesting your presence at the therapy sessions, go. Do not feel as though you are intruding. Bipolar disorder is a complex disorder that has the potential to negatively impact the relationship, and learning about the disorder and how to respond to some of the challenging behaviors associated with bipolar can go a long way in helping the relationship.

Timothy J. Legg, PhD, PMHNP-BCAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.