It’s easy to become the caregiver when you’re married to someone with bipolar. Mark and Giulia Lukach maintain their partnership with empathy and planning.
Mark and Giulia Lukach got together in 2000 when they were first-year students at Georgetown University. If it wasn’t love at first sight for the two 18-year-olds, it was darn close. They were inseparable throughout college, married at 24, and moved out to San Francisco three years later.
Giulia was excited about her new job in marketing with a fashion company. Mark, who started teaching history at a high school in the Bay Area, was thrilled about new surfing opportunities. But their charmed life took a turn when at 27, Giulia had her first brush with bipolar disorder. That severe psychotic episode changed her, changed Mark, changed—and challenged—their marriage.
Nearly 10 years later, though, they have reached a new
equilibrium. Their commitment to each other endured and even strengthened, and
their understanding of what it means to love someone has deepened.
Being together won’t always be rainbows and sunsets and minor squabbles about whose turn it is to clean the kitchen. It’s not about trying to cocoon the other person from problems or play fix-it for whatever’s wrong. The true glue in a relationship, they’ve found, is to be present and patient with each other while taking responsibility for their own wellness.
In fact, that’s the main reason Giulia agreed to let Mark
share their experiences in articles, talks, and his memoir My Lovely Wife in the Psych Ward. Mark, who is a freelance writer
as well as a high school teacher, began writing his way through what happened
to them after Giulia’s first psychiatric hospitalization in 2009.
Over the years, Giulia had grown into compliance with her
medication regimen and other strategies that have kept her stable since 2014. Mark
has learned how be supportive without overstepping.
there’s still friction around bipolar-adjacent behaviors. If Giulia stays up
late to watch a movie or finish up a project, Mark often will urge her to go to
bed. That gentle push can trigger a prickly response.
defensive and protective: ‘I know what I’m doing, I know my limits,’” Giulia
Mark admits that his fears about Giulia relapsing make it hard for him to hang back, since not sleeping is a major red flag for an impending mood episode—which, based on past experience, means psychosis, hospitalization, and persisting depression.
probably why I’m so pushy about, ‘Hey, it’s bedtime,’” Mark reflects.
skirmishes reflect the interlocking experiences of many couples who live with
bipolar. On the one hand, heightened sensitivity when it comes to personal
autonomy and a wariness of being seen through the filter of the diagnosis. On
the other, unhappy memories of absorbing responsibilities on the home front while
faced with a transmuted version of a beloved partner.
For Giulia, sleeplessness and paralyzing anxiety after she
started her new job escalated to religious delusions, paranoia, and suicidal thinking.
Mark made the difficult decision to take her to the emergency room and she
ended up in the psych ward for three confusing, frightening weeks.
After her release, the psychosis slowly subsided into an
immobilizing depression that lasted eight more months. Finding effective medication
finally ended the episode.
During those long months, Mark had to worry about the family
income, maintain their household, and deal with concerned family and friends—all
while agonizing about the love of his life. Stress, fear, and loneliness led to
depression and anxiety of his own.
It was even harder when Giulia was hospitalized again three years
10 days after she returned to work from maternity leave. This time, Mark had their
firstborn, Jonas, to care for while Giulia spent 33 days as an inpatient and four
more months in a depression. They also had to face the fact that the earlier episode
wasn’t a one-off.
Since then, Giulia has evolved toward acceptance, both of an altered self-image and all the life changes involved in staying well. For Mark, it has meant learning to step back from paternalistic oversight and pay more attention to his own self-care.
Patient v. partner
Before her first
hospitalization, Giulia was the detail-oriented, goal-driven member in their
relationship. Mark describes himself as more of a spontaneous surfer dude. That
dynamic changed completely in the early years of her illness: Giulia became the
uncooperative ward to Mark’s controlling caretaker.
“I definitely felt like I lost a lot of autonomy and
independence when I got sick,” Giulia notes.
There’s been give on both sides over time. For example,
there was a time when Mark supervised to make sure Giulia swallowed her pills. Now she meticulously self-monitors her meds, spurred
by wanting to do what’s best for her family.
Meanwhile, Mark has backed off from the uncomfortable
position of gatekeeper. He says he dialed down his “need to fix this” impulses
with reminders from his therapist: “The good news and the bad news is that
you’re not that powerful.”
He also discovered the Mad Pride movement, which advocates
for self-direction for people with psychiatric diagnoses. Mark came to see he
wasn’t doing Giulia or their relationship any favors by acting as an extension
of her practitioners.
He introduced Giulia to the concept of “mad maps”—crisis
plans that are developed based on the opinions of the person who has the
diagnosis. It hasn’t been an easy process for them. Their first negotiations, over when
Giulia should take additional medication to fend off an acute episode, were so
heated they ultimately turned to her psychiatrist to mediate.
Giulia says she wasn’t totally on board in the beginning.
triggering conversations to have.… It was like scheduling time to fight,” she
reflects. “Once we got over the first hurdle and said, ‘This is an outcome we
can both stand behind,’ we realized it was worth it.”
“We made the decision together on what we were going to do, and that feels more
balanced to me.”
that trying to get where the other person is coming from, honoring each other’s
has gone a long way to solidifying their new normal.
really know what Giulia has gone through and the only way I can know is to just
validate what she says.… Not try to deny it and not try to fix it, but just let
it be what it is.
“That has been where we found the greatest success, whether we’re talking about who’s doing the dishes or the bigger stuff—how we’re going to handle it if there’s a fourth episode.”
Mark admits compassion
isn’t always easy to achieve, especially “when your feelings are hurt [or] you
want to be heard.” He warns that listening patiently, without judging or
reacting, “looks passive but it’s incredibly active. It takes a lot of work.”
He adds, “The
biggest thing … is to put the effort in without waiting for the other person to
take the first step. When Giulia and I are both waiting for the other person to
take the first step at being empathetic, things can really drag on.”
It can be
tempting to play the “my woes are worse than yours” game, he says, but that
doesn’t help anybody. Still, the caregiver’s distress shouldn’t be discounted
just because that person is not the one directly coping with bipolar.
He has never
been psychotic or had to take medication against his will, he admits, but
neither has Giulia lived through what it was like “to take care of the person
she’s married to in an altered state or be a single parent for what felt like
months at a time.”
that reading through the different drafts of My Lovely Wife in the Psych Ward gave her crucial insight.
really able to get into Mark’s shoes and I was able to see him. … I saw how
lonely his existence was when I was so sick, everything he had to do to keep
our life going, even though to my mind, everything stopped.”
Mark and Giulia tried couples counseling, but it didn’t suit
them. Giulia says working individually with a counselor she calls her spiritual
guide has done more to strengthen their relationship.
“You learn to be a better partner when you are
happy with yourself,” she says.
therapy has been an avenue to “accepting the whole self, accepting the darkness,
accepting the light that’s in each of us. … All the episodes, being psychotic
and being suicidal, that is a part of who I am.”
they’ve come can be seen in what happened after their second child, Cosimo, was
born in March 2018—or rather, what didn’t happen. There was no psychotic
episode, no hospitalization.
For one thing, Giulia was more relaxed about pregnancy and parenthood the second time around. For another, she had trusted supports. Her mother came for a lengthy stay to help with the baby. Mark was home on summer break when Giulia went back to work—she’s digital marketing director for a specialty retailer—then took a year’s leave to be a stay-at-home dad. Giulia never had to worry about handing Cosimo over to strangers.
She was also
less worried about weathering another relapse if it came. Her third
hospitalization and subsequent recovery, in 2014, was short enough that she
didn’t have to quit her job.
All of that
added up to “not being scared…. I could go to sleep at night and have a
Giulia’s hospitalizations have always happened in the fall. It’s
possible her stability streak will be broken when Mark goes back to work in
guarantee I won’t have a fourth episode,” points out Giulia. “There a high
likelihood I will … and I’ve learned to live with that.”
is uncertain,” Mark agrees, “but I think we both know that if it happens, we’re
going to get through it. It’s going to be ugly it’s
going to heartbreaking; but we don’t have this sense of futility and defeat
that we felt.
“We just learned to accept, this is what our life is now and it’s OK. We still have amazing moments and make it through.”
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