Can Bipolar Get Worse?


I got an email recently that pretty much is about a topic that I get asked about more often than you might imagine, so I thought maybe you might be wondering about the same thing. So here it is:

“Dave, I’m worried about my husband, and I’m hoping you can answer something for me, because I don’t know where else to turn. My husband has bipolar disorder, and he’s had it for all the time we’ve been married, so that isn’t the problem – I knew about it before we got married, and married him anyway. He’s a good man, in spite of what he does when he goes into his bipolar episodes. I hate what his bipolar makes him do, but I don’t blame him for it. I mean, he’s had affairs in episodes before, but only a couple times, and I forgave him for it, because he wouldn’t have done it if it wasn’t for the bipolar disorder. I know that he loves me, he’s just sick. But that’s the problem. I thought he would get better over the years, but he seems to be getting worse. He’s going into more episodes each year, and they’re lasting longer each time. And the episodes themselves seem deeper, at least his depressions seem worse each time, like

he seems sadder than the time before, and he stays sadder longer. I don’t know what to do to help him. But here’s my question. Can bipolar disorder get worse over time instead of better?”


Wow. This supporter sounds really concerned about her husband. But, believe it or not, I’ve heard her story before from other supporters. Yes, you would think that with time, her husband

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 woman would be that her husband’s medication needs to be

looked at. It seems like something isn’t working there. It could be that some of his medication just needs to be changed, or at least the dosages need to be changed. I would also look at his treatment plan.

Then I would ask: Is he seeing a psychiatrist? If so, how often? Are they regulating his medications? When was the last time his medications were changed? Is he seeing a therapist? On a regular basis? A therapist would help him look at some of his bipolar behaviors and help him to change them. They would work together on some of the issues surrounding his bipolar disorder. It sounds like he might still have some unresolved issues going on. It also seems that maybe her husband is still holding some things in that he isn’t talking to her about. So I think there needs to be some work done on their communication.

So it could be not just that his bipolar disorder is getting worse, but these issues that surround

his bipolar disorder that need attention. For example, if he is holding in negative feelings, and not talking to his wife or his therapist about them, they will build up inside him and eventually come out and “blow up” possibly into a bipolar episode.

Also, other things need to be looked at. For example, what are his sleep habits like? Is he sticking to a regular sleep schedule? Loss of sleep can be a trigger to a manic episode, for example, which can then make him crash into a later depression. Any one of these things can be making his bipolar disorder worse.

Well, I have to go!

Your Friend,


  1. My Dad had it. I am 12 and I think I have it. Should I get help or tell my Mom. Is it really that bad? Do I have to tell my Mom or get help? I am already the disappointment of the family. I don’t want to drink or do drugs when I am older.IDK what to do

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