One of the things I hate most about bipolar disorder is how subtly sinister it can be when a loved one is trending toward mania — not manic yet or even hypomanic, just talking faster and louder, blurting out statements that are a little too open and honest and perhaps hurtful, and being more self-centered than usual.

A lot of bad stuff can happen during these times to drive a wedge between loved ones, but nothing bad enough to convince the person or a doctor or therapist that bipolar is at work.

During periods of low-grade pre-hypomania, uncertainty fogs the mind. In our family, we argue more and “walk on eggshells.” Everyone’s afraid to mention the elephant in the room out of fear of being accused of blaming bipolar disorder or the person who has it for our family drama. After all, the rest of us in the family are admittedly less than perfect, and even in a normal, healthy family (whatever that is), interpersonal conflicts arise.

Remember: Blaming all relationship issues on bipolar disorder isn’t fair to the person who has bipolar and may mask non-bipolar related issues, but not acknowledging that bipolar disorder may be the root cause of relationship issues isn’t fair to anyone and can undermine attempts to deal effectively with what may be the underlying cause of those issues.

I begin to doubt my instincts. Maybe it’s not bipolar this time. Maybe it’s something I said or did or a family dynamic we don’t yet comprehend. Perhaps it’s just normal family dysfunction. I find myself trying to referee battles between other family members to keep conflicts to a dull roar. (That never works, by the way.) Then, I get angry and frustrated that adults can’t seem to get along when we’re all essentially living in what a good portion of the world’s population would consider Paradise. Then I do something juvenile and cruel — I stop talking to everyone and mope around throwing myself a pity party.

We all know the number one rule in dealing with family conflict resulting from mood instability: Treat the illness first. But knowing for sure that the illness is what needs treatment isn’t always so clear. We have fire alarms to warn us that the house is on fire and burglar alarms to warn us of intruders, but no alarm sounds and no lights flash when bipolar disorder sneaks in. Nor do we have an objective observer living with us to point out when bipolar disorder is disrupting our lives or it’s just human nature unleashed.

As a result, we often engage in a waiting game until it becomes clear that bipolar disorder is at work or until emotions cool and we enter a period of relative calm. Unfortunately, that game is a dangerous one, during which a lot of relationship damage can occur and the risk of slipping into full-blown mania or depression increases dramatically.

Recently, our daughter started seeing a therapist to work on her own issues that may be exacerbating the tension between her and her mom (my wife) who has bipolar disorder, and all three of us are starting family therapy. While I think that’s all great and long overdue, it seems that sometimes therapy is a pacifier — a drama we play out — until the real problem comes to light and is treated — the bipolar disorder.

Woman shouting photo available from Shutterstock.