Expert: Joanne Chang - 10/8/2007

Question
About a week after my ex(girlfriend of 6 years) broke up with me she told me that she had just been diagnosed with bipolar 1. She told me that she wanted to continue going to the therapist she was seeing (who has a firm stance against using medication), and was afraid if her parents found out they would make her take medicine. She asked me not to say anything and I haven't so far.

I wanted to know if I should tell her parents. Since she told me about her diagnoses she has stopped talking to me, and so I don't know how to encourage her to tell them herself, or whether I could believe her if she told me she had. I just don't want anything to happen to her and am afraid if I don't tell her parents something will.

Answer
Hi Kevin,

You're certainly in quite a dilemma, but let's work through this.
First off, you are to be applauded for caring so much about your ex-girlfriend that you make the effort to enquire about the best course of action.

There are several considerations that need to be taken into account in making a decision in your case.
You mentioned in your question that you are afraid that something might happen to your ex-gf if you do not tell her parents about her diagnosis of Bipolar 1.

1) What, in particular, do you fear might happen?  
Bipolar 1 is characterised by alternate periods of depression and mania.
Hence, are you more concerned that she is going to swing high or low next?
What is the degree of severity in repercussions of either scenario?
e.g. monetary loss due to a spending spree OR risk to life due to suicide ideation and planning
(Please note, however, that in many cases, a period of mania is followed by a depression in mood shortly after.)

2) Have there been specific reasons / clear indications to prompt your concern?
e.g. Has she voiced to you that she has been having thoughts of suicide?  
Were there any other symptoms of her swinging high or low?

3) What is the level of urgency for some action (if any) to be taken on your part?
e.g. Has she put together a suicide plan or made an attempt on her life?
Are any symptoms present of such severity so as to interfere with her daily functioning?

If the level of urgency is not high at the moment, you might want to try to initiate communication with your ex-gf and see if it is possible to have her approach her parents herself.  Alternatively, if she finds it less daunting, she might want to consider asking the therapist, whom she has said she will continue seeing, to talk to her parents on her behalf or to include her parents in a future visit for a family consultation.  Yet another possibility is to have her confide in a close friend or two whom she can trust to see her through the rough patch she is going through until she is ready to share her diagnosis with her parents.

The reason for the above suggestions is that she had spoken to you in confidence and had clearly expressed anxiety over a loss of choice with regard to her course of treatment should her parents find out about her diagnosis.  If you maintain her trust at this crucial juncture (provided that the level of urgency for action is not high), the chances of her turning to you for help if / when a crisis does develop is higher.  Also, breaking her trust might cause her to be more wary of confiding in others (not just you) when the need does arise again.

Having said that, if the level of urgency is high, e.g. she has clearly expressed to you, in no uncertain terms, her desire to end her life coupled with an action plan of achieving this, you would probably have to approach things differently as time would be of the essence.  Ensuring that she has adequate help and support would be of priority.

Take care and do write back if you have further questions or need clarification on any of the above.

Best wishes,
Joanne