Expert: Libby Bonner - 3/16/2010

Question
QUESTION: I am a 48 year old male with 2 children ages 3 and 2 weeks.  I have been diagnosed a little over 3 years ago  with Bipolar,hypomania and clinical depression.  I have attempted suicide once been hospitalized 2x and have been off my meds and therapy for a year.  I am working and have been looking for  a second job to help pay the bills.  My wife does not work.  Our hme is fool of tension because of me.   have become increasingly mor agitated and aggressive and I am afraid that something bad will happen.  I have pushed and hit my wife when in an episode,I have called her terrible terrible names and said terrible things to her.  I understand that I am deflecting my faults and problems onto her.  i know that what I say to her is really what I think about myself.  My son has heard me yell at my wife and witnessed our fighting.  He has just started to repeat what I say and this has caused great pain for my wife and myself.  There is a lot to talk about and when I was in therapy I did not address everything with my therapists.  
   I believe that I have had bipolar since high school but was never diagnosed or sought help.  i have put off my responsibilities for my entire life and have been enabled in my behaviors by my mother who constantly paid my bills for me and let me be lazy.  I have run to my mother way too many times and now she will not help when i need it the most with my sons.  ighth now I am going to try to get some therapy for myself without haveing to go into the hospital if possible because I cant afford to miss any work,

ANSWER: You need to be prepared to go to an ER if needed, and you must find out if there are one or more crisis lines you could call.  Your wife needs to identify women's shelters and be prepared to use them.

Something bad will happen unless you are on the right doses of the right meds.  Forget therapy until your brain chem gets straightened out.

The only thing that puzzles me is your considerable awareness of what you do and the effect it has on others...that's not typically bipolar.  Are we sure this isn't an anger problem - well, no, probably not w/ the hosp and suicide attempts.

"I have put off my responsibilities my whole life."  A very unusual thing for a bipolar, off meds, to say.

"just really what I think about myself."  not typical either.

Does she have any relatives to take her in for awhile.....or are there any ways for the two of you to live separately, whatever arrangement it would take?

IF you should lose your job for any reason, go straight to a hospital and not home.

Pls go over this w/ another expert.  I haven't enough ideas to really help.

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

QUESTION: I am only aware of my behaviors after I am told of them.  I barely remember anything i say or do like I blackout.  Some of my  behaviors are probably not due my bipolar but most of them are.  thanks for answering me back.

Answer
Then you are doubtless bipolar.

Are there any free clinics near you?  They probably won't have a psychiatrist, but often can fill psych Rxs.........and might be able to assist you in connecting w/ a psychiatrist who would see you once, at least.

How long ago did you see the doc who prescribed?  MIght he agree to see you again.....take partial payment, or string them out?

Call the pastoral office where you were hospitalized.  Ask them to help you think of sources of help.

You have no health ins?  Do you have paid sick-leave at work, unused????  We could get you into a hosp perhaps?  

Here, I'm afraid, is what needs to happen:  you need treatment and you earn too much to get any help w/ costs.  So - you need to get treatment, lose your job, apply for disability....maybe work again when you are better.

For lack of a better source of instant info: contact your state NAMI office [nami.org] and talk to someone employed there, not a volunteer.  Ask if they can refer you to any atty who has exp w/ disability who might help you to get your job held while some of this goes on.  

Get anyone to help you learn the ropes really fast on what those w/o income do -- where are the services, how to connect w/ them.  At the very least, your wife and children can get health care and food stamps....maybe food stamps for all.  Look under Human Services in the yellow pages and call one and all.  

Call your county ministerial assoc, or the state office for your church.....see  how they can help.

Get someone, anyone who cares about your family, to do some of this calling and legwork for you.  BE sure they, or you, keep track of:  agency called, person spoken to [name], phone and/or email, info obtained.

You are very sick, and that's why this isn't going to stay afloat much longer......

Where is your nearest community mental health center?  Go there for an free intake appt.  Find the two nearest by going to samhsa.gov.  Enter zip, they will give you two.