Mental illness can place strain on personal relationships. When interacting with someone who struggles with their emotions, it is easy to feel uncertain about reactions and worried about the future. Depression, both bipolar and unipolar types, is especially challenging because moods become quite erratic and changes in personality can be drastic. Bipolar II Disorder is an often misunderstood disorder that places strain on interpersonal relationships for a variety of reasons. When considering the role of Bipolar II disorders in relationships, it is crucial to first understand the disorder and then examine how it impacts communication between individuals.
What is Bipolar II?
In order to understand how Bipolar II Disorder impacts relationships, it is important to first define the disorder. Bipolar II is a type of depression where the individual suffers from mood changes that range from baseline to depressed to hypomanic. To be diagnosed with this disorder, an individual must have suffered at least one major depressive episode and at least one hypomanic episode. The "Diagnostic and Statistical Manual, 4th Edition Revised" (DSM-IV-TR), which is the diagnostic guide used by psychologists and psychiatrists, defines hypomanic episodes as, "A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual non depressed mood (that is) associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic."
Bipolar II is distinguished from the more common Bipolar I Disorder by the fact that the mood swings are not as drastic. A person with Bipolar II for example, does not enter into full-blown manic states, which can consist of psychosis and very dangerous behaviors.
Communication
Bipolar II disorder can make communication difficult within a relationship because of constant mood changes. It can be confusing and disconcerting for the non-ill member of the couple or family because the emotional status of the affected individual may have no logical basis. In her book on her own experience about living with bipolar disorder, Kay Redfield Jamison talks about how her mood swings often came quickly and without warning. Given that partners and/or family members have to communicate during episodes, it is important to understand the workings of both depressive and hypomanic states.
Manganing the Hypomanic State
A person with Bipolar II disorder will suffer from hypomania. The DMS-IV-TR describes hypomania as an irritable or expansive mood state. Additionally, a person in a hypomanic episode may exhibit signs of inflated self-esteem, engaging in ideas that do not make logical sense, and extreme distractibility. Sometimes the hypomanic individual will indulge in excessive and harmful behaviors such as substance abuse. Other specific criteria can be found in the DSM-IV-TR. When in trying to communicate with someone in this state, it becomes important to distinguish the hypomanic-driven impulses from the actual needs and wants of the individual. As such, danger to all involved may be minimized.
Managing the Depressed State
The other extreme experienced by patients with Bipolar II disorder is a state of depression. Depressive episodes usually include feelings of hopelessness, helplessness and general feelings of sadness. When trying to communicate with a depressed person, there will be clear signs of pessimism and maybe even thoughts of suicide. It is important, as with a hypomanic state, to try and focus on the underlying personality of the person involved. If communication can be based on the true self rather than the emotional state, progress can be made even in the worst of circumstances.
Warning
Bipolar II is a very serious mental illness. Though understanding communication skills based on emotional states remains an important part of any relationship, communication will be most effective if the patient is being treated by a qualified psychologist and psychiatrist. Improving communication skills is not a replacement for proper treatment.
References
- "Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR Fourth Edition"; (Text Revision) by American Psychiatric Association; 2000
- "An Unquiet Mind: A Memoir of Moods and Madness "; Kay Redfield Jamison; 1997
- "Personality Disorders in Modern Life ";Theodore Millon, Carrie M. Millon, Sarah Meagher, and Seth Grossman; 2004
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