Expert: Libby Bonner - 12/3/2009

Question
QUESTION: My wife of 18 years has been diagnosed with bipolar depression. It was like a light switch was flipped. Now she wants a divorce. She wont talk to me or anything. When I try to talk to her she gets angry at me and starts yelling at me. I am lost in what to do. I love her so much, and I hate to see her like this. We have four sons, only three live with us. Would this be the cause for her wanting a divorce? I am trying to understand how and when to approach her to talk. I have read about this disease but am still confused.

ANSWER: The wife you married isn't home right now:  she has developed a mental illness.  It affect thoughts, moods, and behaviors.  But it is her reality at this point.  In that reality, she wants a divorce.

She is, by the way, experiencing what's sometimes called an irritated, agitated depression.  People often associate 'depression' w/ people getting quiet and sad.

If you can provide a little more info, I can target my answer to you better.

When was she diagnosed, and by what sort of doctor - family? psychiatrist?  Is she on the same med/s and/or dose/s that the doctor started her on, or have some changes been made?  How many appts has she had?  Have you attended any appts, or does she not want you to? What do other extended family  members think of her illness??  Ages of kids at home?  How is her care being paid for - your ins, hers?  Better check your coverage....  Has she been hospitalized and for how long, how recently?

No good time to approach her and talk. Pretty much a waste of time:  you are rational, she is not.  Oil and water.  It makes things worse for you both to attempt logical discourse.

Things to do right now.  Find you local NAMI affiliate [nami.org] and start attending.  If more than one affiliate, find one that has a family support group and GO>

Go BUY the book by Woolis called When someone you live with has a mental illness.  It will improve the effectiveness of your communication, make you feel less helpless, guide you toward safe, minimal conversations.  99% of people who use this book - who USE it - start living better family lives, almost regardless of how ill the family member is.

My assumption has been that it's pretty early in her illness....and so for each of you, there is learning to do.  Does she understand her diagnosis?  Accept it?  She is at Square One with this, and you are apparently.....going to take time to find right med/s, right dose/s if it's still quite early.    ---  Woolis will help lower your expectations, in a good, way: this will take time, patience, and INACTION...less interaction.....believe it or not.

The holidays will be tough.  Do NOT plan on a xmas like the others, or that she will hostess anything, or even GO w/ family to other people's.   Hols VERY stressful for the mentally ill - just coast through this one.  Don't hang any expectations on particular gifts to her: she may hate them....who knows.   Just mellow your way through this one....and help the kids to do the same.

Last, and as good as Woolis, is wwwl.helpguide.org.  Terrible name; great site.  There is a LOT there.  However, my recall is that in some sample conversations between pt and family, the pt is very aware/accepting of the illness......so some of that might not apply it you both are way new at this.  But it is EXCELLENT.

I hope to hear from you again.  Do get some support from someone:  a family member or friend, someone from work or church, who would be willing to skim the Woolis book and hang in w/ you.  You can certainly also consider counseling for yourself alone, re coping.  Or family therapy, involving you and the kids.

It won't always be this bad, and soon, I hope, it won't be as confusing.

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

QUESTION: She was diagnosed in July 2009. She has been on a couple of different meds. She has been on the same one for a couple of months. I am not sure how many doctor appointments she has had. She will not let me go with her. Our kids are 17, 13, and 11. She has her own insurance.
She is adamant about a divorce. She goes out all night and does not let anyone where she is going. She will not do anything with me. She is always mad at me. She is good to our kids, but I can not do anything right. Everyday is miserable without being able to communicate with her.
She has lost weight real quick and is obsessed about losing more. Am I fighting for a relationship that will never work? She tells me she wants to be friends. Is her illness causing her to think if she gets rid of me everything will be normal?

Answer
You two have barely begun this journey.

I would like you to re-read my other email, and contact NAMI and BUY THE WOOLIS BOOK AND USE IT.

The out-all-night is a whole new ballgame, and I wonder now if she is manic and not depressed?  Did a psychiatrist diagnose her? Not real happy that she's losing weight....was she overweight before.   ---- By the way, though the doc and you cannot exchange info, because currently she will not permit it, it is always possible to GIVE info to the doc.  You can send a note, or you can call and talk to his nurse.  I suspect they don't know about out all night, and you should let them know about it.  You will got NO info from them, but they will put your info into her chart.

You sound like someone itching to get this over.  If that's what you want, do it.  But do you understand that she is seriously ill???  And that her behaviors and anger come out of a mind that is considerably screwed up??

You are at the very hardest part right now, and it will go on being hard until you get more involved in informing yourself, putting some distance between the two of you - don't keep trying to talk to her - and finding out what medicines she's on, how often she sees the doc, etc.

NO, HER ILLNESS IS NOT CAUSING HER TO THINK ANYTHING THAT IS RATIONAL.....  SHE MAY HAVE A PLAN, BUT IT IS PROBABLY A GOOFY ONE.....AND ---SHE IS NOT HERSELF RIGHT NOW.  The garbage that currently comes out of her mouth has absolutely nothing to do w/ you, you haven't caused it.....it's a very hard thing to understand, since she looks the same, still speaks English, etc.  But it's this new screwed-up mind that generates these words and ideas.

IF/when she gets the right diagnosis, right med/s, right dose/s, things will get better......but it is trial and error, and each change in a med or a dose has a built-in wait-and-see period.  This will go on for awhile.

Meanwhile, Woolis [book] does have material on setting limits, among other things.  

You also might think about who should leave the house, if anyone: you, or her?  You're OK; why should you leave?  You also need to think about what happens when she loses her job - is that a near possibility????

Pls write again only when you have more info, are using the Woolis book, and have found a NAMI affiliate to attend.