We never really know what we’re getting into with romantic relationships, but when bipolar disorder is part of your partnership, it helps to have some insight into living and loving through it.

We strive to share insights based on diverse experiences without stigma or shame. These are some powerful voices.

Podcast host and mental health advocate Gabe Howard has been living with bipolar disorder since 2003.

Lisa, Gabe’s first wife, didn’t know about his diagnosis when they started their relationship. They were both taking antidepressants, but it wasn’t until an emergency hospital visit that he received a bipolar disorder diagnosis.

“Gabe got dramatically better very quickly (5 weeks) once he started taking a mood stabilizer. In a way, I think it helped our relationship,” says Lisa K.

“I definitely noticed warning signs before he [received a diagnosis]. Talking about it now, almost 20 years later, Gabe says he knew that something was wrong and that he was having symptoms and feelings that were not [typical for him].

“But I don’t think he shared that with me at the time. And I don’t know when he started noticing that something was going on with him that was more than the antidepressants could help with.”

Gabe didn’t have many manic episodes while he and Lisa were together. He’d usually experience mixed features, they now know.

According to the National Institute of Mental Health (NIMH), the mixed episodes feature of bipolar I disorder is just as it sounds: Both manic and depressive episodes occur at the same time. It’s serious because you may have the energy to act on harmful thoughts.

What bipolar I disorder with mixed features looks like

For some, bipolar I disorder with mixed features can feel like the idiom “laugh to keep from crying.” Some folks might experience this duality for weeks or months per episode.

You might feel depressed and empty yet full of energy and driven to do things that may have harmful outcomes for yourself, your relationships, or your finances.

You can read more on bipolar I disorder with mixed features here.

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“When he had a depressive episode, I was incredibly worried and tried to monitor his mood for changes,” says Lisa. “Once he expressed that he was thinking about suicide, I took him to an emergency room. In retrospect, I was incredibly invasive in trying to monitor his mood and trying to will him to get better more quickly.”

Lisa helped Gabe in many ways.

“I kept track of his prescriptions (ordering them, price-comparing pharmacies, even putting them into a daily pill minder for him). I kept track of doctors’ appointments and insurance billing and usually went with Gabe to any appointments.

“When he once again got to a crisis point (about a year after [receiving a diagnosis]), I helped with a lot of other day-to-day things. If he had a panic attack in public, I would pick him up. If he was nervous about having to do something, I would help him practice in advance.

“The only time he was hospitalized was upon first [receiving a] diagnosis. Frankly, I felt good while he was gone. I had been very worried about him, specifically that he was thinking about suicide or that he would do something extreme (drive too fast, take too many drugs, etc.) and get hurt.

“When he was hospitalized, I knew where he was and that he was safe. It was a relief to know that I could go about my day without having to worry.”

In his next marriage to Kendall, Gabe entered the relationship with honesty about his bipolar disorder.

“Gabe told me he had bipolar disorder via a text message before we met. He had been burned before going out with women, having a good first date and then having them ‘ghost’ him after he tells them [he has bipolar disorder] on the second or third date. He decided to tell me upfront, and I appreciated the honesty,” she says.

Kendall helps manage Gabe’s pills each week, putting them in the Sunday to Saturday boxes, and watches for any sudden changes in his behavior or mood.

I am in a relationship with all of him — the good, the bad, and the ugly — just as he is with me.

“Gabe has been handling this for so long that he has it under control, so our day-to-day life is pretty straightforward and [what most would call] normal,” Kendall says.

Managing Gabe’s mental health condition isn’t very prevalent in their lives, Kendall notes.

“Illness is a personal thing and affects everyone differently, so it was important for me to understand Gabe and how he lived with his bipolar disorder. Gabe and I manage his illness together, which is important, too. I’m in a relationship with all of him — the good, the bad, and the ugly — just as he is with me.

“I can absolutely understand it’s scary, but the more you know, the more tools you have in your toolbox to help manage and work together.”

Mortgage loan officer assistant Alyson Gregory, from Salt Lake City, Utah, received a bipolar disorder diagnosis during the COVID-19 pandemic. She’d been living with major depression and anxiety for years.

“[Alyson] just told me right after her diagnosis, since we were already together 5 years,” Jess, Alyson’s spouse, says.

“I try my best to figure out when [she’s having a manic episode] to help be the stability she needs.

“She was unable to work for 4 months, so I supported her [financially] throughout that time. I try to hype her up when she’s down and calm her when she’s upset,” Jess says.

The million-dollar question

Common sense says that not every point of contention in a relationship is because of bipolar disorder. Many partners of folks managing bipolar disorder want to know how to differentiate what is part of their loved one’s personality from what is part of their condition.

Lisa says if she knew that answer, she’d probably be a millionaire … and might not have divorced.

“If I had to give an answer, I would say that the best way to know would be to look at how often the subject comes up,” Lisa shares.

“Is this a personality trait your partner has or a subject you fight about only when they are symptomatic? Does this only come up when your partner is struggling the most with bipolar disorder, or is this something that is also present when they are [in a calm state]?”

She warns of getting caught up in the trap of telling your partner that an issue was because of their mental health condition. If you’re right, it’s neither here nor there because they might be able to see it. If you’re wrong, your words can be dismissive or a convenient excuse to skirt your own accountability.

Lisa adds, “Does it really matter? … The knowledge that something is a symptom might make me less angry or more understanding, but that knowledge still doesn’t fix it.”

She says that if something is a problem, it’s a problem, no matter the cause. If it’s something that’s a deal breaker, like overspending, infidelity, or violence, you have to make that decision for yourself and know your line.

Lisa wonders whether a spouse “ha[s] some sort of obligation to stay? In sickness and in health and all that?”

Kendall suggests taking the person as a whole without trying to parse what’s what.

“I approach everything surrounding my relationship and interactions with Gabe as his personality, not the disorder,” Kendall says. She adds that you’ll get to know your partner. If something seems unusual to her, Kendall will consider that Gabe may be trying to manage an episode.

But Kendall says that treating everything as part of their persona “goes for the good and the bad.”

“Many couples will attribute all the good to the personality and all the bad to the disorder. That’s not fair or truthful,” she says.

“There are things with Gabe’s personality that annoy me (just like I do with him), but if you start to attribute all the negatives to the disorder, as your loved one starts to improve their mental health but the ‘negative attributes’ remain, it can create animosity and issues.”

Don’t be afraid to let someone love you and to love them back.

“Educate yourself!” Kendall urges.

“When Gabe told me about his diagnosis, the first thing I did was read everything I could find on the subject to learn about what it was. Then, I asked him questions about how it personally impacted him.”

Lisa says she found the National Alliance on Mental Illness (NAMI) Family-2-Family class very helpful. She touts it as “probably the most helpful thing I did during that time.” A support group was also useful, as were books on bipolar disorder.

“Do your research, and honestly ask yourself if you can be that type of support for someone,” Jess recommends.

Bipolar disorder is a chronic condition, but you can still live a full life. Don’t be afraid to let someone love you and to love them back. You deserve it.