*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.

Crisis Management is the key to every aspect of your emotional health in a bipolar marriage. Please notice that I didn't say 'marriage to someone with bipolar,' but a 'bipolar marriage.' This is because every family member involved is directly affected by bipolar disorder and the spouse of someone who has bipolar is literally married not only to the person but to his circumstances as well. She (or he) will share the ups and downs and experience the highs and lows.

A crisis is simply a moment in time when someone who has bipolar either has already, or is beginning to, enter into a manic or depressive state. The longer you are married to him, the sooner you will see the warning signs and be able to help him through the crisis before it becomes full-blown. In some cases, you may be able to alleviate it. In others, you will only be able to support him through it. In either case, your presence and understanding will be vital.

One thing that you should discuss is a possible signal between the two of you that you could use in a social situation if you feel that he may becoming manic or drinking too much alcohol. This is delicate territory because you don't want to be seen as 'baby-sitting' him, but it is true that as his wife, you will begin to see the signs earlier of an oncoming bout of mania, and you certainly will know when he's had too many beers while taking his medication.

You should also know how he wants things handled if he does become so ill that he needs to be hospitalized or (God forbid!) he takes off and you aren't sure where he is. For instance, should you notify his family? What about friends? How much do they know, and which ones know?

Crisis Management also involves making your bipolar spouse safe, secure and as stable as possible while they ride out the storm of either mania or depression.

  • Don't argue with your spouse during an episode. They can't be reasonable at this point; it simply isn't possible when mania or depression has set in. If you want to help him, you must accept that what he is saying is the illness talking, not him, and let love carry you past the hurtful words.
  • Encourage him to contact his doctor and therapist to let them know he is heading into a crisis in order to get help. If he is in a mental state where he doesn't want to do this, call them yourself and alert them to the situation.
  • Do everything you can to minimize stress for your spouse at this point. Take over any chores or responsibilities that he finds confusing or demanding so that he can focus on calming and centering himself.
  • Try to shield him from stressful or confrontational family and friends who may make the situation more inflammatory.
  • Develop a regular schedule, especially for his sleep and eating habits. Studies have shown that getting regular rest and at least eight hours of sleep a day can make a significant difference in the quality of life for bipolar sufferers.
  • If you have put a financial emergency plan in place (we'll discuss this later), put this into effect as soon as you feel it's necessary.
  • Learn to recognize the signs of a possible suicide attempt and take them seriously. Never ignore talk of suicide and never try to talk a person who is contemplating suicide out of it without professional intervention. Try to get them to a hospital immediately, call 911, track them down if they have left a suicide note and left home…do whatever it takes to get them to a safe and secure place where they can be professionally monitored and assisted.

It can be an incredible act of will for a spouse to put up with the derision and verbal abuse that is sometimes thrown at them by a spouse during an episode. They can begin to feel desperate and alone, and want to fight back. After all, they do have a right to fight back if someone is insulting them in other circumstances.

The other risk you run is that your spouse may become very angry when you are trying desperately to keep the peace. It can be very difficult to remain calm and avoid confrontation when he is spoiling for a fight and trying to push your buttons, begging for an argument and becoming more and more upset with you because you won't fight back. If he is in this type of mood, it may be best to simply leave for a time until he cools down. Sometimes during a bipolar mood swing, anger is so intense nothing you can do is going to defuse it, so you just need to get out of its path.

Part of crisis management is understanding that after the crisis is over, a bipolar sufferer must also acknowledge what their spouse has been through and be willing to discuss it in a calm and loving way on neutral ground. This will give you the opportunity to express your hurt and frustration and allow him the opportunity to apologize and try to express his desire to overcome the situation.

Each crisis survived should also be used to learn and develop a better Crisis Management plan for the next time around. Discuss it with the doctor and therapist and any others you would like involved so that everyone understands their role so that if there is another episode the situation is handled with as little stress and confusion as possible.

Crisis management in a bipolar marriage can be lonely at times. During the throes of your spouse's episode, you will often be on your own; you will be the one shouldering the burden of holding things together and getting things done. Fortunately, in a strong marriage, your spouse will appreciate and understand the magnitude of these efforts when he has become stable again. At that point, he will be able to contribute toward a plan for the next time so that you can build toward a better future.