It can be difficult to focus on your health when you are coping with the day to day work of meeting core needs, such as making rent or mortgage payments, earning a living wage, or taking care of your family. It is especially difficult if you are facing financial hardship – something that many people struggle with at one time or another, often through no fault of their own. Additionally, financial roadblocks may be even more challenging for a person who lives with a mental health condition like bipolar disorder.

In this section, we will:

• review what we know about bipolar disorder and finances
• share strategies you can try that may help you to protect yourself and your family from financial problems
• discuss how to find assistance and support, and
• review how poverty can impact quality of life more broadly

Why money is important to your quality of life

There is still relatively little research specifically examining financial problems in people with bipolar disorder. Impulsive spending, however, is a fairly frequent occurrence during episodes of hypomania or mania. One Australian study, for example, found that over 70% of patients with bipolar disorder type II report spending large amounts of money when hypomanic¹. Consequences of over-spending included financial difficulties (no surprise). But the research participants also described increased interpersonal conflict with family members and partners as a result of overspending, as well as feelings of guilt and remorse. Another small research study looked at the relationship over time between financial difficulties and mental health in people with bipolar disorder.

Study results suggested that the relationship between financial problems and mental health problems may be a two-way street: mental health problems may increase risk of problems like compulsive buying, whereas worries about finances can exacerbate poor mental health₂. Other research suggests that financial management skills may be lower in people with bipolar disorder compared to people in the general population, and that this may be related to higher levels of impulsivity₃.

In qualitative research (using surveys and focus groups), people with  bipolar disorder talked about over-spending, impulse shopping and being excessively generous with money when in hypomanic or manic episodes. Study participants described sometimes experiencing severe anxiety, depression, suicidal thoughts and guilt afterwards. They described comfort spending and avoiding dealing with their financial situation as a means to cope during times of depression⁴.

Gambling, spending, and risk-taking

One way in which spending and risk-taking can be combined is through gambling. Commercial forms of gambling contain a built-in ‘house edge’ so that continued gambling is a costly behaviour that can create or exacerbate financial hardships. Gambling Disorder is a recognized form of behavioural addiction, characterized by a loss of control over gambling. ‘Chasing’ losses is an important indicator of gambling problems; for example, returning to a casino in an attempt to recover earlier debts. Recent research has found that a number of behavioural addictions are more common in people with bipolar disorder, including gambling problems as well as compulsive buying . For example, in one study from the U.K., rates of moderate to severe problem gambling were four times higher in people with bipolar disorder than in the general population⁵. This finding fits with other research studies^6,7.

At the same time, people with bipolar disorder might at times benefit financially from the increased risk-taking and creative planning that may go with the condition. Research shows that some individuals with bipolar disorder report that it has increased their abilities to creatively and energetically tackle a wide range of real-world problems⁸. It’s reasonable to assume that for some people, bipolar disorder delivers improved financial outcomes some of the time⁹. But it is very important to acknowledge that these cases are uncommon, especially compared to those in which bipolar disorder or another mental health condition is linked with increased financial hardship.

How you can take action

The best time to protect yourself from bipolar disorder-driven financial decisions is when you are feeling stable. When you are exercising good judgment, your mood is fairly stable and your energy level is appropriate for you, you are in a position to plan ahead. It can be helpful to include your family or someone you trust in these plans. Here are some strategies you may want to try.

For information about the signs and causes of excessive gambling, the CAMH website is very useful https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/problem-gambling. Support for people experiencing gambling problems varies by country and jurisdiction. For example, in British Columbia there is a dedicated treatment program https://www.bcresponsiblegambling.ca/problem-gambling. Many regions have specialized telephone helplines and options for gamblers to ‘self exclude’ from casino venues or online gambling websites. GamTalk offers online live chat for gambling support https://www.gamtalk.org/. Finally, some banks are beginning to provide tools to enable gambling blocks on debit- or credit- cards; it is important to be aware that gambling on a credit card can incur high interest rates.

Accessing support

Many people who live with chronic health challenges, including mental health conditions, are unable to do paid work to support themselves financially. If you’re unable to do paid work it is possible to seek other forms of support. Many countries offer disability support for people who are unable to work because of serious health conditions. This may be through a public plan (sometimes called a disability pension) or through a private insurance carrier. Note that the process of applying for a public disability pension can be demanding, so you may need support in completing the application process. See your healthcare provider or support worker to discuss where in your area you can find this kind of assistance.

Finally, it bears repeating that it can be challenging to manage a chronic health condition if you are struggling financially. One study described how people with bipolar disorder, even in countries where access to mental healthcare is generally good, still had financial problems accessing sufficient treatment, usually related to monetary constraints or problems with health insurance¹¹. In this way, your financial wellbeing can have a strong impact on other areas of quality of life and your overall health. For example, you may struggle to maintain physical health if you can’t afford healthy food. You could struggle in your home quality of life if you can’t afford rent in your area and are forced to live in unsafe or unsatisfactory housing. Concentrate on meeting your core needs first, such as  accessing supported housing, public assistance or asking a support worker to help you meet  your core needs.