Mindful Intimacy: How mental health affects relationships

It starts with the ‘partner problem’. We’re taught from a young age that we must find a partner to live out our lives with. It shapes a deep, sometimes unshakeable desire for one person to be faithful to and intimate with. But what happens to intimacy with another when your internal experience of yourself keeps changing? It’s a dilemma rarely explored on screen. So when I saw that episode of Modern Lovess with Anne Hathaway, evidently living out scenes from my life and proclaiming, “I’m bipolar”, I knew someone understood me.

I was diagnosed with Bipolar II Disorder in late 2018. I’m obviously not alone—India’s National Mental Health Survey data from 2016 suggests that about 0.3-0.5 per cent of India’s population, suffers from Bipolar Affective Disorder (BPAD). I got a diagnosis and started treatment—a 2023 study found that there’s a 70.4 per cent treatment gap among people with current bipolar disorder in India. Honestly, receiving the diagnosis was a relief. I’d had years of prolonged depressive episodes on and off, but I couldn’t explain the manic, hyperactive and hyper-productive stints in between. The diagnosis, paired with a prescription and a treatment plan that included self-compassion, meant I could finally ‘be better’. In 2022, a psychiatrist diagnosed that I had attention-deficit/hyperactivity disorder (ADHD) symptoms too. I read up on the incidence of bipolar disorder and ADHD occurring in people at the same time, and was surprised to find that it’s not uncommon at all—as of the 2020s, one in 13 adults with ADHD globally can be expected to experience bipolar disorder.

A diagnosis alone, however, doesn’t always lead to addressing challenges with one’s love life. I’ve had therapists and psychiatrists gloss over, even do an eye roll when I bring up romantic conflicts as major triggers. Some of the key conflicts any person with advanced mental health issues can struggle with, such as with self-image, body image, rejection dysphoria, loss of or excessive libido, are all deeply linked with the ability to find and maintain a romantic partnership. Dr Sneha Sharma, psychiatrist and founder of Anvaya Care in the Delhi-NCR region, tells me, “I can’t speak about other psychiatrists… but if [we] are not intentional about understanding the effects of treatment, medication and diagnosis [on interpersonal relationships] then overall wellbeing isn’t being taken into account...a patient might relapse [based on] on how a partner might perceive them, and those factors can precipitate an episode”. If not in the first sitting, the conversation on relationships needs to be intentionally brought forth by mental health practitioners, Dr Sharma insists.

A diagnosis can also sometimes lead to a stalling mechanism, even if inadvertently. Astha Ahluwalia, a Gurugram-based psychologist, says she finds that “for some, dating is postponed with a diagnosis: they think ‘I need to sort my mental health out first’. Sometimes that is genuinely what someone needs, but I wonder whether ‘working on myself’ can also become a safe space over allowing oneself to be vulnerable with another person. Sometimes diagnosis can also become a lens to assess almost every emotional reaction or relationship difficulty… something to hide behind, particularly when accountability and facing our own contribution to relational patterns feels harder”.

Then there’s the crucial challenge of sharing a diagnosis with a partner-in the-making. Ray (name changed), a friend from a BPAD support group in Delhi-NCR, has been adamant in his guidance to me: “Diagnosis is just that; it is not your identity. If you conflate identity and diagnosis, and lead with that, you shut doors to other opportunities.” His advice has always been not to disclose a diagnosis “the first couple of dates”. “Only when things progressed and when it was clear that I could trust the other person, would I share that I live with bipolar disorder. Sites like JeevanSaathi.com were a disastrous experience…the most people could relate to were words like ‘anxiety’ and ‘depression’—dropping the words ‘bipolar disorder’ was like dropping a bomb.”

Ray is now happily married, but he only shared his diagnosis with his wife after a few dates, and she had shared that she sought treatment for depression and was working with a therapist.

I myself have struggled with not sharing. A few months into my treatment, I tried dating during a hypomanic phase. I found myself matching with men who wanted to talk post 10PM, once they were away from the gaze of their prying parents. Treating mental health conditions require sleeping early—not entirely conducive for late night texting. My drowsiness would signal a lack of interest. In my hypomanic phases I’d either excessively crave nothing other than to work long hours, or nothing more than to explore my sexuality. I’d lock in. In both scenarios it would negatively affect my physical health, but also my prospects. When it was the former, I’d forget to eat, hydrate and occasionally medicate, and romantic partners’ appeals to talk or meet would be met with barefaced irritation, or just plain ghosting. In the latter scenario, I’d chase physical intimacy over genuine connections—it sometimes led to connecting with ‘one night stands’ who neither understood nor cared for protection, let alone aftercare. (A 2023 Indian study with a small sample size found that people experiencing acute bipolar depression reported high percentages of sexual dysfunction, up to 91 per cent. Mental health conditions are known to induce both sexual hyperactivity and sexual shutdown, depending on the phase of illness and treatment.)

The highs from both excessive work and excessive dating eventually led me to crash without warning. I’d ghost my paramours again, gladly. When I finally identified the pattern, I decided I would share my diagnosis in dating app bios, and let it serve as a filter. I can’t say whether this decision has paid off or not; Ray, and indeed a few other friends and relatives, have disagreed with this measure. I do know, however, that if I share my BPAD-linked limitations, and the ‘prospect’ cannot or will not understand, perhaps said prospect is not for me.

I’ve had the ‘Anne Hathaway in Modern Love’ days—accidentally having one good look at that face in the mirror is enough to stop all date prep and to sink to the floor for a cry. For many others, the start of the dating process is not the problem. Saket (name changed), who also struggles with BPAD and anxiety, feels “it’s about maintaining the connection”. “The challenges that accompany mental health conditions and treatment mean that I can’t always sustain interest in the process.” The excitement invariably dipping is often brought about by waning moods. It’s not that partners or romantic prospects universally fail to understand mental health blocks. “Most people want to be supportive partners, but they aren’t certain on how to offer support, without neglecting their own needs,” says Pratiksha Tewari, a psychotherapist and learning space specialist at the Hank Nunn Institute (HNI).

Pratiksha and HNI paired up with Sharma and her platform Anvaya Healthcare earlier in 2026 to run a six-part discussion circle, ‘Dil, Dimaag, Dialogue’, which aimed to create a discussion space for persons experiencing mental health conditions as well as their partners. (Disclosure: my own collective, Izaar, helped design and facilitate this series, and I had the opportunity to attend each of these sessions.) “It was surprising to find a mix of regular and new people joining each time, with new inputs to dissect, but there was one repeated, shared concern that stood out for me: participants being in the distressing position of explaining themselves repeatedly… ‘How do I cope? Is it my responsibility to explain, or should it be my partner’s to understand?’ ” Pratiksha says.

Pratiksha also finds that with increasing familiarity with therapy-speak, there’s an increasing use of certain terms or phrases as common parlance, which then find entry into relationship-making and placing responsibility on the other. “People struggle with navigating their relationships around the language of a mental health diagnosis,” she says. (For example, an ex-partner who repeatedly put his indiscretions down to his ADHD, making it tougher to ask for accountability) For Dr Sharma, the main takeaway from the sessions was how important it is to assess relationships during diagnosis: “As a doctor, I have underestimated at times the importance of relational experiences, and the impact it has on well-being, self-esteem, confidence, in relation to how others perceive us. To witness practically how much it affects people has been my biggest takeaway”.

It’s tough to negotiate mental health-speak, even when it’s supposed to induce a modicum of compassion or sympathy, and if possible empathy, in us. No doubt there are a few of us who have figured out how to insist on accountability, and stay genuinely accountable, while also being open with a mental health diagnosis. As for me, having hit perimenopause relatively early, I now find myself even more focused on managing myself over finding someone new. I am now increasingly leaving the dream of an ‘equal partner’ behind, in favour of quiet evenings spent alone or with understanding family and friends instead. It’s not that I’m completely closed off; it’s just that I’ve made peace with and make peace with the ambiguity of what the future holds for a 40-year-old menopausal BPAD woman in India. The more I’ve sought treatment, and the more I’ve conversed with friends, support group members and so on, the more I find I’m secure in not having an answer to the partner problem.