Expert: Libby Bonner - 1/19/2009

Question
QUESTION: I was diagnosed a few months ago with being bi-polar,agoraphobic,obsessive compulsive and major depression.  I have been separated since 2007 and my kids are with my ex.  I left them with him knowing that i couldn't take care of them, which is hard enough in its own and the guilt i feel from that far outways any problems so far, but i am dealing with that.  So I have finally met the man that i know is the right one for me.  He is a caring loving man, would do anything for me, loves my kids to death treats me well.  The question I have is I keep trying to push him away especially when in a manic stage.  I am afraid im going to loose him.  He knows all the problems I have, and is willing to stick by me but i think maybe my meds are not working anymore because the mania is getting worse or the obsessive or the depression i can't tell which one it is.  I take effexor, not lithium but the one that is close to it and clomazapam when needed.  I truly love this man and I don't' want to loose him.  Anything you can tell me or recommend would be appreciated

ANSWER: Need some info to get met better oriented to your question.

Your age.  Exactly when diagnosed.  How often to you see a doc?  Do you get any other services, like from a therapist or a community mental health center?  Are you living w/ the guy, and for how long?  What has been your source of income since your divorce?  Do you have Medicaid -- or, how are the meds being paid for?

If not living w/ him, how often do you see him?  Does he know all your diagnoses?  How much younger or older is he than you>

AND - have you told your doc you are getting sicker, to give him a chance to adjust meds?

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

QUESTION: Sorry my age is 42 he is 45 I was diagnosed last year in february of 2008 we do not live together but would llike to as soon as we can.  He knows all of my diagnosis and he understnads.  I am currently waiting for councilling as there is a 4 month wait and i see my phsyciatrist every month

Answer
My suggestions for keeping the relationship going is to take whatever time is needed to get stable on the right doses of the right medicines.  I am assuming that you see a doc at a community mental health center, and that's why you see him every 30 days?  It would benefit you to be able to see a doc oftener, at least until things are stable.  1 - Can you see your doc any oftener, or at least report anything to him oftener than every 30 days, so that he or his nurse could maybe make med changes as needed?  2 - Are you on Medicaid, or have a way to finance a private doc.

You say your boyfriend "knows all the problems I have," but knowing their names, or even the textbook symptoms, is not the same as living w/ them.  I hope he will try to get info about these diagnoses from others sources, like nami.org or helpguide.org   You also may need to know more than you do now, in order to work more closely w/ your doc.

These are steps I would take to help this remain a good relationship.
I would report immediately, to your doc and to your friend, that you think your bipolar is getting worse.  Try to get an earlier appt.  Find out also when your friend could go with you to an appt....the scheduler will probably want to allow some extra time.  Prior to that appt, next time you see the doc, ask him/her about living w/ someone, or even being in a relationship now, and get his opinion.

Whether or not you now see a doc at a community mental health center, the centers have much to offer a patient w/ multiple diagnoses.  Any doc can write an order for one service or any services at the center that are appropriate.  I would like to see you involved w/ those sorts of things, and probably have a social worker assigned to help you.  To find the two centers closest to where you live, go to samhsa.gov

One of your key 'jobs' as a patient is to become good at managing your illnesses and their symptomes.  The center may have classes to help you.  It's important that you know what stresses to avoid and how to monitor your symptoms, and how to stay as well as possible.

NAMI - find these at nami.org -- has good self-mgt classes called Peer to Peer but they may be hard to find.

You don't want to lose this guy, but you don't want to get closer and then have it fail.  You maybe need to be brave enough to encourage him to have some contacts w/ other adults who have a family member w/ diagnoses like yours.  He may find there is a local affiliate of NAMI near where you live, and I would encourage him to attend.

Thank you for writing.