Expert: Libby Bonner - 8/10/2008

Question
QUESTION: My husband is Bipolar and a alcoholic. He has been on several different meds. He is going to out patient treatment for Alcoholism and has met another Alcoholic. He moved out last Wednesday and is living with her. What advice can you give me? He has not been taking his medicine like he should and drinking more.

ANSWER: PS - You mentioned in your reply that I was maxed out.  I take 2 Qs/day - I hope this doesn't happen to very many people.  If you want to stay in touch, you could prepare your answer/s or next questions/ and have them ready to cut and paste next time I'm free....I expect  that will be very soon.  
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Does his doctor know any of this?  Are you and s/he able to exchange info?  If privacy laws prevent this, you can write the doc to tell him and your letter will go into yr husband's chart, and be read by the doc.

Has your husband ever stayed on meds long enough  to see if they seemed to improve his symptoms?  Any bipolar meds that seemed to reduce his drinking??

It's common for bipolars to abuse substances - alcohol, for him - as a means of self-medicating and feeling better.  So, in theory, if bipolar meds can make them feel better, they will reduce or cease their alcoholism.   Perhaps your husband hasn't had the right meds, in the right doses, to make him give up drinking.....or perhaps he hasn't given the meds a chance.

I don't see much that you can do, really, except to know that, off meds, bipolars may be more sexual than normal, and not care too much w/ whom.  This "affair" may have more to do w/ being pretty sick right now, and becoming more sexually interested, in anyone, and less about caring for the particular partner.

I'm not sure what you would like to have happen here.  Would you say you were happy together?  Or is it more that you are offended that he would leave?  Not sure either what you family situation is, or was:  kids?  What is the source of your family's income...and so what happens if he is gone???

If you'd like to write again, I'd like to know also:  how long he has been an alcoholic, how long ago diagnosed w/ bipolar, when you met, when you married, where he gets treatment for his bipolar - VA, mental health center, private doc????  And how is his care paid for - Medicaid, or private ins????

See if there is a NAMI affiliate near you, nami.org.  You might begin attending their meetings - lots of info, lots of support.

Good luck, and thank you for writing.

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

QUESTION: Libby,

You wanted more information. He has three doctors and I have spoken to all three of them. They are very concerned, and yes we are able to exchange information. He has never stayed on his medicine long enough to work. He has only been diagnosed for a little over a year, and he is 48 years old. For the last year they have been tweaking his medicine to try to find the right combo., also he won't stop drinking long enough to see what the medicines will do. The longest he has gone without drinking is 30 days. He says "he don't like the way the medicines make him feel".

I do believe we were happy. We have three children, all boys, ages 31, 25, and the youngest (still at home) 24. Three Grandchildren, a 4yr old grandson, and a 3 yr old granddaughter, and a one year old granddaughter.

We have had problems, like everyone else, but his parents passed away, his father in 2001 and his mother in 2003. Ever since then things have been very bad with him. When his father passed he broke down and cried like he was a child in his mother's arms, but when she passed he didn't. He had to be the man. He had to take care of everything. After she died, his drinking and craziness really started to get worse. H has always had problems dealing with death. H grandfather passed away in 1971, and he had a mental breakdown then.

I love my husband very much and want him to come home. I am very hurt by this, but do understand that it has to do with his illnesses, Bipolar and Alcoholism. Our income is nothing to brag about. He gets a long term disability check monthly, and has applied for Social Security (and been denied, we have a lawyer) and I work for a Major Retail Store. We have no money. That is part of his problem too. It doesn't matter if I have gas to go to work, as long as he has cigarettes and a "coke and chips???"

To answer your questions:
1. He started seriously drinking about 10 to 12 years of age (pictures of him with a beer can drinking it at age two).
2. He was diagnosed last year.
3. We met in the summer of 1980, and married June 26, 1981.
4. He sees 3 private doctors. They are all private pay. He is covered on my insurance, but because of prior existence, it will not cover doctor's visits for 18 months, but will pay for his medicines.

One thing I would like to know is, 'Is there any way to get Medical Guardianship over him, or should I TRY to get a Durable Power of Attorney?


Answer
Guardianship

For answers to questions like these, try:  treatmentadvocacycenter.org
and also get the book by Amador called I am not sick; I don't need help.  Re the book, only get the later edition - think it is 2006 or later.
    
However, note that mental health laws vary greatly by state, so you will need to know info for your own state.  The website does give state by state info, I believe.

I hope you have someone handling your SSDI appeal who does many of these every year. That's essential for a successful appeal - but SSDI takes a dim view of drinking. However, is you have 3 psychiatrists supporting your case, that should help.

You cannot use a Durable Power unless the person is legally incompetent, unable to give consent on his own.