Why relationships are important to your quality of life

Humans are social beings, and while time alone is important, most of us thrive when we also have supportive others in our lives. Relationships, of course, are complex, always changing, and interwoven with diverse social issues. As such, we cannot cover the broad range of relationships and social issues here. So in this section we’ll discuss relationships from the standpoint of ‘social support’. We’ll share information about supportive relationships in the context of bipolar disorder, and give a few suggestions to try in your own social life.

First, however, it is important to start this section with a note on safety. Relationships exist on a spectrum, so there may be times when it can be hard to tell when certain behaviours cross the line from healthy to unhealthy, or even abusive. This can occur in any type of relationship. Domestic abuse disproportionately affects children and women, but anybody, of any gender, sexuality, ethnicity, or social class can be affected. Click here to learn about the types of abuse, and some warning signs of abuse in partner relationships.

The benefits of social support

‘Social support’ describes helpful support from others: emotional support (e.g., love, compassion), informational support (e.g., giving advice) and tangible support (e.g., help with day to day needs)¹. While we, as social creatures, sense that social support is helpful, many research studies show just how important it is for wellness.

Social support is linked to improved physical health (i.e., immune functioning, stress hormones and cardiovascular function)^2,3 as well as psychological benefits. People with mental health challenges who live in close contact with others report feeling less isolated and lonely and more comfortable in having someone to discuss their distressing symptoms or life events⁴. Even contact through more distant and casual relationships, such as shop owners, people in cafés, librarians or pharmacists, can increase life satisfaction and feelings of belonging⁴.

Social support can be especially important for people living with bipolar disorder as it relates to self-esteem (feelings of self-worth and confidence)⁵. Research suggests that people living with bipolar disorder who have higher levels of social support recover more quickly from mood episodes^6,7 and report less suicidal thoughts and behaviors^7,8. Social support relates to less recurrence of mood episodes and better overall functioning and fewer weeks of mood episodes^10,11, especially depression^6,10, than people with lower levels of social support. Interestingly, how much social support a person thinks they have seems to make more of a difference to how well they feel, more than the actual amount of social support they have¹⁰.

Many people with bipolar disorder experience low social support^12,13. Symptoms of depression and mania can take a major toll on social life¹⁴. When depressed, people tend to keep to themselves. When manic, symptoms can push people away. As a result, many people living with bipolar disorder report both close and distant relationships to be unavailable or inadequate¹⁵. Even between episodes, people with bipolar disorder report less contact with friends¹⁶, and increased sensitivity to rejection from others, which relates to depression, poor social support, and quality of life¹⁷. People who have had many lifetime mood episodes (especially of mania) and some lasting symptoms report the most challenges in getting social support^15,16.

Again, supportive relationships are beneficial, but not all relationships are helpful. Research has looked at interaction styles within families (i.e., how families communicate with each other), as family relationships are a frequent source of social contact. Family interaction styles that are described as critical, hostile, intrusive or over-involved predict higher rates of relapse in people with bipolar disorder^18,19,20. These negative interaction styles can also predict poor overall functioning⁹ and longer episodes⁶. So, while relationships may provide support, relationships with people close to you that have a lot of conflict in them can add to your stress, so it’s a ‘double edged sword’.

How to take action

Ask yourself what your ideal social life looks like. Some people thrive with lots of relationships and social contact, while others prefer just a few close friends. It can be helpful to have a friend with similar experiences and struggles as you have – support groups can be a place to identify people who understand what you’re going through. But it can also be helpful to have a casual friend who you participate in a concrete activity with (like going to the movies or taking a bike ride) without needing to talk about deeper issues.

Assess your social network. The first step to making improvements in your relationships is to consider the people in your life who are, or who could become, sources of support; importantly, consider what you can do to provide mutual support to those people, as a one-sided relationship is not healthy for either participant. Try to keep an open mind for possibilities for relationships. You could include family, friends, co-workers, neighbors, healthcare providers or other acquaintances and familiar faces. You can include people you speak to regularly, people you haven’t seen in quite some time, or people you don’t know very well yet.

You might find that you want to change your social networks to promote healthier relationships and lifestyles. For example, you may need to find friends who don’t use recreational drugs or take part in unhealthy behaviours that may put you at risk for a mood episode. One useful source of social support is peer support by ‘informed supporters’. Informed supporters are people who are living well with a condition similar to yours. They are trained by a mental health professional to provide support²¹ and can be helpful in providing emotional and practical support for managing your condition. Becoming a peer supporter to others can help you feel a greater sense of connectedness with your community²¹.

Ensure that you have a healthy balance of social contact. Too much social contact can be exhausting or over-stimulating, increasing your risk for mood symptoms. It’s essential to find the right balance for you. It can be helpful to monitor your mood as you make changes to your social life. You might find that your depressed mood improves with more social contact. However, if you have too much, you may find you are becoming at risk for hypomania or mania.

Many therapies have been proven helpful for people living with bipolar disorder. Family-focused Therapy (FFT) targets family interactions to help make relationships more supportive18. Interpersonal and Social Rhythm Therapy (IPSRT) focuses in large part, too, on interpersonal challenges²². IPSRT helps people build and maintain healthy relationships, while learning to recognize and end unhealthy ones. While Assertiveness Skills Training is not specific to bipolar disorder, it may be helpful, rather than using passive-aggressive or aggressive communication styles. An example of a passive-aggressive communication style would be giving someone the ‘silent treatment’ when you’re angry with them. An example of an aggressive communication style would be saying things that are meant to hurt someone. These communication styles can wreak havoc on relationships.

If socializing is difficult for you, you may want to consider Social Skills Training or Cognitive Behavioural Therapy (CBT). CBT can be helpful to improve mood symptoms and social functioning²³. It can help challenge distorted (or false) thinking patterns about yourself or others. In particular, CBT can help to cope with over-sensitivity to rejection, which many people living with bipolar disorder report. CBT also works to gradually schedule in regular social activities and other healthy behaviours.

Ask yourself how close your actual relationships and social life are to your ideal vision of them.  You may be interested in strengthening current relationships, or working on past ones. If your actual social network is smaller than your ideal, you may need to take steps to widen it. If it is large and not feeling healthy for you, you may want to concentrate on strengthening some relationships while easing off on others.

Quick tips for connecting with others

Some ideas for connecting with others in a supportive way:

Widening your network

Or, you may want to widen your network by creating brand new relationships.