Expert: Libby Bonner - 7/29/2008

Question
QUESTION: My husband is bipolar and recently had a manic episode.  He always "moves out" when this happens and says our marriage is over.  This time when he was brought home he was suicidal and homicidal.  I was able to talk him into going to the E.R. and they put him in the local inpatient facility.  Two days later they ask me if I'm ready for him to come home. I told them no, but I went and got him anyway.  They have put him on Lithium along with his other medication.  He seemed more calm when he came home, but he still wasn't right.  We had an argument and I told him he had to leave.  It was just too much.  Now all of his friends are calling me and saying he needs to be back in the hospital.  He won't go willingly.  Is there any way I can force him to be hospitalized?  We need help and no one seems to know if there is anything I can do.

ANSWER: Call your state NAMI office or a local NAMI affiliate for info and advice - nami.org

Not much you can do now, really, except to keep your own safety in mind.

Only way to "make" him go back in is to call 911 if he is again suicidal or homicidal....but again that could lead to a release w/in 2-3 days, probably, unless you undertake to try to have him committed, which is not easy.  You might want to talk to an atty NOW.

What are his other meds and who prescribes them?  Is he willing to take meds??  Have you let that doc know of this hospitalization?

He is gone now?  Angry?  Enraged?  You could change the locks and let both the police and sheriff's office know what is going on.

Manics can be terribly dangerous, so do be careful w/ whatever you decide to do.

---------- FOLLOW-UP ----------

QUESTION: His other meds include seroquel, lamictal, and effexor. They are prescribed by his psychiatrist.  He says he is taking his meds, but he is also using street drugs-marijuana and meth that I know of for sure.  I have kept his doctor up to date on everything I find out.  He is gone now.  The police say get an order of protection, the doctors and nurses say he needs me now more than ever.  I had never been afraid of my husband until a couple of days ago.  I was upset with him because he had gotten ahold of our checkbook and was out writing hot checks.  I got the book back, but with several checks torn out so I had to close out the account.  When I asked him why he was doing all this, he just smiled and laughed.  He just kept smiling and he had this look in his eyes.  That was the first time I have ever been afraid of him.  I would much rather he had been upset or having some kind of "normal" reaction to everything.  I called to let him know the account was closed, and he started talking about coming to get his things.  I told him that he could not just show up at my house anytime he wants because he is ill.  He started screaming at me and threatened to burn my house down.  I don't know what all he said because it just sounded like a bunch of raving garble over the phone.  I talked to his parole officer who went and picked him up and I think maybe drug tested him.  But he had to let him go because there was no warrants. I love my husband and I know that our relationship may never be saved, but I just can't bring myself to completely turn my back on him.

Answer
Sounds like he is way manic right now.  You don't necessarily have to turn your back on him, but you do have to stay SAFE, whatever it takes.  

It would be good to have any personal contact w/ him outside, where either of you can run.  IF you both are inside, make absolutely sure that the two of you don't end up in any room w/ only one way out.  If you are closer to the only door, he may feel threatened and trapped. If he is closer, you have no way out....none at all.

If he threatens you violently at home, call 911 and hope he is still like that when the police arrive.

I would keep all contacts, incl phone, as brief and business-like as possible until things get better.  Pls buy this book right away:  auther is Woolis; title is When someone you love has a mental illness.  A lot is about communicating in ways that are effective, in ways that won't cause accidental escalation.  You will have a sense of direction and feel less uncertain about what to do.  Pls do get it - it has helped thousands and thousands; I am one of them.

Pls also see if there is a good NAMI affiliate near you - nami.org.
If they have a support group [as well as speakers] you will get an immense amount of help from others who have had to solve problems lide yours.  And, if you continue in a relationship w/ him, do try to take the free NAMI Family to Family class.  It can make all the difference.

Do let others know about his condition now - they need to be safe, too - and be sure they know of the sort of threats you have received.  Do the docs and nurses know of these threats?  What, and how, will you [safely] be a help to him right now....I am a little puzzled about that.   They maybe want you not to reject him utterly right now, but they also surely value your life.