You’ve seen the sleepless nights, the spending and the weeks in bed. You love them, and you may also be tired, scared and fielding advice from both families. This guide covers what helps, for them and for you.
Living with a partner who has bipolar disorder goes better with a plan made while they’re well: know their early warning signs, agree safeguards for money and safety, support their treatment without policing it, and get support for yourself. Involving the family in treatment reduces relapses.
What you’re dealing with
Bipolar disorder is a long-term condition with episodes of mania or hypomania (highs) and depression, and well periods in between. In a World Health Organization survey across 11 countries, about 1 in 100 adults had bipolar I or II at some point in their lives, and more had milder forms. Nigerian surveys have found few cases, but the researchers think stigma and survey methods hid many of them.
Two things surprise partners. Over the years, people with bipolar disorder usually spend more time depressed than high. And relapse is common even with good treatment: in a large US programme, about half of the people who recovered had another episode within two years. A relapse doesn’t mean anyone failed.
Our guides to bipolar disorder in Nigeria and bipolar I vs bipolar II cover the basics.
It’s an illness, not a spiritual attack
In a Nigerian community survey, about 3 in 10 people blamed mental illness on evil spirits. People with bipolar disorder in Nigeria describe being told by religious healers to stop their medicine and fast, and then relapsing. Overspending, irritability and a sudden high sex drive during mania are symptoms of the illness. Faith can be a real support, alongside treatment rather than instead of it. Our piece on traditional healers and mental illness covers how families combine the two.
Learn their early warning signs
Most people with bipolar disorder can name early signs that an episode is coming. The most consistent early sign of mania is sleeping less, often without feeling tired, and warning signs can appear days or weeks before a full episode.
Make a plan together while your partner is well:
- List their personal signs. Sleeping less, talking faster, big new plans, spending, irritability, pulling away or staying in bed.
- Agree two stages. At the first signs, you both keep a closer eye on mood and sleep. At later signs, they contact their doctor, or you do, as agreed.
- Write down who to call, and keep it somewhere you can both find it.
In a UK trial, people taught to spot their early signs and get help went longer before a manic relapse and did better at work. It didn’t prevent depressive episodes.
Don’t treat every mood change as a relapse. Ask instead: “I’ve noticed you’ve been sleeping less. How are you feeling?” And protect sleep: a regular routine helps, and night shifts and overnight travel are worth avoiding where possible.
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Agree safeguards while they’re well
- Money. Mania can bring spending sprees, loans and risky deals. With your partner’s agreement, set up safeguards in advance, such as a separate account for rent and school fees, spending limits, or a rule to wait before any big purchase. Avoid sharing PINs and passwords as the workaround, because it leaves room for misuse.
- Big decisions. The UK’s NICE guideline advises people not to make important decisions during mania. Agree in advance that big decisions wait until the episode has passed.
- Sex and trust. A higher sex drive and loss of inhibition are recognised symptoms of mania, and they can lead to risky sex or affairs. It’s a symptom, and it can still hurt deeply. Talk about it while they’re well, include sexual health in the plan, and get support for yourself if it happens.
- Driving. An episode may mean not driving for a while.
- Who decides if they can’t. Under Nigeria’s Mental Health Act, your partner can appoint someone, while well, to make care and treatment decisions if they become too unwell to decide.
Support their treatment without policing it
Treatment is usually long-term medicine from a psychiatrist plus psychological help. Stopping medicine suddenly is linked with fast relapse, and some medicines need regular blood tests. If your partner wants to stop or change anything, encourage them to plan it with their psychiatrist.
Involving the family helps. In a US trial, adding family sessions to medicine cut relapses over two years from 54% to 35%. Groups for caregivers alone also reduced manic relapses. If your partner agrees, go to some appointments and help write the crisis plan.
Research also links a critical, tense atmosphere at home with more relapses. That isn’t a reason to blame yourself. It’s a reason to get support before things reach boiling point.
When it’s an emergency
Suicide risk in bipolar disorder is about 12 to 14 times the general-population rate. If your partner seems low, ask them directly whether they’re thinking about suicide. Asking doesn’t put the idea in their head. Our guides to asking about suicide and making a safety plan show how.
Get urgent help if your partner talks about harming themselves, stops eating or drinking, or behaves in ways that put themselves or others at risk.
Most people with bipolar disorder are never violent. In a large Swedish study, the higher rate of violent crime was mostly among people who also misused alcohol or drugs, and people with severe mental illness are more often victims of crime than others. But if you or your children feel unsafe, especially with severe mania, threats or heavy drinking, your safety comes first. Leave and get help.
In immediate danger, call 112, or 767 in Lagos. To talk to someone at any hour, Safe Place Nigeria is on 0800 800 2000. It’s toll-free and answered 24 hours a day.
If your partner needs hospital care against their will, Nigerian law sets the order of who can apply: a parent or guardian first, then the spouse. Two independent doctors must examine them, and a review committee checks the admission. Chaining or shackling anyone with a mental health condition is a crime, including at a prayer camp or healing home. Our guide to psychiatric hospitals in Lagos lists where to go.
Planning a family
Women with bipolar disorder have a high risk of relapse after giving birth. In a large review of women with bipolar disorder or a past postpartum psychosis, about 1 in 3 relapsed after birth. Among women with bipolar disorder, about 1 in 6 had a severe episode, such as postpartum psychosis. Women who were off medicine during pregnancy relapsed far more often than those on preventive treatment.
Plan pregnancy with the psychiatrist before stopping or changing anything. One medicine sometimes used for bipolar disorder, valproate, carries serious risks in pregnancy. UK regulators now also advise men taking it to use contraception. Don’t stop it without the psychiatrist’s advice.
Suggested read: Cyclothymia: The Milder Mood Swing
If it’s the father who has bipolar disorder, the risk after birth doesn’t apply to him. Broken sleep with a newborn can still trigger an episode, though, so plan night feeds together.
Look after yourself
Caring takes a toll. A study in south-west Nigeria found that family caregivers of people with bipolar disorder had more depressive symptoms than caregivers of people with schizophrenia. In studies elsewhere, between a quarter and nearly half of caregivers report depression. Programmes for caregivers have improved their depression, and their partner’s too.
- Share the load with relatives or friends you trust.
- Keep something that’s yours: friends, church or mosque, exercise, sleep.
- Get your own support. Our piece on caring for a partner when you’re exhausted has more.
- Set limits. You can love someone and still say you won’t accept abuse, or that staying in treatment matters to you.
You may have heard that 90% of marriages affected by bipolar disorder end in divorce. That figure has no credible source. In a survey across 12 countries including Nigeria, bipolar disorder that started before marriage raised the odds of divorce by about 1.6 times. It’s harder, but not hopeless.
You can find a therapist who works with mood disorders, or a couples counsellor, by video, voice or chat. Medicine stays with the psychiatrist. Read more on our bipolar disorder page.
Frequently asked questions
Can a marriage survive bipolar disorder?
Yes. Bipolar disorder raises the odds of divorce, but the “90% of marriages fail” figure has no credible source. A plan made while your partner is well, steady treatment and support for both of you make a real difference.
What are the early signs of a manic episode?
Sleeping less without feeling tired is the most consistent early sign. Others include talking faster, big plans, spending and irritability. Signs differ from person to person, so list your partner’s together while they’re well.
Should I make my partner take their medication?
You can’t force it, and policing usually backfires. Talk about it while they’re well, agree what you’ll do if warning signs appear, and encourage them to plan any change with their psychiatrist. Stopping suddenly is linked with fast relapse.
Will our children have bipolar disorder?
Their risk is higher than average, but most children of a parent with a severe mental illness don’t develop one. If you’re planning a family, talk to the psychiatrist first.
Is it my fault when my partner relapses?
No. Relapse is common even with good treatment. A calm home and a good plan help, but you can’t prevent every episode, and you need support too.
This article is awaiting clinical review. It’s based on published research and health guidelines, and we’ll update it once a clinician has reviewed it.
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