Work: Many people with bipolar disorder can continue to work, even if they have symptoms. Try to reduce stress at work and keep predictable hours that allow you to get to sleep at a reasonable time. Discussing your illness with employers or co-workers can also be difficult as many people do not understand mental illness and make false judgements. Your healthcare team will be able to give you advice on how to handle the situation at work.
Family relationships: Support from partners, family and friends can be really helpful. Family therapy may help them to accept the condition, to understand the need for medicines and to deal with the stress of having a loved one who has a long-term disorder. Ask your doctor or therapist to help educate you and your family about bipolar disorder. Joining a support group may also help.
Sex: During a manic episode, your sex drive may be unusually high and your impulsive behaviour may mean that you have sex without being careful to prevent pregnancy or disease. You should give careful consideration to the method of birth control you use. A continuing, fail-safe system is preferable, since intermittent or more difficult methods may not be effective. During a depressive episode, you may lose all interest or pleasure in things you normally enjoy, including sex. If you have lost interest in sex, or have any other concerns, talk to your doctor as he/she may be able to help.
Having children: There are several approaches to treating bipolar disorder (and preventing its relapse) during pregnancy. If you are planning to become pregnant, you should talk to your doctor. Your doctor may wish to make changes to your medicines and he/she will closely monitor your health and that of your baby during your pregnancy.
Heredity: You may be worried that your children will inherit a risk of developing bipolar disorder from you. However, if you have bipolar disorder and your partner does not, there is only a 5% chance that your child will develop the illness, although this chance may be greater if other relatives, such as an aunt or an uncle, are also affected. If both you and your partner have bipolar disorder, there is a 30% chance that your child will develop the illness.
Minimising the risk of suicide: Around 15-20% of people with untreated or inadequately treated bipolar disorder attempt suicide. The risk is greatest during the first few years of illness. The most important thing to remember is that suicidal thoughts are temporary and can be treated. Make a list of phone numbers of close friends, relatives or healthcare providers and support hotlines you can call when/if you are having trouble. The best thing you can do for yourself is to get help as soon as you start having these thoughts – don’t wait for them to become unbearable. If you have a friend or relative with bipolar disorder, there are some precautions you can take to minimise the risk of them committing suicide. Listen to their concerns and be aware of their symptoms. If they start talking about suicide or begin to harm themselves in any way, make sure that they receive medical attention straight away.
Minimising the risk of aggressive behaviour: People with untreated bipolar disorder often become easily irritated and may display aggressive behaviour. However, these feelings can be effectively controlled by medicines. Therefore it is important that you take your medicines as recommended by your doctor. Don’t stop taking your medicine without talking to your doctor first. If you have a friend or relative with bipolar disorder who has started to display irritable or aggressive behaviour, make sure that they receive medical attention straight away.