Shirley Rogerson thought her husband of 40 years was simply prone to dark moods. At other times, he was the life of the party, telling jokes that had everyone in stitches. But as years passed, his behavior became frightening. “He threatened to kill himself and had hallucinations,” says Rogerson, an author and library information specialist. “Once, he saw visions of killing me and the dogs.” Her husband was eventually diagnosed with bipolar disorder.
Bipolar I is the classic type, what used to be called manic depression. Patients typically alternate between full-blown mania and depression, which causes severe behavioral shifts. In some, those symptoms occur concurrently.Occasionally, the mania or depression is so severe that it becomes psychosis — a break with reality characterized by delusions or hallucinations.Bipolar II is the less extreme, more common version of the disorder. Depressive episodes alternate with hypomania, a milder version of mania. People with hypomania are sometimes highly productive and function well.“It can start out lovely,” says Cynthia Last, PhD, a clinical psychologist in Boca Raton, Fla., and author of When Someone You Love Is Bipolar (Guilford Press).
Mood-stabilizing drugs. Usually the first choice, these include lithium, the oldest mood stabilizer, and anticonvulsants, a group of drugs originally developed to treat seizures.Antipsychotics. These drugs are prescribed when lithium or anticonvulsants don’t work, or if the patient has symptoms of psychosis.Antidepressants. Often combined with a mood stabilizer or antipsychotic, “there’s controversy over whether antidepressants should be used to treat depression in people with bipolar disorder,” Dr. Galynker explains. That’s because there’s a risk of switching abruptly from depression to mania.
Cognitive-behavioral therapy. This approach teaches people how to counteract negative thoughts and use behavioral strategies to cope with mood swings.Interpersonal and social rhythm therapy. You’ll learn how to maintain consistent daily routines and sleep schedules. This therapy also works on resolving interpersonal issues and conflicts that contribute to symptoms.Family-focused treatment. Couples or parents and children work together to manage a sufferer’s bipolar disorder in this type of therapy.
Persuasion: Start by reasoning with him. Explain that he can improve his life by getting help.Intervention: Enlist the help of people your mate values, such as parents, siblings and friends.Manipulation: Present treatment as a privilege. For example, you could mention that he’ll be seeing the same doctor who treated a local celebrity.Ultimatum: If all else fails, “tell him, ‘Either you see somebody or I’m leaving,’” Dr. Galynker says. While harsh, it may be your only option.
