Expert: Jennifer - 12/30/2009

Question
I am a 34 yr old female who has struggled with mental illness since about 15 yrs old.  I was treated with various antidepressants until being diagnosed bipolar about 6 yrs ago.  My dad was bipolar and both parents struggled with alcohol and chemical dependancy.  I married at 17 and have 4 children.  My husband is understanding, but often puts no effort into meeting my needs.  I often feel trapped and overwhelmed and have anger attacks that cause me to sweat and shake, say horrible things and break things.  I also often hurt mysely and was hospitalized for a self inflicted gunshot wound 2 yrs ago.  It's getting more difficult to control and I am afraid; sometimes I dont know if my children are better off with or without me.  Some of the anger seems to be triggered by marital issues, but my husband blames everything on my illness.  I have been on every med there is which caused me to really almost lose my mind.  I currently take only Lithium and Klonopin as needed.  I can't take care of 4 kids under the side effects of drugs.  My question is, is the anger strictly a result of bipolar or could external issues be contributing?  Is there a med that focus' on the rage without a bunch of horrible side effects? I love my family, but am beginning to resent them and hate what I've become.

Answer
 I think that all of us, medicated and more or less stable or not, can get a little overwhelmed with the everyday aspects of our lives.  Because bipolar disorder is characterized by the two extremes that we go back and forth in the cycles in moods, there's usually going to be a much greater impact from the external issues associated with spouses, kids, boyfriends, girlfriends, and even co-workers that we experience.  

When you say that your husband isn't meeting your needs, have you told him what your needs are?  Sometimes, we start getting upset about situations, get angry at people for letting us down or not understanding what the problem is; and if we were to think about all of that when it wasn't in the middle of a relationship-meltdown kind of fight, that's when it finally becomes clear - we're expecting someone to be a mind reader, to know what we're feeling, to "figure it out" what we're so mad at them over - and all the resentment that's been building up is directed at a person who is kind of overwhelmed themselves and absolutely confused, not knowing what they're supposed to do. Maybe the best way of starting towards a better relationship is by talking openly with your husband, when neither of you are mad, distracted, and definitely not in the middle of a fight.  If things don't improve by going in that direction, or if you feel that you are simply not in a state where doing that is possible - talk to your doctor about what they suggest for changes in your medications that might help bring the anger down.

Let me know if I can help you with anything further, and I'd like to hear back from you regarding the situation.