Expert: Libby Bonner - 12/15/2008

Question
Libby,
I've been dating my girlfriend for over a year now and we were even engaged for a while. Then she went to a doctor in Houston who said she wasn't bipolar and took her off her medication. Well you know what happened then. She went into a mania and ended up in the hospital. While she was in this mania she broke up with me saying I deserved better than her and that I didn't know her.
Well after she got out of the hospital and regulated on her medication again we got back together.
I didn't want to rush anything so I played along with her and she was talking about marriage and that is what I have been wanting for a long time now. SO I proposed and we were engaged for about 3 weeks.
Now she has called off the engagement and only wants to be friends because she says she has nothing to give. When she was telling me this she was crying and said that she didn't want to break up with me but she didn't have anything to offer.
I have read up on bipolar disorder a lot and have a lot to learn yet. But in my reading on bp I have read that this is common for someone with bipolar.
My question is, how do I manage a healthy relationship with her? What do I need to do?

Answer
"...have read that this is common....?  Not sure what "this" is: frequent break-ups, or the person feeling unworthy, or.....?

I also realize that I don't know you ages, nor whether either of you has been married, or had children....   Nor when she was originally diagnosed, prior to the doc in Houston.

I also don't know if she has completed her education and/or had begun working in a field in which she was likely to remain, nor for how long she had been.

Some observations, nevertheless.

I would leave aside all questions of marriage for a time until you both know more about bipolar, have -both of you - established a good relationship w/ a psychiatrist whom you trust and respect, have either or both had some educational exposure to mental illness, and both of you and the doc agree that she is functioning optimally.  I would also add - until after she is getting services additional to a doc's via a community mental health center.  Find the two closest to you at samhsa.gov.

I hope you will try to attend most of her psychiatrist appts, forever, since that is almost the key to remaining in a successful bipolar relationship.  Your relationship, in fact, will be the two of you AND this serious illness that will always be present in your lives and will create some disruptions to it.

The education that I mentioned might be:  for her, the NAMI Peer to Peer classes, and for you, the NAMI Family to Family classes, as well as both of you becoming active participants in a local NAMI affiliate.  See nami.org, but contact the state NAMI office re classes; the list at the nat'l site is not always kept up.

It would be very good for both of you to have some contacts w/ other patients [consumers, in NAMIspeak] to see the range of illness/wellness of those moving toward recovery.  Your girfriend might get some of that through a mental health center, maybe more easily there than through NAMI's Peer to Peer, which is not always available.

You may want to go w/ her to her intake interview at a center, so that you can both be on the same page about what the center offers and what might benefit her.  Her doc can write an order for all services at the center, or for particular ones.

I would also involve family in friends in this, as appropriate.  The larger your network, the better.

This online source is good re mental illness: mentalhealth.com.  This, for her: dbsalliance.org.  For both of you, helpguide.org.  That last has some of the very best info on helping those w/ bipolar disorder.

Now, back to marriage.  Stress is the enemy of the mentally ill, and they feel stress in situations that would go utterly unnoticed by you or me.  So-o-o it will be no surprise to learn that things that stress anyone - planning for a wedding, moving, changing jobs, etc. - may knock them for a loop -- may set them back, make them more symptomatic, make them quite ill.   The engagement itself may have done this to your girl...or the thought of a wedding/marriage/hoopla.

And/but - I'm not quite sure what this 'don't have anything to offer' is about.  Because she has an illness?  Because she fears going forward?  Or a genuine lack of self-esteem?  I would want this to get straightened out ASAP.   But - put this paragraph and the one above together:  if you want to go forward w/ her, try to find out if becoming un-engaged would make her feel better....or it could be she would be equally comfortable to be engaged but w/ a very fuzzy date for the wedding.  [And the wedding should be SMALL and QUIET and the whole shebang over FAST.....the longer prep and parties trail on, the worse it will be.]    And I would do all the other things suggested above, and I would ask the doc, ask the mental health center person/s, about the self-esteem issue, as in, IS there an issue here?

Other matters.  Does she have health insurance; who will pay for docs and meds.  And -- far down the road -- pregnancy.  Check online, but I think she would have to be off meds at least for her first trimester...though I know of women whose illness remits when they are pregnant.

Too much information, perhaps.  Write again if you wish.