Everyone experiences bipolar disorder differently. People with bipolar disorder have different levels of functioning. Sometimes a lot of help and support is needed, other times less so. The same goes for loved ones of people with bipolar disorder. Sometimes spouses have an easier time giving support. Other times they find it incredibly difficult. Bipolar disorder is difficult. It can be a third partner causing rifts, tension and anger in a relationship. Rarely does something positive come out of the chaos. It turns out that this burden is harder on women married to men with bipolar disorder than men married to women with bipolar disorder. Why?
There may be a few of reasons. Recent research from Aleksandra Arciszewska and colleagues at Jagiellonian University Medical College found that the psychological impact on a spouse with bipolar disorder varied not only between the severity of the disorder, but also between genders.
In the study, Arciszewska focused on two types of bipolar disorder- bipolar I and bipolar II. Bipolar I is characterized by episodes of mania in which periods of elation or severe irritability accompany risky behavior. They also suffer from periods of depression. Bipolar II patients experience what’s called “hypomania.” The highs are not as intrusive as they are in bipolar I. Some even say they enjoy periods of hypomania. The key trait in bipolar II is severe depression.
For either subtype of bipolar disorder, women feel the most burdened when caring for their ill spouses.
It may seem intuitive that supporting a spouse during a bipolar disorder I manic phase causes the most strife. It’s not uncommon for people to refuse their medication or decide on a whim to take a trip to Hawaii, for example. They can become seemingly unreasonable. Psychosis is also fairly common. For relationships, tension increases significantly and partners spend more time supervising their bipolar disorder counterparts.
For bipolar disorder type II, depression is hardest on spouses. Depressive episodes are longer in bipolar II than bipolar I. They are more frequent and can be more severe. For these patients, symptom-free periods may be rare. People with bipolar II are more likely to have rapid cycling, in which they experience more than four mood cycles in a year. Worry and watchfulness are more common for spouses of bipolar II patients.
Gender roles leave women caring for more than just their spouse.
According to the study, women resign themselves more to the role of caregiver than men, and succeeded in it more often. This is not limited to bipolar disorder. Worldwide and throughout history, it has been a given that women should assume the role of caring for the young, the elderly and the sick. They are seen as nurturers by nature.
Women also spend twice and much time as men on domestic work like cleaning or cooking, even if they work outside the home as much as their male counterparts. Add to that caring for someone whose moods are unpredictable and full plates quickly become overflowing. There’s also another factor in why women feel more of a burden when caring for a spouse with bipolar disorder.
Women aren’t as accepting of their husbands’ mental illness.
Divorce rates more than double when at least one person has a mental illness. Despite being classified as caregivers, the women in Arciszewska’s study were significantly less likely to accept their spouse’s illness and reported that bipolar disorder had a negative impact on the relationship. One factor in this may be that men are more likely to have bipolar I and substance abuse disorders, which are dramatic and unpredictable.
It’s easy to cast off depression as laziness or mania as bad behavior or irresponsibility. The hard part is realizing that not only does bipolar disorder influence patients’ moods and behavior in ways they cannot control, it doesn’t go away.
Living with bipolar disorder takes work. Spouses can walk away if it gets too hard or they can try to ignore it completely since it can’t be fixed. Alternatively, they can seek help. There are resources available to spouses of people with mental illness including individual and/or couple’s therapy. Self-care and social engagement are also vital to maintaining satisfaction and lessening the burden.
Photo credit: Bianca Moraes