Monday, November 18, 2013

Bipolar and divorce



Is there a connection between bipolar and divorce?
 
Can a person with bipolar disorder still be a wonderful spouse?
Are "bipolar families" doomed?
Research statistics do show that bipolar disorder is slightly more common amongst the single and divorced. The single and the divorced are more likely to have bipolar disorder when compared to people who are married or never married.
However, in Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression, 2nd Edition, experts Dr F Goodwin and Dr Kay Redfield Jamison state clearly that:
"we know of no evidence to support a causal relationship between the disorder and marital status".
Read the above statement again. It is very important information!
All over the Internet you will find the unsubstantiated claim that 90% of marriages to a person with bipolar disorder end in divorce. THERE IS NO EVIDENCE TO SUPPORT THIS STATISTIC ON BIPOLAR AND DIVORCE. It comes from an article posted in 2003 on Psychology Today.com. There is no research cited to back up the statistic and it is important to understand that this is a COMMERCIAL website, not an academic website for proper peer reviewed scientific research.

Reminder 

It is typical for partners of bipolar spouses to report higher than usual levels of conflict.
Again, as explained by Drs Goodwin and Jamison in their authoritative text:  "Although it is likely that symptoms of untreated mania are disruptive to forming or sustaining intimate relationships, this hypothesis is not supported empirically."
It seems incontestable that there is causal relationship between bipolar and divorce, and that bipolar creates serious challenges within a marriage. However, it is also important to remember that many marriages do work and that the 90% figure is unsupported and overstated.
Approximately 40% of American marriages end in divorce. This figure varies by age of couple, whether or not it is a first marriage, and whether or not there are children. In other words, we really mean it when we say "approximately"!

Two studies have found that divorce is twice as likely where at least one spouse has bipolar disorder. (Coryell et al 1993 and Drieling 2010)
However, in both of these studies the rates were high relative to the control group, but low compared to divorce statistics in general.
In the Coryell study, 45% of bipolar patients ended up divorced compared to 18% in the control group. In the Drieling study, 12% of bipolar patients ended up divorced compared to 6% of the controls.
Much more research is needed on bipolar and divorce, using larger samples and longer time periods and more careful matching with control groups before reliable conclusions can be drawn. 

One important point to note is that what research has shown is that marital outcomes for people with bipolar disorder are no worse than for the clinically depressed.

So what is it that makes it so hard to sustain marriage with a bipolar spouse?
A UK study by management consultants Grant Thornton, estimated the main causes of divorce in 2004, based on data from divorce lawyers:

1. Adultery; Extramarital sex; Infidelity - 27%
2. Domestic violence - 17%
3. Midlife crisis - 13%
4. Addictions, e.g. alcoholism and gambling - 6%
5. Workaholism - 6%

It is easy to see where bipolar disorder, particularly where there is untreated mania, fits into this picture. After all, the hallmarks of untreated mania include hyper-sexuality, anger, impulsiveness and grandiosity, substance abuse, and compulsive behavior - all features that would reflect directly in the 5 main divorce causes cited above.

I lost my own marriage due to untreated mania - infidelity arising from bipolar hypersexuality. If adultery is the main cause of divorce, then bipolar disorder with its elevated rates of infidelity, is very likely to lead many couples to divorce:


A bipolar marriage may often seem very chaotic. We don't yet know how much of this due to the real time challenges of coping with manic and depressive episodes, and what proportion may be attributable to the poor relationship skills that come from growing up in a bipolar family.

Can we break the seeming nexus between bipolar and divorce? Of course! Remember that we have been discussing issues that arise when bipolar disorder is untreated. 

Problems also arise from other social, interpersonal, and general functional impairments suffered by people with bipolar. For example, the financial difficulties that arise from unemployment and the "downward drift" that characterizes even the brightest and best educated bipolar patients.

Another issue is what is known as assortative mating. This is the tendency for people with bipolar disorder to marry partners who also have bipolar disorder or other mood disorders or mental health challenges. This multiplies the bipolar and divorce risk exponentially.


It seems that accurate diagnosis and effective treatment plays a double role. As well as stabilizing the bipolar patient, the spouse is educated about the disorder. Evidence shows that spousal knowledge and understanding strongly contributes to a more successful, positive, happy relationship.


Like many people after diagnosis and treatment, I have had the wonderful blessing of a second chance. But I never forget the risks I present as a bipolar spouse.

For me, it is very important to use tools such as a Wellness Plan and a Treatment Contract so that my spouse knows I am taking my medication, seeing my therapist, and there is a safety net in place to prevent a manic or depressive episode from getting out of hand. 

There is nothing inevitable about bipolar and divorce!

It can be very difficult to find useful, practical and target resources that deal specifically with managing relationships with people with bipolar disorder.

One book we have found very helpful in our own home is Cynthia Last's:
The ideal is for a happy and healthy marriage with your spouse who is bipolar - not divorce.
This is a comprehensive but easy to follow book that provides the tools to support this important but challenging goal.

http://www.bipolar-lives.com/bipolar-and-divorce.html

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