Expectations, Conflicts & Compromise

Medical Reviewer

I know of a couple whose relationship seems characterized by regular flare-ups, walk-outs and threats of divorce. It's a stormy relationship but somehow it has lasted like this for a number of years. In some ways it's no different to the lives of some other couples but one key difference, and a source of much of the conflict, is the fact that one has bipolar disorder.

Sit with them and the issues start to emerge. He says his partner over-identifies with their disorder and uses it to excuse their actions. It results in a situation where he feels manipulated, confused and angry. His partner says this just isn't the case. She never consciously tries to use her situation to such an advantage. There are times however when her partner imposes unrealistic expectations and seems incapable of recognizing her symptoms for what they are. It's not an uncommon scenario. Without digging deeper into their personal situation and history many of the conflict issues with this particular couple, and I suspect many others, revolve around expectations.

There's little doubt that people who support a loved-one with bipolar frequently feel the tension. Sometimes they beat themselves up because they feel they aren't capable enough to provide support. They may feel guilty because they wish it would all just go away. They may get angry and then feel bad about it. Then again there are others who may know about bipolar but basically disregard it. They genuinely believe the person has far more control over their situation than they do. The tension resulting from this causes a great deal of stress, the perfect trigger for relapse.

Coping with bipolar is effortful and complex but when people disagree about the best ways to cope it can become problematic. In an ideal world the person with bipolar accepts their situation and, as part of this, accepts their responsibility to manage it. Life is rarely without its upsets however and it's not uncommon to find couples who disagree over what is effective and what isn't. Unless there is a level of restraint exercised such situations can quickly lead to blame and criticism, neither of which actually solve anything.

A common area of conflict, or at least disagreement, involves medication. There is certainly an expectation on the part of the doctor and usually the partner that medication should be taken consistently. This doesn't always equate with the view of the person who has to take the medication and deal with their effects. Whether this is due to denial or simply a dislike for taking medication what remains is untreated bipolar and this fuels conflict.

The most effective partnerships, whether bipolar is involved or not, require a good level of compromise and agreement. There are no easy answers here but if both people value their relationship then the effect bipolar exercises within it needs to be discussed and some plan agreed as to how to move forward.