Hi, my husband has been diagnosed with bipolar. He is manic about 90-95% of the time and then once every few years has a bout of depression.  The current bout of depression has lasted for nine months - the longest so far.  He has been on several different drug mixes, but is still not stable. 

My question is, how much is he able to control himself through positive thought etc.  He will not exercise, although he used to be an avid sportsman - he says he is not interested anymore.  Because of this he has put on weight.  He recently started working again after seven months off, but apart from that, he mainly lies in front of the TV or in bed.  I cannot get him to take in interest in anything or do anything of his own free will.

I don't know how far I can push him into doing something, and if I push him, is there any point if he isn't enjoying it or interested in it i.e. going for walks etc.

I also don't know how much I can expect him to do round the house etc.  He usually comes in, drops his clothes on the floor, leaves dishes around, shoes lying around etc.  Can he help these thing himself, or is he so drugged that he doesn't really know what he is doing?

Thanks for your help.

Dear Debbie -- 
I saw a performance by an amazing juggler recently, who also has a great sense of humor.  After performing an act that left balls and bowling pins and flowers and such strewn around the stage, he then said "and now for the most amazing part of this act", and then ran around picking it all up and putting it away, as he explained the act: "a man who picks up after himself!"  

In other words, it seems statistically very likely that most of the behaviors you describe are "normal" (I hesitate to say "normal male"), or at least "not due to bipolar disorder".  Some of this is what you might see during a depressive phase: people don't care about much of anything, and don't have the energy to do anything even if they did care -- in addition to feeling really "depressed".  Now during those phases you might attribute some of what you see in him to the bipolar disorder.  Similarly, in manic phases, there is so much energy people could end up starting a lot of different projects and have parts and brochures and partially finished pieces all over the place; but that doesn't really sound like what you're describing.  

So, I'm tempted to conclude, on the basis of your description, that some or much or maybe even all of these behaviors on his part are due to "because I can" rather than bipolar disorder; i.e. he has been reinforced in these behaviors because someone else will do the dishes if he leaves them, and so forth.  If he's really depressed, that could account for all the lying around and low level of interest and such.  And he might be mildly depressed, instead of the bigger versions you've seen in the past.  

But, ultimately, even if a person has bipolar disorder, she/he is responsible for his/her behaviors.  If symptoms are limiting, she/he is responsible for getting treatment for the symptoms so that they at the least limiting level -- responsible, in this case, in terms of the relationship with you.  That is,  if he was single and no relatives or anybody else cared about how he was behaving, then he'd have only himself to worry about; but if he's in a relationship with you, then he needs to take responsibility to get treatment if that's what's limiting his ability to take care of his side of the normal responsibilities of a relationship, however the two of you would define that (and you are implying how you'd define it!)

Dr. Phelps