Contemplating marriage to someone with bipolar disorder? Your marriage will not be like any of your friends’ or family who do not have to deal with this extra relationship challenge. 

Here are 15 questions to ask the psychiatrist about your future husband or wife if he/she has been diagnosed with bipolar disorder.

1. How can I participate in my future bipolar husband’s/wife’s therapy plan?
2. What are the potential long-term side effects of lithium and/or other psychiatric drug treatements?
3. Is there a chance that the medication prescribed now will become ineffective? If yes, what happens then?
4. How will other medications or alcohol affect my fiancee over time if he gets sick, has bad allergies or drinks too much?
5. What if the dosage on the medication(s) is too high? What does medicinal toxicity look like? Is a blood test twice a year enough to detect this?
6. Will my bipolar future husband or wife ever be “cured?” Will he/she ever be able to stop taking medication?
7. Are there other treatment options besides medication?
8. What are the bipolar disorder “warning signals” I should watch out for?
9. What are the risks to our marriage? What’s the worst that could happen? What are the chances of that happening?
10. Should we have children? What are the chances we’ll pass bipolar disorder to them? Is that an ethical consideration? Or a medical one?
11. Will bipolar disorder medication affect my future bipolar husband’s or wife’s ability to have children?
12. All things being equal, what percentage of a “normal” life can we hope to have together if he/she stays on a treatment plan?
13. How will bipolar disorder affect my future husband’s/wife’s ability to get medical insurance?
14. Does medical treatment for bipolar disorder shorten somebody’s lifespan or damage health or organs?
15. What should I be asking you about marriage to a bipolar husband or wife that I haven’t asked you yet?

Obviously, this is a lot of ground to cover with a medical professional. But even if it takes more than one session with your future bipolar husband’s/wife’s psychiatrist to get these questions answered, you’ll want to take your time in absorbing the enormity and ramifications of the answers.

No doubt you’ll want to discuss the answers with your future spouse, as well.  Better to be informed as possible before you walk down the aisle than to be surprised with information you hadn’t considered after the wedding.

With a bipolar husband in the family, sometimes avoidance is easier than communicating. That’s what Mary J resorted to with her bipolar husband. “His verbal abuse got so bad I just avoided him,” said Mary J. of her husband, who was recently diagnosed with bipolar disorder.

It’s not uncommon for wives of bipolar husbands, like Mary, to instinctively shut down all lines of communication rather than to address the negative behaviors that bipolar disorder causes. Unfortunately this can make a bipolar marriage situation worse by triggering more dysfunctional behavior.

Online research about bipolar disorder and, especially searching for help in dealing with a bipolar husband, was how Mary found the book, “70 Signs of Depression: Recognize and Cope with Your Loved One’s Clinical or Manic Depression.”

The book provided her with proactive tools for dealing with a bipolar loved one. “70 Signs of Depression gave me the knowledge, even the words to use, to start really helping my husband and our marriage get back on track,” she added (Mary’s full name has been withheld to protect her family’s privacy.)

Crafted from the hands-on knowledge of thousands of bipolar victims and their family members by Marlee Fisher, a best selling ghostwriter-turned author and Certified Faculty Member of NAMI, the National Alliance For the Mentally Ill, “70 Signs of Depression” takes readers into the minds of bipolar disorder sufferers by uncovering the illness’ 70 Signs, 4 Emotional Trip Wires and 2 Defense Mechanisms. It then provides proven step-by-step strategies and techniques to help co-manage each of them.

“The non-communication between Mary and her husband is all too common,” stated the author. Members of the medical and mental health communities endorse this book as a page-turning must-read for anyone with a bipolar spouse, family member or friend.

Fisher wrote her book to offer an easy-to-understand look inside bipolar disorder, alongside firsthand know-how from thousands of bipolar co-victims that readers can use to help themselves and their own ill loved ones immediately.

Then she details the step-by-step strategies and proactive techniques, including the exact words, that have already helped others deal with a bipolar loved one.

This book is based on the author’s personal experience as a bipolar co-victim, including her years of extensive research meeting with psychiatrists, M.D.s, psychologists and social workers; actively participating in NAMI support groups; serving as a NAMI faculty member and interviewing thousands of bipolar victims, their family members and friends.

The result is an in-depth and easy-to-understand look inside bipolar disorder, often written in its victims’ own words, that reveals valuable first-hand insights and expert hands-on knowledge.

For a long time now, researchers have suspected a genetic link to bipolar disorder. But they’ve not been able to find it conclusively.

In a new study, doctors pooled resources to create the largest genetic analysis of its kind to date for bipolar disorder and discovered machinery involved in the balance of sodium and calcium in brain cells as a root cause.

“Faced with little agreement among previous studies searching for the genomic hot spots in bipolar disorder, these researchers pooled their data for maximal statistical power and unearthed surprising results,” said NIMH Director Thomas R. Insel, M.D. “Improved understanding of these abnormalities could lead to new hope for the millions of Americans affected by bipolar disorder.”

Researchers supported in part by the National Institute of Mental Health, part of the National Institutes of Health, found an association between the disorder and variation in two genes that make components of channels that manage the flow of the elements into and out of cells, including neurons.

2 Proteins at Fault in Disrupting Ions that Regulate Neuron Firings

Doctors found that two proteins may be involved in disrupting the ions that regulate whether neurons can fire properly. “Finding statistically robust associations linked to two proteins that may be involved in regulating such ion channels — and that are also thought to be targets of drugs used to clinically to treat bipolar disorder — is astonishing,” said Pamela Sklar, M.D., Ph.D., of Massachusetts General Hospital (MGH) and the Stanley Center for Psychiatric Research at the Broad Institute of MIT and Harvard, who led the research.

Sklar, Shaun Purcell, Ph.D., also of MGH and the Stanley Center, and Nick Craddock, M.D., Ph.D., of Cardiff University and the Wellcome Trust Case Control Consortiuum in the United Kingdom and a large group of international collaborators reported on their findings online on Aug. 17 , 2008 in Nature Genetics.

In the first such genome-wide association study for bipolar disorder, NIMH researchers last fall reported the strongest signal associated with the illness in a gene that makes an enzyme involved the action of the anti-manic medication lithium. However, other chromosomal locations were most strongly associated with the disorder in two subsequent studies.

Bipolar Disorder Thought To Involve Many Gene Variants

Since bipolar disorder is thought to involve many different gene variants, each exerting relatively small effects, researchers need large samples to detect relatively weak signals of illness association.

To boost their odds, Sklar and colleagues pooled data from the latter two previously published and one new study of their own. They also added additional samples from the STEP-BD study and Scottish and Irish families, and controls from the NIMH Genetics Repository. After examining about 1.8 million sites of genetic variation in 10,596 people — including 4,387 with bipolar disorder — the researchers found the two genes showing the strongest association among 14 disorder-associated chromosomal regions.

Variation in a gene called Ankyrin 3 (ANK3) showed the strongest association with bipolar disorder. The ANK3 protein is strategically located in the first part of neuronal extensions called axons and is part of the cellular machinery that decides whether a neuron will fire. Co-authors of the paper had shown last year in mouse brain that lithium, the most common medication for preventing bipolar disorder episodes, reduces expression of ANK3.

Variation in a calcium channel gene found in the brain showed the second strongest association with bipolar disorder. This CACNA1C protein similarly regulates the influx and outflow of calcium and is the site of interaction for a hypertension medication that has also been used in the treatment of bipolar disorder.

The National Institutes of Health (NIH) — The Nation’s Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Why My Marriage To a Bipolar Husband
Qualified Me To Write a Best-Seller
on Being “Married To Mania”

…And Why the Bipolar Support Groups
Don’t Want You To Read My True Story

After 15 years of marriage to a bipolar husband, I wanted to help other spouses who were married to bipolar husbands and wives get answers they’d never hear from the professional mental health community. So I wrote a book that became a best-seller among spouses married to a bipolar husband or bipolar wife.

In doing so, I drew criticism from the “experts” because I was honest and realistic about bipolar marriage. As of now, my bipolar marriage book, “Married To Mania,” has sold in more than 38 countries and I continue to get positive feedback, like this note from Lynn in Michigan:

“I received the book yesterday, and have read it through twice already. There are no words for me to describe the level of emotions evoked through reading this information…sadness, awareness, shock, disbelief (are those all denial?) just an over-all unsettling feeling at the enormity of the situation I am in being ‘married to mania,’ and also the relief that there is someone else out there that “gets it”.

I have been married for almost 20 years, and all those ‘personality quirks’ and challenging times that we’ve had–well, I was clueless…..substance abuse has always been there, and my husband went to treatment 2 1/2 years ago, and was, for the first time, diagnosed as bipolar. We had a great two years, until (I didn’t realize he had quit taking medication) and he went into the first several day, non-alcohol induced manic phase that nearly did blow the roof off of our home, and we have 4 beautiful children!
What a relief to know I’m not alone. But now that denial is creeping away, I am in the grieving process, and stunned to the point of caution and apprehension for the next move. Thank you for writing “Married to Mania” and for providing this tool.”

This Is How My Book About Bipolar Husbands and Bipolar Wives Came To Be

I didn’t have medical credentials to write “Married To Mania.” But after 15 years of marriage to a man who was the most important person in my life, I was motivated to stay married, and was looking for all the answers I could find to do so. In my darkest, most hopeless hours of coping with my husband’s bipolar disorder, when I tried to reach out for information and help, I didn’t find many options. Most bipolar support groups are created for parents. Or they are for adults coping with a parent’s or a sibling’s illness. In the many support groups I attended over the years, I rarely met spouses.

Spouses are overlooked and under served in the bipolar treatment world. We’re continually uncertaint about whether our emotional needs are more or less important the needs of our bipolar spouse. If we choose our own emotional needs first (how selfish!), we often punish ourselves with guilt, then anger toward our spouse. Inevitably, that creates new problems for the marriage. But if we choose to put our spouse’s emotional, physical and mental health needs ahead of ours-—after all, they’re the sick one—who we get to be in life is a little more diminished. The choices are hard and always agonizing. A spouse is alone in coping with her bipolar husband or his bipolar wife.

Besides managing doctor visits, medications, decisions on whether to hospitalize or not, a spouse also has to fight to have a tenable relationship, which has turned out to be so very different than we originally expected. The line between partner and caregiver is thin and often non-existent. It can make for a lonely, if not devastating life.

You cannot share your feelings with your spouse; he’s the sick one and the cause of your distress! Your parents are empty nesters; you don’t want to burden them with your problems. And siblings have their own families to worry about. Unless your friends have mental illness in their families, they’re not going to understand what you are going through, and your spouse may not want you violating his privacy to share the details anyway. The pressures on us from friends, family and professionals can be unrelenting as well. It’s not supportive or even sensitive to be asked why you stay in your marriage or have it implied that it’s your duty to do so.

Bipolar spouses run roughshod over relationships. The divorce rate with bipolar disorder is two to three times higher than in the general population. When I did find a “spouse’s support group,” there was one man (divorced) and 16 women. A third of the women had husbands living in their basements as recluses, incapable of holding a job or contributing financially or emotionally to their family life; a third were divorced from violent men who beat them or were unstable and emotionally abusive to them or to their children; and a third were widows—their husbands had committed suicide. (The suicide rate for Bi Polars is 12 times higher than the “normal” population.)

Everyone in this support group thought I was in denial for having a goal to stay married. So I didn’t go back. Some help isn’t help. But I felt more isolated than ever. I just knew there had to be a “happy medium” somewhere that would allow me to “live life on purpose,” despite the unfair hand I was dealt in love and marriage. I knew there had to be better choices than living with bipolar chaos and avoiding emotional mine fields everyday.

So I set my sights on finding out my own answers, constructing a plan to take charge of my life, to retain control of my life’s goals and to discover concrete ideas for handling unexpected mood swings, uncontrollable outbursts of anger, inevitable guilt and remorse (mine and his!), and the emotions accompanying the realization that my life partner was no longer the one I married anymore.

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