Last week, Joe posted a piece entitled "Bipolar Dilemma: Insensitive Jerk or Irresponsible Oaf?" in an attempt to spark a discussion and collect insights on what to do when you sense that your loved one with bipolar is exhibiting symptoms of mania or hypomania. This week, Dr. Fink weighs in. Dr. Fink Replies... This dilemma lies at the heart of so much of the strife that families living with bipolar disorder face every day. I don't have any magic answers – I suspect that people living with these challenges have creative solutions that will be more helpful to others than anything the doctor might have to offer.

When you're in a relationship with someone who has bipolar disorder and seems to be exhibiting symptoms of mania or hypomania, you're likely to face the dilemma of whether to say anything:

Some time ago, on our other blog, Bipolar Blog, a visitor posted a piece in our Share Your Bipolar Story section entitled "Bipolar Extramarital Affair," which generated some discussion. Recently, another visitor commented on that story about the need to make some allowances for bipolar: "Allowances must be made. Not to do so is unfair because it [bipolar] holds people to unrealistic standards and disappointment becomes the inevitable outcome." He goes on to say that "You have two choices: moderate the behaviors and/or moderate the expectations."

Bipolar disorder affects more than the individual who has it – it affects everyone it touches, especially family members, and can in turn be affected by the words and behaviors of others. In my family, for example, when my wife starts cycling into mania, I tend to get depressed. Our son becomes borderline abusive. Our daughter gets confused and defensive. All of our reactions seem to feed into the bipolar, worsening the mania.

kjenny kelton asks... I have recently entered into a relationship with a man with this illness and know nothing about it. I want to be there for him, but he just says he needs to be on his own. How do I help him?

Syndicated from the Bipolar Blog with a couple minor changes Jill Ravitz recently posted her bipolar story, which caused me to think about my own situation with my wife and our family. Back in 1999 my wife was diagnosed as having bipolar disorder. Within about two years, we were discussing divorce.

Syndicated from the Bipolar Blog Susan Asks... I believe that my sister is bipolar. She has all the symptoms. She is 36 and has two kids. I have tried talking with her about seeing a doctor but she seems to think she doesn’t need any help. I just worry about her, and I would love some advice on how to handle the situation without losing a sister.

Syndicated from the Bipolar Blog I grew up in a household with mental illness in a parent. The illness was never fully identified or named, yet it decimated our family life. I was enormously relieved to realize, over time, what was going on in my family when I was growing up. It helped me understand my parent more and to tell my family story in a way that is less judgmental and critical and more compassionate – toward my parent with mental illness and toward me and my siblings and my other parent. As a professional and as someone who lived with this, I feel strongly about the need for honest, open communication in families when a parent is struggling with mental illness.

Syndicated from the Bipolar Blog In a previous post, “Should I Go or Should I Stay?” I discuss the dilemma that many people face when living with someone who has bipolar disorder. Lately, I've been thinking about relationship dynamics and how these dynamics can trigger confrontations. I'm one of those people, for example, who really needs to please others. I'll clean the house, cook dinner, do laundry, plant flowers, and so forth, just to see her happy. (According to the book The Five Love Languages, my "love language" would be "acts of service.")

When I was growing up, I earned a reputation for having a hot head. My dad used to look at me and say I was so angry he could fry an egg on the top of my head. So when bipolar disorder decided to set up shop in my home, we had a formula for disaster – my wife’s mania made her wicked, and my first instinct was to fight back. The result was the equivalent of a tropical storm quickly transforming into a Category 5 hurricane with plenty of energy to keep it raging for weeks on end.