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"Taking care of bipolar disorder is a team effort, involving the two people and a psychiatrist or other mental health professional," she says.

While she would never speak to a spouse without her patients consent, such open communication empowers both parties to make treatment decisions that lead to a healthier relationship.

"No matter what youre doing, there will be symptoms," Fred says.

Their teenage daughter has also been diagnosed with the disorder.

The pillars of their success, both say, are open communication (Fred is free to reign in Kristin's clothes spending when he thinks she is manic) and predictable schedules.

Tim, 37, tried for three years to sustain a relationship with a woman eventually diagnosed with bipolar disorder.

"She would cycle between extreme happiness and depression," he says, recalling her paranoia, impulsiveness, and self-destructive insecurity.

For starters, the ups and downs of bipolar disorder can disrupt the rhythms and routines of a household.

In a 2005 survey of people with bipolar partners published in Bipolar Disorders, more than half of the participants reported that their partners illness had reduced their socializing, required them to assume more household responsibilities, forced them to take time off of work, and caused financial strain."She broke up with me and started dating other people, and then when I dated other people she tried to win me back." Like many people with bipolar disorder, Tim's girlfriend also struggled with drug and alcohol addiction and got deep into debt—with his credit card.Tim eventually broke down emotionally himself, ended the affair, and tried to forget the experience.For example, he says, he is worried about the long-term effects of medication on Kristin's health.And while both his daughter and his wife comply with medication and therapy, neither is symptom-free.Viguera, such relationships don't have to be destructive and separation is hardly inevitable.