Does Bipolar Disorder Always Get Worse Over Time? What Partners and Caregivers Need to Know
One of the most frightening things a partner or caregiver hears after a bipolar disorder diagnosis is that it only gets worse — but is that actually true? In this episode of The Other Side of Bipolar, we take an honest, research-informed look at bipolar disorder progression, what the science really says about long-term outcomes, and why the "it only gets worse" narrative can be both misleading and deeply damaging to relationships. Whether you're loving someone newly diagnosed with bipolar I or bipolar II, or you've been a caregiver for years wondering why cycles seem to be intensifying, this conversation is for you. We explore the role of treatment consistency, sleep disruption, substance use, and stress on episode frequency — and what partners can actually do to support stability rather than spiral into hopelessness. If you've been Googling "does bipolar get worse with age," "bipolar disorder long-term prognosis," or "how to help a partner with bipolar," this episode was made with you in mind.
0:00 Hello everybody. I haven't uploaded anything recently just to be honest with you. I needed some time to to not be so involved in this because it's so gut wrenching. What I wanted to talk today is the end stage bipolar that my wife unfortunately is going through right now. I was with her for 10 years, as you may know, and when we first met she was manic, which I've found most of us are in this boat. They were manic. She was incredibly all over the place, hypersexual with me, blah blah blah. What I'm trying to get to though is, is more and more research papers are showing specifically that this is a progressive illness. It doesn't get better.
0:47 They are not miraculously going to come around and be OK. They'll only get worse. I'm sorry to say that but it's the truth. Unless it gets worse for all of them, but the the difficulty they give to their partner can be reduced substantially if they literally are self aware. They know they have a problem, they know they want to fix it, they use you to help them fix it and everybody's on the same team. If they're not or if they're unmedicated, literally leave mind. To be honest with you, 10 years ago she was to the point after her late husband passed away. She got together with me within four or five months after her husband passing of 17 years.
1:37 I look back on it now and I'm just wow, why the hell did I do this? But at the end of the day, back then she was. I remember one time we're sitting in a restaurant and she was mumbling, literally mumbling. She couldn't talk. I feel so sorry for even now. And then after that she got more and more stubborn, more and more self-centered. Believe me, if they're the only person on the House, the mortgage and you're not, they will use that leverage to hurt you. Mine did, I own my house outright. But anyway that's another story. But I'm getting to though it. It's a progressive disease. It doesn't get better and it only gets worse.
2:19 And if they are not taking medication it's going to get a whole lot worse and a whole lot worse. Looks like them cycling faster and faster, meaning they go into an episode and the worse the episode is the less protection they have for the next one and the next one will come faster. If you if they've discarded you and didn't want to come back, please read all the stories. That just happens again. I'm sorry. So I wanted to get to though mine at the very end after I became paralyzed. At the very end, she got into what I've never seen in 10 years, which is called ultra ultra rapid cycling, where literally she was changing minute to minute.
3:05 It's hard to believe, but I saw it with my own eyes. She could be yelling and she was, she was yelling and screaming at me to get out of the house, to leave, leave, leave. And I was in the wheelchair. And then literally when I said, you know what, let's go to counseling, she said I don't need to go to counseling. I'm just fine, which was to me indicative of if she quit her medicine. And then I said, you know what, I'll go to counseling. She instantly, I mean instantly looked at me and went OK, went and sat down and scrolled on her phone. Boom, I mean the incredible rage. And two seconds later she was doing her phone. After that she came over and actually showed me her phone something sweet.
3:51 We watched a baseball game together for about an hour, an hour and a half. She went and cut the cut my hair on the back porch with the dogs. Everything was great and then something happened and boom, kicking me out of the house again. I I was in awe of how she could go. Awe and sadness to watch her destroy our ten years together. This beautiful woman that destroyed everything. And I don't know. And what they, the experts tell me is she'll probably never know. Some bipolar people tell me that they do remember what goes on and I've heard the whole phrase of it's like being in a car watching yourself destroy everything but you just don't care.
4:39 But mine, I don't know if she ever she doesn't talk to me. I'm sure she got angry after I left because I'm sure she wrote the history and saying that somehow I was this huge problem again, I wasn't perfect, but come on. But the ultra, ultra rapid cycling means that they been abusing themselves for many, many years. And this not going to get any better. It's only going to get worse. And I don't care how much you love them. I don't care how much patience you have with them. You will destroy yourself. Some people are able to do it. I've, I've heard and talked to people, you know, the spouses that can sit there for 20 years and 30 years and have them cheat on them.
5:20 Because if they cheat once and you allow it to happen, they'll cheat again and again and again. That's written in stone. So and then I've got many bipolar people have told me they would never think of cheating. That's a character issue and they must be in control. The worse they get, the more in control they need to get. Not because they necessarily mean it's because they have to control things to keep themselves from going more insane. I don't know if that makes sense, but that's the way they think is I understand it. So listen, everybody, if you're with a bipolar person and wondering if it's going to get better, it won't. Period.
6:02 I can't tell you how many stories I read of people, Oh, they got on the new drug and they're doing great. He's been so wonderful for the last two or three years, and then boom, somebody passes away, they have a kid, they move to a house, something happens, they blow it all up, discard him, and they never hear from him again. That's the unfortunate part of the ticking time bomb I've talked about in another episode. So keep your heads up, do as much research as you can. But, and from my personal experience and my studying that I've done on this, it doesn't get better. It only gets worse with age. The if they're heavily medicated and doing the right thing, it keeps the highs and lows in check to some degree, but it doesn't mean that they might blow up because I've heard of the stories.
6:48 Every, every bipolar person is different. Of course. They're all on the spectrum but I've seen many stories where they were great for 20 years, no problems whatsoever and boom they destroy it in a matter of a month. 20 years of marriage. It's so sad. Thank you guys for listening. Take care.
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