Bipolar Disorder and Abuse: What’s the Link?

A history of experiencing emotional abuse can contribute to bipolar disorder, but other factors like substance misuse and the type of mood episode may influence whether abuse occurs in adult relationships.

Childhood abuse and bipolar disorder

Emotional abuse in childhood is a significant factor in developing bipolar disorder, according to 2022 research. Additionally, over 50% of people with bipolar disorder may have experienced abuse in childhood — most commonly, emotional abuse.

Childhood abuse is also connected to developing bipolar disorder at an earlier age.

One theory is that childhood trauma alters your stress response, which can mean a higher sensitivity to cortisol and stronger emotional responses to stress in everyday life.

Research from 2016 suggests childhood abuse may contribute to aggression and impulsivity for some people with bipolar disorder, although it was more directly connected to a higher risk of substance misuse and suicide.

Meanwhile, a 2020 study suggests childhood abuse may increase some women’s chances of experiencing depressive episodes, but researchers didn’t find a strong connection to episodes of mania or hypomania.

Can bipolar disorder make someone abusive?

While bipolar disorder has been connected to specific types of abuse, such as domestic violence, it’s important to remember this doesn’t mean all or even most people with bipolar disorder act this way.

Because episodes of mania can come with more impulsive or even aggressive behavior, it’s possible someone could act abusively during a strong mood episode — but there’s often more to the story.

For example, the impulsivity that comes with mania can make someone more likely to misuse substances like alcohol. About 1 in 3 incidents of violence involve alcohol. A 2019 study found substance use disorder, with or without bipolar disorder, brought a higher risk of intimate partner violence than bipolar disorder alone.

Bipolar disorder and experiencing abuse

People with bipolar disorder may be more at risk of experiencing abuse: Just over 60% may experience abuse in a relationship, and around 45% may be abused by their family, suggests older research.

Experiencing abuse as an adult tends to be more likely if you were abused in childhood. In addition, the substance misuse that sometimes comes with bipolar disorder may also increase the risk of experiencing abuse or assault.

Someone with bipolar disorder may also experience emotional abuse directly related to their mental health condition. For instance, an abusive partner might dismiss their self-expression as “just the disorder talking” or try to convince them that they’re “crazy” to gain power and control in the relationship.

Past emotional abuse could intensify aspects of bipolar disorder, including:

• rapid cycling
• psychosis
• mood episodes
• comorbid conditions
• difficulties with emotional regulation

A 2017 study suggests that exposure to trauma, including domestic violence, can increase the risk of suicidality and suicide attempts for people with bipolar disorder.

People with bipolar disorder may also experience substance use disorders more often. Many substances can magnify bipolar disorder symptoms. And while substance use may happen due to a mood episode, it could also be a coping mechanism for childhood or relationship abuse.

There are ways to get support if you live with bipolar disorder. It may also help to know what to do if you’re experiencing abuse from a partner with a mental health condition like bipolar disorder.

If you have bipolar disorder

Some steps toward support might include:

• Know the signs of abuse: Sometimes it feels unclear if what you’re experiencing is abuse, especially when it’s not physical. Here’s more on how to recognize emotional abuse.
• Make an escape plan: Leaving an abusive relationship can feel daunting if you rely on the person abusing you for financial or emotional support. Here are some resources for getting out and finding support.
• Identify people you can trust: Focus on sharing with people who believe you and offer support without strings attached. It might also help to join a support group and talk with others with bipolar disorder who are healing from abuse. Here are our top picks for bipolar disorder support groups.
• Trauma recovery: Recovering from abuse and trauma can involve trauma-informed therapy, self-care, and support from people who understand. Learn more about trauma recovery.

If your partner has bipolar disorder

If your partner lives with bipolar disorder and has acted abusively toward you, know that mental health condition or not, there’s never an excuse for abuse.

If you’re not in immediate danger and your partner is dedicated to the health and safety of your relationship, consider these ideas:

• Set boundaries: Set clear limits for which behaviors you will not tolerate. Respecting your boundaries is a good indicator that your partner is dedicated to your well-being in the relationship.
• Plan for mood episodes: Work with your partner to develop a plan for what to do during a mood episode. This might involve ways you can support them and constructive ways to deal with mania or depression.
• Consider therapy: Couples therapy with a professional who has experience supporting people with bipolar disorder and relationship concerns could help you navigate discussions about setting boundaries and sticking to them. Keep in mind that couples therapy is not recommended in cases of abuse.
• Know when to leave: If your partner refuses to take responsibility for their behavior, it may be time to part ways. You might feel guilty or as if you’re “giving up” on them, but don’t forget that your well-being matters too.

Experiencing abuse can be a risk factor for developing bipolar disorder. It’s not uncommon for people with bipolar disorder to experience abuse in relationships. Sometimes someone with bipolar disorder may act abusively toward a partner.

While bipolar disorder can have a significant impact on your life and relationships, it is treatable — and treatment is often key to managing mood episodes and maintaining a healthy romantic relationship.

Medications, therapy, or a combination can give you the tools to navigate mood episodes or difficult situations in a relationship. Therapy, especially trauma-informed care, may also help you work through and heal from memories or PTSD related to past abuse.

Over time, you might find that treatment helps you work through past trauma, setting the stage for a thriving relationship that serves you and your partner.