In sickness and in health, right? Well, mania and maybe episodes of depression, too, are putting your vows to the test. With the right tools, you can cope with whatever comes your way.

You and your spouse may have knock-down, drag-out verbal matches. They might go from feeling sad to feeling elated; from wanting loads of sex to having none; from having fun times filled with energetic activities to being unable to take out the trash.

Maybe they talk your ear off at one point, yet don’t speak to you for days at other times. Or perhaps they go from saving money to wild spending sprees.

This is what a marriage to someone living with bipolar disorder can look like.

Or, with transparency, strong mutual intimacy, and having routines and a solid treatment plan, it could look like a smooth-running train: Yes, there are departures and arrivals, but you’ll both know the signs, act accordingly, and keep things moving forward.

Bipolar disorder, previously called manic depression, is a mental health condition known for sudden or intense changes in mood.

Someone with bipolar disorder may experience highs — mania or hypomania — that involve high energy, an increased sex drive, impulsivity, agitation, and even anger or irritability. Some people may also have lows, known as depressive episodes.

There are three types of bipolar disorder: bipolar I, bipolar II, and cyclothymic disorder. Each type comes with its own set of similar symptoms, patterns, and cycling phases. A diagnosis may also include features or additional specifiers to better describe your spouse’s condition.

What might bipolar disorder look like? In an episode of mania, your partner may drive too fast or recklessly, overspend, act out sexually, or even become emotionally or physically abusive. On the other end, in a depressive episode they may be too depressed to get out of bed, work, or just perform everyday tasks around the house.

A small study in 2019 found a significant increase in marital distress among partners of people with bipolar disorder, including issues like:

The good news is that if your partner is diagnosed with bipolar disorder and moves forward with treatment, you can work together to make your marriage healthy and successful.

Since people with bipolar disorder may have different types, severity, and particular features, each person’s condition will be unique.

For example, an analysis in 2009 observed how someone’s symptoms and condition can change in type and the length of episodes as they age.

Educating yourself on bipolar disorder can help you learn what to expect from your relationship and your partner’s mood episodes.

Being in contact with your spouse’s healthcare team is also a great idea, according to Nicole Nina, a therapist in Aurora, Colorado.

If your partner agrees to include you as a contact on their medical release forms and share information access, it can:

  • provide 2-way communication between you and their treatment team, in case of emergency
  • help you know their particular diagnosis so you know what to expect in general
  • keep you in the loop on their treatment plan, therapy, and medication routine so you can be an advocate in their journey

Sasha Jackson, therapist in Brooklyn, New York, says that psychoeducation is crucial to helping your marriage.

Other ways you can help your spouse, yourself, and your marriage

Make a plan together

As a spouse, you may be the most in tune with how symptoms occur in your loved one. “Over time, you will likely be able to pinpoint when your spouse is getting ready to enter either a cycle of mania or a cycle of depression,” says Nina.

You may not be able to stop the cycle, but you can develop plans to ride them out together.

For instance, you can have a plan in place to prevent your partner from making large purchases or engaging in harmful behaviors when they’re having a manic episode.

You can also weather depressive episodes by helping them get their tasks completed or giving them a pass on the garbage or yard work when you know they’re not up for it.

Even just having plans in place for when an episode comes on can give you a sense of control and help you prepare.

Talk about impulsive and reckless behaviors

Since impulsivity and reckless behaviors can be symptoms of bipolar disorder that affect marital life, addressing them openly when your partner is in a stable state — called euthymia (you-thigh-me-uh) — can make a difference.

“Create a plan with your partner to help reduce damage from behaviors,” says Jackson. An example would be agreeing to limit access to credit cards if they have a history of impulsive spending or gambling when experiencing mania or hypomania.

Likewise, agree to opt for the passenger seat or a rideshare, or reschedule a long road trip if they have trouble with speeding or reckless driving during mania.

Don’t take mood changes personally

“It’s difficult to not take your partner’s mood dysregulation (depression, irritability, anger, or [ill-timed] happiness) as a personal attack,” says Jackson. “However, mood swings are a symptom of bipolar disorder and have to do with a chemical imbalance.”

Even though it’s hard, instead of taking it personally, communicate with your partner about ways you can help them cope and ways you’d like them to try and communicate their needs so they can avoid escalations like raised voices, the silent treatment, or personal attacks.

Ensure they have the resources they need

“Bipolar disorder is primarily managed through medication to stabilize the [mood],” says Nina.

If they ask you to hold them accountable, you can remind your partner to take their meds, keep their supply current, attend their therapy and medication appointments, and prioritize their health — eating right, exercising, and sleeping well. Lifestyle habits are known to help reduce severity of episodes.

Psychotherapy can also be a vital tool for managing the emotions that come with the condition.

Nina says helping your partner find the right therapist for them can ensure they have a trusted relationship with an objective party to help maintain and build on their progress.

Remember to enjoy time with each other

It’s easy to forget the pleasurable memories you’ve had with your spouse when managing health conditions takes so much of your time and energy. But it’s important to stay present, create space to enjoy each other’s company, have fun together, and continue to build your life.

“Every couple experiences highs and lows — spouses of those with bipolar disorder just get more heights and canyons to see,” says Nina.

Take care of yourself

Whether it’s a mental health or physical condition, taking care of a spouse, parent, or child can be taxing.

When supporting someone, you’ll want to have a self-care plan in place, where you put yourself first and make sure you get proper sleep, exercise, and downtime you need. Otherwise, you’ll burn out — or worse, feel resentful.

Choose activities that increase your energy and calm your emotions:

  • Do an exercise you love like hiking, swimming, meditation.
  • Find a hobby like reading or doing puzzles.
  • Get away for me-time.
  • Spend time in nature or with friends.

Ask for help when you need it

“Being in a relationship with someone who has bipolar disorder may be overwhelming at times,” says Nina. It’s OK — scratch that — vital to get an assist from online support groups, a therapist, or your spouse’s family if they’re privy to the diagnosis, whenever needed.

You may even consider marriage counseling to help you two meet the challenges and rise above them.

Marriage is less of a static institution and more of a living, breathing, organism: It grows healthy when we nourish and nurture it.

There may come a time when you need similar support, grace, and a proactive investment from your partner who’s also managing a chronic condition. Stay encouraged. A healthy bond is adaptable — physically, emotionally, and mentally.