*Throughout the article, reference is made to 'he' or 'she' when talking about a person who is bipolar. It can be either, and using one term or the other is merely for the sake of convenience. These suggestions are meant for anyone, male or female, who is suffering from bipolar and his (or her) family and friends.

The most important decision to be made in any marriage, of course, is whether or not you will have children. This is an entirely personal decision, but it the most crucial decision you will make as a couple. The ramifications of having children are infinitely complicated by having a parent who is bipolar. There are physiological aspects, such as the increased risk of your children developing bipolar, to consider. In addition you will need to discuss how and when you will explain bipolar to any children you will have.

Should you have children?

Talk to doctors. Talk to therapists. Find a support group and talk to other parents who have children and talk frankly with them. If you can, talk to parents whose children are bipolar. Do research into child-rearing techniques that address the mood swings prevalent in bipolar children.

Statistics show that if one parent has bipolar disorder the chance of a child developing bipolar disorder goes up somewhat, to somewhere around 10-20%. If both parents are bipolar, the likelihood that a child will develop bipolar disorder at some point in their life approaches 50%.

If you choose to have children you will need to develop two complete sets of plans to address two different situations: How you will handle any situations with the children when your spouse is either manic or depressive, which can be very confusing to children; and how you will handle raising a child who has bipolar disorder.

Pregnancy adds additional stress to a marriage, so be prepared - whether you or your spouse are bipolar - to anticipate changes in mood as the pregnancy progresses. As an expectant mother, make sure you take extra care of yourself and invest in a bit of pampering. During the first weeks after your child is born you and your spouse will both lose sleep and be operating on altered shifts.

You will both be filled with joy and anticipation, but this unusual state of affairs can be enough, combined with a change in routine and lack of sleep, to begin an episode. To avoid this, meet with the doctor regularly for additional monitoring of medications and to discuss how to handle the new changes in your life.

How do we talk to our children about my spouse's condition?

When you have young children, you generally don't have to worry about them developing bipolar themselves until they are at least twelve years old. While some develop it younger, this is pretty rare. Your concern early on will be how to raise your children in a happy, healthy environment and make them feel secure, even when one of their parents is behaving strangely.

It can be helpful to talk to a child psychologist and your spouse's own psychologist or counselor, who can give you helpful advice on how to handle acute episodes without unduly alarming your children.

Some things you should discuss in detail if you have children or are considering having children with a bipolar partner include:

  • Determine a plan for explaining bipolar to your children and decide on how you will know when it's time to sit down and talk to them about it.
  • Make sure you have an emergency plan in place for child care in the event you have to take your spouse to the hospital or retrieve him from a dangerous situation.
  • Discuss how you will handle raising the children, including handling discipline, rules, schedules and schooling.
  • Talk about what you should do if your spouse has a manic or depressive episode and frightens or upsets the children. Items to address include:
    • How to keep the children safe from any irrational actions
    • Whether your children should stay with relatives during acute episodes
    • How to run interference between the kids and your spouse if he is being unreasonable or belligerent. Develop a signal for defusing the situation if possible.

The chances of successfully raising a child who is well-adusted and happy even when one of the parents suffers from bipolar disorder is directly related to how prepared the parents are for every situation and closely they work with their doctor and therapist for the best interests of their child.