Expert: Ivan Goldberg, M.D. - 10/19/2008

Question
QUESTION: Hey there Dr.Goldberg,I am 20 years old and I have a boyfriend(24) who is bipolar. We have been living together since the beginning or our relationship 1 year ago, and we have had our ups and downs like any normal young couple learning about each other and growing up.
When I first met him he suffered from general anxiety disorder and would have panic attacks. I suggested he start seeing his Psychiatrist of 2 years again for some help. Soon there after he was diagnosed with Bi-Polar disorder, I understand it is a mood disorder? He has been on Seroquel for the past few months, in September our relationship started to fall apart he told me things like "its over, I have no feelings for you" or "it will never work between you and I"
I finally broke up with him, and the next night, he in his own way made amends and started showing me affection again and telling me I love you, and I asked if this is our "fresh start." He said "Yes"
My question is:
Lately he's been beginning to isolate himself, when he comes home from work. He just wants to be on his computer or play computer games, and just wants to be left alone. He doesn't really want to go out, since he doesn't want to spend money, which I understand with the economy and all. Some days he'll chat up a storm with me, and we'll have nice conversations, and other days he gets in the "I want to be left alone" mood.If I try to ask him questions hes very vague i.e: "i dont know","i suppose" "i guess" or "i'm okay" - when hes not acting "okay"
Is this a common thing for people suffering from Bi-polar to do? I thought medication was suppose to help this?
Or is this more of a relationship problem, because as far as I see it and know we haven't really ever fought since reconciling. (a good thing because its less of a stress for both of us, because we want home to be a positive and safe environment we can come home to, to de-stress from work and school)
I'm the one who feels bad about it because it hurts my feelings when he acts like this. I've became paranoid that maybe he doesn't like me or have feelings for me even though he says he loves me and we are affectionate and intimate. Although I know hes bi-polar and moods are roller coasters!

ANSWER: Hi Gina . . .

Relationships are nearly always difficult and a relationship with someone who has bipolar disorder (BPD) is especially difficult. As you have observed, people with BPD have frequent fluctuations in their mood and behavior when their disorder is not well-controlled. Sometimes they are full of life and are interested in having a good time and at other times they are introverted, depressed, and withdrawn.

I think there are a couple of things you can do to make things better for yourself. You might look for support from the closest chapter of the De Depression and Bipolar Support Alliance. They provide services for the friends and family od people with mood disorders. You can locate the closest group at:
http://www.dbsalliance.org/site/PageServer?pagename=support_findsupport&JServSes

Another thing you might consider is getting involved is some sort of couples counseling with your boyfriend. Such counseling may reduce some of the stress you are experiencing.

Best regards . . .

Ivan
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---------- FOLLOW-UP ----------

QUESTION: Hi Ivan, last night, we went through a horrible squabble.
I was worried sick because he was not home and its was 3am! I know he went to dinner and hung out with people, but I was kind of shocked to find out it was with a woman I had never heard about.(I think he did it to make me upset)
Well he came home around 3:15am, still lividly upset with me from a argument we had earlier at 6pm.
He basically told me in his angry state of mind, "I'm tired of dealing with, I don't care if your sorry, I'm just not dealing with you anymore".."I just don't care"
I toned my voice down, and calmly explained that I understood and "if its meant for us to broken up, then so be it, but I enjoyed every moment we've share, and honestly I wouldn't trade all those good and bad times for anything ect ect."
His mood changed because I think his Seroquel and Lamotrigine began to kick in that he took when he got home. We had a lovely chat about how you know it would be the right time to break up. He asked me to move out this week before he left for Dubai. He says "He only one call away, and that he treasures us, and maybe someday if we're meant to be, we are meant to be." Which I found very sweet.
Dr.Ivan, do you think that maybe me moving out would be good for our relationship maybe to not have tension swirling around us everyday and not living in close proximity to each other?
I wanted to suggest to him, when he wakes up, that even though we were very angry with each other,and then settled on a good note, if we can still date? or propose something kind of other than a final "break-up" for now.
Seeing as our last "break up" a month ago was initiated by me, and the next day he made his amends. My take on him breaking up with me was out of anger and his moods and him not thinking logically.
No less I would love to keep living with him, our place is so comfy, and the thought of me not seeing him everyday is devastating to me. I'm unusually strong right now, I think Wellbutrin SR does help, but I just know its not truly over for him or I.
What do I do?
- Thank you for your advice, always..
Gina

Answer
Hi Gina . . .

One of the things about people with BPD that I did not mention in my last reply to you is they they often tend to be impulsive and show poor judgment. The impulsivity is dangerous as when in an elevated mood they may do foolish things with respect to money, sex, relationships and even driving. When depressed they may end relationships and even make suicide attempts impulsively. One of the things I try to teach my patients with BPD is that they should slow down the decision making process and make no irrevocable decisions when elated and/or depressed. Yes, it is possible for someone to be both elated and depressed simultaneously.

I am not able tot ell you what to do but maybe you will get some ideas from reading the paragraph above.

Best regards . . .

Ivan
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