In terms of the effect of bipolar disorder on initializing and maintaining relationships, it is important that the individual with bipolar disorder be examined in a longitudinal fashion before a secure representation of how bipolar disorder affects their relationships can be reached. If a patient, for example, is exhibiting symptoms of a major depressive or manic episode, it may be difficult or impossible to state that the
patient has bipolar disorder if their history is not known and the person with whom they are attempting to have a relationship with, cannot see that they have a past history of episodic mood behavior with stabilizations or base-line behaviors between episodes. Therefore maintaining relationshisp is a very important problem to consider when looking at bipolar disorder: it could easily be mistaken for mania suggesting some other disorder such as schizophrenia, or depression.
“The operational definition of the form of depression typically occurring in bipolar illness is major depressive disorder” (Dilsaver, 1989) In short, the episodic nature of the patient’s mood swings must be central to a diagnosis of bipolar disorder, which is involved as well in the relationships the patient establishes throughout the lifespan. The professional looking at the effects of bipolar disorder on relationships should have observed these mood cycles as they have started and gradually ended.
They should have observed the patient’s behavior in both depressive and manic states, and also in baseline behaviors, before coming to a correct idea about a person, and of course this is very difficult on relationships, when a person is thus always switching moods. It must also take into consideration the aforementioned distinctions between type I and type II bipolar disorders.
“At least five of the following symptoms have been present during the same two-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood, or (2) loss of interest or pleasure” (Werder, 1995). As mentioned, individuals with type II bipolar disorder experience less intense manic episodes, so this may actually make them more likely to initialize and maintain relationships than type I cases.