Bipolar: Worsening Bipolar Disorder


I got the following email and wanted to share it with you:

“Dave, I have to tell you about my wife, because I don’t know what to do and was hoping you might have some advice for me. Susan has bipolar disorder. I knew she had it when I married her, but she was pretty stable at the time, and over the next few years, too.

Then something happened. She got really stressed out and went into an episode. She spent a lot of money, and even started to gamble. She went through all of our savings. I learned through your courses to forgive her for this, so I did. But our finances were really stretched and it took a long time to get them back to normal. Just when they were, she did the same thing again!

Now, I know I’m supposed to forgive her, but it wasn’t so easy this time. I know she didn’t do it on purpose, that it was another bipolar episode, but it was still hard for me to take. I hadn’t expected another episode to happen so soon, that was the thing. I thought she would be ok for awhile. But there she was, in another episode.

Only this time it was worse. She didn’t just spend all kinds of money and gamble – she also had an affair. She was all apologetic about it and everything, and I knew she wouldn’t have done it if she wasn’t in an episode, but this time I really didn’t think I could forgive her.

This increase in episodes, and the things she is doing really has me worried. I thought she would get better with age, but instead, she is getting worse. The mood swings are happening more often, and so is the episodic behavior. What do you think about all this? What should I do?”


Wow. It sure sounds like this man has his hands full with his wife. Yes, you would think that with time, she should get better instead of worse. However, there are some researchers who
believe that bipolar disorder does get worse over time. And untreated bipolar disorder definitely
gets worse over time.

The first thing I would tell this man would be that his wife’s medication needs to be looked at.
It seems like something isn’t working there. It could be that some of her medication just
needs to be changed, or at least the dosages need to be changed.

I would also look at her treatment plan. Is she seeing a psychiatrist? How often? Is he regulating her medications? When was the last time her medications were changed? Is she seeing a therapist? On a regular basis?

A therapist would help her look at some of her bipolar behaviors and help her to change them.
They would work together on some of the issues surrounding her bipolar disorder. It sounds like she might still have some unresolved issues going on. It also seems that maybe his wife is still holding some things in that she isn’t talking to him about. So I think there needs to be some work done on their communication.

So it could be not just that her bipolar disorder is getting worse, but these issues that surround
her bipolar disorder that need attention. For example, if she is holding in negative feelings, and not talking to her husband or her therapist about them, they will build up inside her and eventually come out and “blow up” possibly into a bipolar episode.

Also, other things need to be looked at. For example, what are her sleep habits like? Is she sticking to a regular sleep schedule? Loss of sleep can be a trigger to a manic episode. Any one of these things can be making her bipolar disorder worse.

Well, I have to go!

Your Friend,



  1. Hi Dave,
    I’ve been bipolar since as far back as I can remember so are all three of my sons the oldest got so bad the older he got that he killed him self the middle one has to have his meds changed all the time because they don’t work any more and my youngest has seizures does drugs will not get help in fact his father and a woman that he has lived with for 10years gets him and keeps him high she and all her friends in the town they live in all call him the town clown because he has a comprehension disability always has which they use against him he is 31yrs old and has become really bad just in the past year from what alot of people are fining out is that medications are losing their affects as we get older women have hormone issues that can really put that mans wife through alot of stress our endocrine system also can cause emotional issues and if you add that to bipolar disorder that can put her in episodes one after another I have learned that one on my own also I have noticed that my episodes are getting worse have been the older I get also menopause thrown into it doesn’t help so maybe she needs to get in touch with her obgyn and get a check up to along with adding some natural alternatives wouldn’t hurt medicine needs as much help as possible

  2. I met my husband on June 12 of last year. He told me the first day I had a date with him that he was bipolar. He proposed to me 2 months later, he moves in in October and we married in November. I just gave birth the our first child June 10. The last 5 months of my pregnancy he was in and out of facilities due to severe manic episodes. He is classic bipolar, reckless, no sleep, verbally abusive, hyper, heightened senses. Etc… I have stood by his side the entire time. Even while he was so verbally abusive it caused me to stop eating and sleeping. I visited him in every facility while pregnant pushing myself to my limits to be by my husbands side. Telling him everything will be ok, it can’t rain forever. I was discharged from the hospital after giving birth on our 1 year anniversary. My husband was nowhere to be seen, I drove myself home from the hospital. A few days later he was admitted again. One facility he was in had to restrain him to his bed every day for 2 weeks. My heart was broken to see my love in so much pain. I would have switched spots with him in a second. 5 days after giving birth my worst fears came true when I had a female message me that she had slept with my husband 1 month prior. I was broken, holding my 5 day old son in my arms. Truth is if my husband did have this affair he has denied it the entire time. Who will ever know if it happened. My trust is killed for now. He was released from the hospital and I accepted him back home because I love him and I truly believe if he says he did not commit this act, then he didn’t. In my heart now going forward our relationship is on a day to day basis and he knows that. I monitor his doctor appointments, medications, therapy and basic every day life. If I see him taking a turn for the worse I immediately take action. It has taken 5 months but finally he is 100% better. He is on lithium and the Invega shot (antipsychotic) and it is working great for him. I finally have my husband back. As far as the mistakes and hurtful things that were said while he was manic, I know that this person he was then was not my husband and I forgive him. People must understand what they are taking on when entering a relationship with a person with this condition. I married my husband, the man I met. I didn’t marry the disease. It is manageable with the proper medications and support. Never give up though. If you want to talk, anyone my email is

  3. When I read your email which stated that bipolar often gets worse with age, I was stunned. Recently I saw my psychiatrist and I asked him about this. He said he had seen no evidence of this in his practice and had not read about it in journals.

    Now I have a brighter future to look forward to!

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