Expert: Libby Bonner - 3/28/2007

Question
I am in the beginning of a relationship with someone who is bipolar. She is what she calls high functioning and is taking meds as well as seeing a therapist. I have a 5 year old daughter and do not know much about this disorder or how it could affect her. I don't want to just cut and run like I am sure so many people would do. I'd rather understand it the best I can and make an educated choice. Please help.

Jason

Answer
You are very wise to want more information and wise to keep this in the beginning stage while you acquire it.  If it seems likely to both of you that this could lead to permanence, then I see nothing wrong with getting much of your information from your friend and other persons in a position to have known her over the course of her illness, including close family members and her psychiatrist - if she and the doc would be comfortable having you along for part of an upcoming appt.  [Certainly, I would want to meet the doc and be met by the doc before formalizing an engagement, for instance.]

You can get some factual info at www.nami.org and some real-life accounts by attending a NAMI affiliate if there is one near you.  If you will google NIMH you can also get good info there.

I'll do a fast take for now.  All serious mental illnesses are chronic illnesses that remit and relapse over time, regardless of the patient's current stability, faithfullness in taking meds, etc.  And all are characterized by disorders of thought, mood, and behavior due to faulty brain chemistry, which meds help to correct.  The meds most useful in bipolar are mood stabilizers.

Some additional potential for instability exists w/ bipolar disorder, which by definition includes mood swings.  How disruptive these are is dependent partly on the frequency of the mood changes, which varies by patient, as well as how vividly or subtly the differing moods are expressed.

That your friend is "high functioning" implies to me that she probably was diagnosed and properly treated early after becoming ill, has responded well to meds, and is faithful in taking them.  None of this insures that this status will continue indefinitely - see above - tho there is every reason to expect that she can return to this stability after a period of lessened stability.  This [return] will probably come about through changes in med/s and/or dose/s until things are going well again.  Tinkering w/ meds is an ongoing project....

If she has the best course of illness in the history of psychiatry, you should nevertheless expect that any chronic illness will be part of the background of a marriage, at the very least, and a matter to which attendion will regulary need to be paid to maintain the equilibrium........as would be true of any serious chronic adult illness.

The things that might be most important in your inquiries might include:  whether she has ever experienced mania; when and for how long or how often she has ever been hospitalized; whether any serious family or other relationships have been disrupted or ended because of her behavior when ill; whether hospitalizations or illness symptoms have caused job loss and how often.

If you hope to have children w/ her, her family history of mental illnesses will be of interest.  If she is the one and only - among grandparents, parents, sibs, cousins, aunts, uncles - w/ any mental illness, then the chances of her having affected children rises mildly, but not alarmingly.  The picture changes if there is a great deal of mental illness in her family -- or in yours...you will want to do some checking w/in your own family.

This is a personal observation of my own: in general, it seems to me that persons who have completed developmental tasks and perhaps begun working have a more stable course of illness.  Persons whose developmental tasks are interrupted by, or complicated by, serious illness sometimes have a difficult time ever completing all the stages toward adult development.....and I think this incompletion, added to the illness itself, makes their lives a bit more complicated.   You might, for instance, see behavior that is not entirely age-appropriate, though not necessarily troublesome or terribly obvious.....just something to be mindful of, and to take into account in interacting.

Good luck.  I'll be here if you need me.