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.”
While I agree that allowances should be made, I wonder whether there could be too much of a good thing. NAMI’s Family-to-Family Program while stressing the importance of developing a sense of empathy, also encourages loved ones to set well-defined boundaries. In fact, not having clearly defined boundaries and consequences in place could be a disservice to the person with bipolar – see “Setting Boundaries in a Marriage Complicated by Mental Illness,” by Kathy Bayes.
The concept of “boundaries” speaks to the idea of a point at which behaviors, whether they are symptoms or not, may become so harmful or toxic to the patient and/or loved ones, that something (or things) must change. It is important to keep in mind that bipolar disorder presents with behavioral as well as emotional symptoms. Teasing out the difference between planful and volitional behavior and symptom behavior is a daunting and often impossible task.
In short, I believe that compassion is the primary approach – if we default to the position that our loved one’s ability to respond appropriately is impaired due to illness and we try to adopt a problem solving, rather than blaming, posture we will generally have more positive outcomes. However, as the illness is not rational, and can present with extreme behaviors that can be dangerous, we need to be sure that we do what is necessary to keep our loved one and ourselves from serious harm. Boundaries and consequences need to be identified that trigger more assertive responses, but short of those we need to remember that the illness can interfere with every level of function and try to remain non-judgmental but engaged in trying to solve problems.
Please post a comment to share your thoughts and insights. If you’ve defined boundaries, what are they? What consequences are in place? If you’ve achieved a greater level of calm and stability in your relationships through the use of boundaries, please offer your suggestions. And if you have a negative view of or experience with boundaries, we’d like to read about that, too.