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Q:  I have been dating a lady who is bipolar.  I have been there for her on many occasions when she has needed me. I have left work early to take care of her.

 My question has to do with what appears to be childish, inappropriate behavior. For example, she became upset with me and left my house when I suggested I use protection during intercourse.  This behavior seems total strange to me.

 She is on medication (effexor and Welbutrin), and yet even when she is stable she seems "strange".

 Any advise or thoughts would be greatly appreciated.

Dear M,

     You are to be commended for trying to view the "childish, inappropriate behavior" and poor judgement of your partner as "behavior", possibly part of her illness and not her personality.  This suggests you already have a healthy point of view with which to work.  Remember to consider your needs as well in your relationship.  In other words, just because your partner has bipolar disorder does not mean you have no right to explanations of how she treats you or acts around you.  Please bear in mind as well that even "normal" individuals are prone to acting "strange" from time to time.  Close communication between the two of you about words or actions that are not well understood are critical as they are in any relationship.

     Treat the bipolar disorder first.  If your partners' medications are limited to effexor and wellbutrin, I would strongly suggest a visit to her psychiatrist.  The FDA has approved both Effexor and Wellbutrin for Depression.  The use of antidepressants alone for the treatment of bipolar disorder is questionable and may explain why the more manic expressions of your partners illness, such as impulsivity, irritability, etc.,  continue to break through on a regular basis.  This may provide at least a partial explanation of her "strange" behavior during times of relative stability.

     Encourage your partner to confirm her correct diagnosis.  Assist her to communicate openly about all of her behaviors and symptoms to her psychiatrist and or therapist who is persistent in getting as much accurate information as possible.  Make certain she has chosen a physician or psychiatrist who is knowledgeable about bipolar disorder.

     Sit down with your partner and discuss what both of your needs are in your relationship.  Set clear boundaries about what you will and will not tolerate and then stick to what you both say.  This is a process of communication and negotiation that can take place in any relationship.  Good luck in your efforts.

David Schafer, M.Ed.
Staff Psychologist

Published April, 2006

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