Bipolar Disorder and Abuse: What’s the Link?

The connection between bipolar disorder and experiences of abuse is multifaceted. Important overlaps include childhood maltreatment, emotional mistreatment, and abuse within intimate partnerships.

Abuse — particularly emotional abuse — frequently appears alongside bipolar disorder. A substantial number of people with bipolar disorder have endured abuse during childhood, and these early harms can increase the likelihood of encountering abusive dynamics in adult relationships.

The phrase “bipolar abuse” is also used to describe situations where someone with bipolar disorder behaves abusively toward a partner, which may occur during an episode of mania, depression, or another mood state depending on their form of bipolar disorder.

Read on for more about how childhood abuse can play a role in developing bipolar disorder and in later abuse as an adult, plus guidance on finding support if you or a partner with bipolar disorder are involved in an abusive situation.

Is bipolar disorder associated with abuse?

A background of emotional abuse in earlier life can contribute to bipolar disorder, though other elements such as substance misuse and the specific mood episode can affect whether abuse emerges in adult relationships.

Childhood maltreatment and bipolar disorder

Emotional mistreatment during childhood is a notable contributor to later bipolar disorder, according to 2022 research. In fact, more than 50% of people with bipolar disorder may report childhood abuse, most often emotional abuse.

Early-life abuse is also linked to developing bipolar disorder at a younger age.

One hypothesis is that traumatic events in childhood change the body’s stress system, producing heightened sensitivity to cortisol and stronger emotional reactions to everyday stressors.

Research from 2016 indicates childhood abuse may contribute to increased aggression and impulsivity in some people with bipolar disorder, although it showed a clearer relationship with elevated risk of substance misuse and suicide.

Meanwhile, a 2020 study suggests childhood maltreatment may raise the likelihood of depressive episodes for some women, while researchers didn’t find a robust association with manic or hypomanic episodes.

Can bipolar disorder cause someone to be abusive?

Although bipolar disorder has been linked to particular forms of abusive behavior, such as domestic violence, it’s essential to recognize that this does not imply most people with bipolar disorder are abusive.

Because manic episodes can involve heightened impulsivity or occasional aggression, someone might behave abusively during an intense mood state — yet there are usually additional contributing factors.

For instance, the impulsiveness tied to mania can increase the chance of substance misuse, including alcohol. Around one-third of violent incidents involve alcohol. A 2019 study found that substance use disorders — whether paired with bipolar disorder or not — were associated with a greater risk of intimate partner violence than bipolar disorder by itself.

Bipolar disorder and being subjected to abuse

People who have bipolar disorder may face a higher risk of being abused: older data suggest just over 60% may experience abuse within relationships, and approximately 45% may be mistreated by family members (older research).

Adult abuse is generally more probable when someone was abused as a child. Additionally, substance misuse that can accompany bipolar disorder may further elevate the risk of experiencing abuse or assault.

A person with bipolar disorder may also face emotional abuse that targets their mental health condition directly. For example, an abusive partner might dismiss their feelings as “just the disorder” or label them “crazy” to gain control and dominance in the relationship.

Does abuse worsen bipolar disorder?

Prior emotional abuse can exacerbate features of bipolar disorder, including:

• rapid cycling
• psychotic symptoms
• mood episode frequency or intensity
• co-occurring conditions
• challenges with managing emotions

A 2017 study indicates exposure to trauma, including domestic violence, can increase the likelihood of suicidal thoughts and attempts among people with bipolar disorder.

Those with bipolar disorder may also have higher rates of substance use disorders. Many substances can intensify bipolar symptoms. While substance use may stem from a mood episode, it can also be a strategy to cope with childhood or relationship-related abuse.

Getting help for abuse

There are resources and strategies to seek support if you live with bipolar disorder. It’s also useful to know how to respond if you’re being abused by a partner who has a mental health condition like bipolar disorder.

If you have bipolar disorder

Possible steps to find support include:

• Learn the signs of abuse: It can be hard to tell if what you’re enduring is abuse, especially when it’s not physical. Here’s more on recognizing emotional abuse.
• Create an exit plan: Leaving an abusive relationship can feel overwhelming if you depend on the abuser financially or emotionally. Here are resources for getting out and locating support.
• Identify trusted people: Share with people who validate you and provide help without conditions. Joining a support group and connecting with others who have bipolar disorder and are recovering from abuse may be beneficial. Here are recommended bipolar disorder support groups.
• Seek trauma recovery: Healing from abuse and trauma can involve trauma-informed therapy, self-care practices, and support from those who understand. Learn more about trauma recovery.

If your partner has bipolar disorder

If your partner has bipolar disorder and has behaved abusively toward you, remember — regardless of a mental health diagnosis, abuse is never acceptable.

Find help now

If you fear imminent physical harm, get to a safe location if possible. You can also call 911 or local emergency services for immediate assistance.

If you are not in immediate danger but need to talk or find shelter, call the National Domestic Violence Hotline at 800-799-7233. This free, confidential, 24/7 hotline can link you to services and shelters across the United States.

Find additional resources here.

If you are not in immediate peril and your partner is committed to safety and wellness in the relationship, consider these approaches:

• Set boundaries: Establish clear limits about behaviors you will not accept. A partner’s respect for your boundaries is a key sign they are committed to your welfare.
• Prepare for mood episodes: Collaborate with your partner to create a plan for handling mood episodes. This can include ways you might support them and constructive strategies for managing mania or depression.
• Consider therapy: Couples therapy with a clinician experienced in bipolar disorder and relationship issues can help you discuss boundaries and enforce them. Note that couples therapy is not advised when abuse is present.
• Recognize when to leave: If your partner won’t accept responsibility for harmful behavior, it may be necessary to end the relationship. You may feel guilty or as if you’re abandoning them, but your safety and well-being are important too.

Bottom line

Experiencing abuse can be a factor in developing bipolar disorder. It’s common for people with bipolar disorder to encounter abuse in relationships, and on occasion someone with bipolar disorder may be the perpetrator of abuse.

While bipolar disorder can deeply affect life and relationships, it is treatable — and treatment frequently plays a central role in managing mood episodes and sustaining healthy partnerships.

Medications, psychotherapy, or a combination can equip you with tools to handle mood episodes and challenging relationship dynamics. Therapy, particularly trauma-informed approaches, may also help you process and heal from abuse-related memories or PTSD.

With time and appropriate care, treatment can assist in resolving past trauma and create the foundation for a flourishing relationship for both you and your partner.