Monday, May 27, 2013

At a young age, Bonnie Rice married her husband, Troy, only after a week of knowing each other.

What at first she thought were the waves of love engulfing her, she learned was mania, and set out on a long path of caring for and loving a man with the complicated disorder of bipolar
Bonnie wrote a book about her experience, Love Has Its Ups and Downs, “a manual for living with a husband or wife who has bipolar disorder.”
Bonnie took time out of her busy life to answer some questions from Healthline, as well as offering important tips for those who love someone with bipolar disorder. 
Your story is a truly fascinating one. If you could, please explain how you met your husband, the short courting period, and what your marriage has been like for the last 26 years.

I was at technical training school for the United States Air Force and one Friday evening I went with a group of friends to the Airmen’s Club, a bar on base for enlisted members. My roommate was joking that she just got engaged to a guy back home to try to get one of the guys jealous, and when they were out dancing, a guy at the table suggested that we tell everyone that we were getting married—a guy I’d never met before. I went along with the joke and everybody knew we were kidding, but the next day we went for a walk and got to talking. We went out together on Monday and bought rings and on the next Friday we went to a Justice of the Peace and got married. I don’t recommend a one-week engagement to anyone, but we were in love and we’ve been together—for better and often for worse—for 26 years.
I didn’t know what mania was in those days—we were in love and that seemed normal. It wasn’t. Our first year together was difficult. I got pregnant and was having a few mood swings, but Troy’s mood swings were always more pronounced than mine—and he wasn’t carrying a baby.
I had been through domestic violence counseling and recognized a cycling pattern of violence, but the cycling violence I saw with Troy’s bipolar was different because Troy honestly didn’t approve of his own behavior and actively sought out education and counseling to correct it. Typical abusers just don’t act that way. Although he had undiagnosed bipolar, Troy did get into an anger management class and we discussed the coping techniques he was learning and worked out ways for both of us to feel safe and get our point across without violence or verbal abuse. The violence stopped there and it was nearly 8 years before he started treatment for bipolar. Violence can be part of the mood swings but even if it is, it doesn’t have to be. Poor impulse control makes violence more common, but it can be controlled if the person is determined to control it and has coping skills to do it. The diagnosis was a mixed blessing. While we had a name for what was going on and could get real treatment for it, a serious mental illness is not something anyone expects to be dealing with. You don’t just take a couple pills and feel better—it took about two years of trial and error to find a combination of medications that work well and don’t cause major side effects. We know that even on optimal medication, some stressor could still trigger an episode and we’d be starting over. That’s stressful for both of us. Still, Troy was the one who sought out treatment and he has been completely compliant with his therapy. Many with this disorder live in denial, fight the diagnosis, refuse treatment because of stigma or side effects, and continue to get worse until they have to be hospitalized. We were lucky. 
What advice do you have for someone who has just begun seeing someone who has bipolar disorder? What important information should they know right away?
One thing I would tell someone is that bipolar isn’t a deal-breaker, but it is a serious issue. You can have a great relationship with someone who has bipolar, but things that most people can take for granted, you have to talk about and agree on. If you can communicate and work as a team, bipolar can make the relationship stronger—because you are forced to talk out things that other couples ignore—like finances (manic spending), affection (hyper-sexuality or lack of interest with certain medications) and health habits that might trigger episodes (alcohol, tobacco, exercise, diet).


In your book, Love Has Its Ups and Downs, you use the analogy of putting your oxygen mask on first to help a significant other of someone with bipolar disorder. What are some ways a caregiver can take care of his or herself when dealing with someone with bipolar disorder? What are some examples of boundaries you and your husband share?
The first thing a caregiver can do to “put on the oxygen mask” is to recognize that whatever happens really isn’t about the healthy partner. It can take therapy to really understand that the things a person in an episode says or does are not a reflection on you—it’s the disorder talking. Just take a deep breath and maybe write down those cruel words. Give it some time and when you are calm, come back and think rationally about whether any of it is really true—sure you’ve been hit with some real weaknesses, but usually the exaggeration is obvious when you get out of the heat of the moment. That doesn’t sound like something practical to do, but it puts a whole new perspective on things and helps you to detach from a lot of the garbage that can drag you down and lets you recognize your own responsibilities and rights in the relationship. You are not responsible for your partner’s behavior, but you are responsible for your own. You have the right to be treated as a partner and not as an object.
When I recognize that I have rights, I can’t take them for granted like many couples do (and even healthy couples could benefit by not taking so much for granted, but I digress) and I have to set up boundaries to protect myself. My boundaries have been as simple as “I will not argue with an irrational person”, so when I hear irrational arguments, we have agreed that I can stop the argument and come back to discuss it later when we are calm. Honestly, this came from the anger management class—where we learned that as arguments get going, they get less and less rational and more prone to violence, so stopping the discussion and rescheduling it is really the best option. This isn’t as easy as it sounds, especially at first, because it’s hard to pull back in the heat of the argument, but it absolutely works and once you’ve done it a couple times, it gets much easier because you can see that it works. I’ve had to say, “look, I’m not thinking too clearly just now and I’d like to talk about this later,” keeping the “blame” on me to keep from switching the argument to a “you think I’m crazy” argument that goes nowhere. Being the designated sane person has its downside, but it does get easier with practice.
During the mania, there is also a chance for a person with bipolar disorder to become promiscuous or hypersexual, but that isn’t a guarantee the person will.

How important is that a caregiver be involved in his or her spouses’ treatment?
It is almost mandatory that a caregiver be involved with the treatment of bipolar disorder. People who have bipolar are notoriously poor reporters and have limited ability to assist in their own treatment. Bipolar is known to be a cognitive, as well as a mood disorder and patients who are expected to report on their progress over the past month or the past three months may not remember where they were at the last appointment. If they are going into or coming out of an episode, their mood at the appointment may be very different from the rest of the time. If they are feeling “great” at the moment, the doctor won’t hear that they were talking about suicide last week or that they missed the last three days of prescribed medication unless there is another person who can describe the behavior. Not only is the patient more likely to get the right medication with the added input, but the partner can also ask questions and learn to watch for signs of side effects or mood swings that might warrant calling the doctor between appointments.
How did your four children help during the years?
Our four sons gave us added motivation to make things work. It’s amazing how pulling together to raise children can force you to think outside of your own immediate desires. We actually had a sort of support group together where we all knew that if their father was irrational, that we could talk about it and work out ways to deal. We developed a sort of “reality check” that helped us all keep track of where “rational” ended and “irrational” started by being open and talking about what we heard or saw. I wanted the boys to know that if their father behaved inappropriately that they could always talk to me about it. It was never a big family secret so it didn’t have any special power. 
What are some good ways a caregiver can take a break from the relationship without jeopardizing it?
Taking a break or getting some breathing room can be complicated with an unstable partner, but actually finding ways to get some breathing space may be the best way to save the relationship. If you are constantly arguing and there is a threat of violence, physical separation (going to another room, to visit friends, or to a motel) may keep either of you from doing something that will be impossible to undo. Simple things like going out for coffee with a friend or family member, taking a class related to a hobby you enjoy, or taking a walk can be nice, non-threatening escapes from too much drama. So can a long hot bath or a good book. It is important to understand that getting this kind of space has little to do with the bipolar and is actually quite normal in most relationships. If you keep the attitude that this is all very normal, you lose a lot of the “blaming” mentality. 
Where did you find most of your support?
I found most of my support in an online discussion support list. These have many advantages including the fact that you are communicating with people who actually believe you and who have experienced the stuff you are going through. Your partner’s family may be in denial, your family may just want you to walk away and never look back, friends may not believe you, and nobody will have the objectivity to give you good advice. Local support groups may be available in larger cities, but you may not be ready to meet support group members in person. I’ve heard that NAMI has a great family-to-family class, but again, only in the larger cities.
Are there any really important lessons you’d like to add?
There are a lot of bad behaviors that are associated with bipolar disorder. Most of these are the result of the delusion of being “above the law” and poor impulse control. While mental illness may explain the behavior, it does not excuse the behavior. Setting up firm boundaries can actually help a person stay motivated to control dangerous impulses. Your boundaries might be protecting your partner more than you realize, so you shouldn’t feel bad about setting and maintaining them. 
All of us here at Healthline would like to say thanks for your time and best wishes with everything in your future.

From
http://www.healthline.com/health/bipolar-disorder
Article link:
http://www.healthline.com/health/bipolar-disorder/guide-marriage-true-story

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