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Ask the Mental Health Expert Archives 2001-2004

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Bipolar Attraction

Q. Is there any substantial evidence that bipolar people are commonly attracted to others that are bipolar? It seems that arenas like the media are full of the bipolar type and I'm wondering if research has been done on this--whether bipolar relationships are healthy, etc.

A. I'm not aware of any credible evidence showing that individuals with bipolar disorder are attracted to others with this disorder. Of course, to study this issue, we would need a more precise term than "attracted to"--perhaps, "married to", or "in a long term relationship with".

Some studies have shown that individuals with bipolar disorder have somewhat lower marriage rates than those in the general population (51% vs. 58%; see Krauthammer & Klerman, 1979). Most likely, this stems from the interpersonal difficulties created by the illness itself. And there is one study (F. Benazzi, Journal of Affective Disorders Oct 2000) finding higher rates of interpersonal rejection sensitivity in bipolar patients than in unipolars (37.8% vs. 20.5%). This trait, in theory, might predispose bipolar individuals to seek out a certain kind of personality in their close relationships--for example, somebody who is extremely nurturing or empathic. But I'm not aware of any studies showing this to be the case.

I can recall one couple I treated, both of whom had bipolar disorder. They did seem to get along quite well, perhaps because they understood each other's mood swings and emotional needs so well--and were prepared to accept each other. However, one case does not prove much. In terms of how healthy the relationships of bipolar individuals are, I think a great deal has to do with how well-controlled the illness is, and whether there are concomitant problems, such as substance abuse. One study of Chinese bipolar patients (Tsai et al, J Journal of Affective Disorders, Jan-Mar 1999) found that those with a history of suicide attempts were more likely to have interpersonal problems with spouse or romantic partner, compared with those without a suicide attempt history.

The suicidal sub-group also tended to have an earlier age of onset of their illness and a history of poor occupational adjustment. This suggests not so much a general bipolar type, as a subgroup of bipolar patients--probably those with more severe illness--whose relationships tend to be more disturbed.

Of course, it's always hard to know to what degree the underlying disorder leads to disturbed relationships, and to what degree interpersonal problems actually trigger episodes of the illness. But in my experience, the former is more common. Certainly, my own impression is that the more effectively bipolar illness is managed and treated, the fewer the interpersonal problems.

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September 2001
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