Question: Is my girlfriend bipolar?

Hello and sorry about a break in posting. My bipolar was acting up (I’m sure you can relate). I’m back though, with a question from a reader:

Hi, I would like some advice. My girlfriend Jane [name changed] is showing symptoms of bipolar. I think she’s hypomanic (but I am not a doctor). I’m scared, confused and I don’t know what to do. Could you give me some information? Most of all, what can I do as her boyfriend, and how to help rather than harm?

Lost in Miami

Dear Lost,

I’m not a doctor either but here are my thoughts.

First of all, symptoms resembling hypomania do not have to mean bipolar disorder. They can also be a sign of thyroid problems (I found this hard to believe for a long time until I met a few people who, indeed, exhibited all symptoms of bipolar, only to find out they had malfunctioning thyroid). They can also feature in other illnesses, such as borderline, schizoaffective disorder or schizophrenia. Only a professional can give you a clear diagnosis.

The important thing is to do your best to convince Jane to seek medical help. Mind you: forcing her will not help. People with mental illnesses are often experts at appearing “normal” just long enough to make it through the appointment. The result is a medical professional assuring them they are fine, which they take as a permission to immediately resume manic behaviour. It’s not something I like to admit but manipulating a psychiatrist is something I have done (to much lesser extent, but still). Therefore it is important to convince Jane to be open and honest with the medical professional. If possible, try to be present during the visit as well to ensure she is indeed telling the truth.

Definitely do not try to improve the situation by doing things such as adding medication obtained via Internet to food. First, everybody reacts to medication differently and there is no golden standard for bipolar that works for everyone. Second, because obtaining medication illegally means you don’t know what you are actually buying, even if the box and blisters look pristine.

If Jane refuses to see a doctor, do not try to save her against her will. Remember yourself first: as they say in the airplanes, put your oxygen mask on before helping your child. You can try to shield her from some consequences of her behaviour, but – similarly to addiction – if she doesn’t want to get help, you’re just going to find yourself in one impossible situation after another. If she is indeed manic, at some point she might get arrested and/or sectioned and forced to get treatment. It’s going to be really hard on you – and on her. But similarly to an addiction, mental illness can only be stabilised if the patient is willing to cooperate. If Jane gets prescribed medication, but instead of taking it, she flushes it down the toilet, nothing will improve. If Jane gets to see a therapist, but spends every session saying nothing… you get the picture.

Do not let her spend your money. Do not give her permission to drink or use drugs (as much as she is willing to listen to you). A part of (hypo)mania is the feeling that we are doing fantastically well, to the point of feeling immortal. This makes it difficult to introduce the idea of seeing a psychiatrist – why would she go and see a psychiatrist when she’s feeling really great, better than ever in fact, and everything is hunky dory?

To sum things up: Big hugs. You are in a very complicated situation right now. I wish I could throw in a “love will save the day” sort of sentence, but ultimately the only thing that can save the day is a medical professional. Once you get Jane to see one, and she gets diagnosed, you won a battle; to win the war, you have to ensure she stays medication-compliant, attends her medical appointments and becomes willing to accept the help on offer. I will be keeping my fingers crossed for you.

Photo: Xu Jingjing by Jonathan Kos-Read (CC BY-ND 2.0)

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