Expert: Ivan Goldberg, M.D. - 10/18/2008

Question
My husband and I have been married for 14 years, have 4 young kids and run a business together. He is also a lawyer and is incredibly creative and successful. That being said, the last 2 years have been pure hell. I really didn't understand what was happening, but I fought against his behavior and finally had 2 independent counselors diagnose him as bipolar. During his last manic episode three weeks ago he left us, but now wants back in the house. He has agreed to seek an evaluation and counseling, but does not agree with the diagnosis. At what point should I allow him home? When he gets the diagnosis or when he agrees to treatment or when he had been treated for a period of time? I feel if I let him home I have no leverage.

Answer
Hi Heather . . .

In situations such as the one you describe I tell the spouses of my patients that they should not allow their spouse back in the house until it is clear that the patient is taking medication and that the major symptoms of the bipolar episode are under good control. Also I go out of my way to see the patient and spouse together two or three times.

I hope this helps.

Best regards . . .

Ivan
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