Expert: Libby Bonner - 8/15/2004

Question
I am in the army and stationed in Korea without my family. Last October my wife called me to tell me she slept with another man. I told her it was over and she tried to commit suicide. She was subsequently diagnosed Bi-Polar. I tried to deal with this and help her, but until they got her meds right, dealing with her was like a rollercoaster! She tried suicide one more time, in May of this year. I love her and don't want to be away from my kids, but don't know if I can deal with this thing that she has. She claims it was the disorder that made her cheat on me, but she took her ring off before she got into bed with him so that tells me she knew what she was doing and that it was wrong. Am I wrong for being scared of this disorder and that something like this will happen again? Can you direct me to an online chat/support group for people like me to help with answers and questions I have? I would appreciate any help you can provide. Since October, my seemingly perfect marraige has been turned upside down and I can't make sense of much.

Answer
[There is a new PS stuck on at bottom -- scroll!]

Dear Sean - Bipolar = Rollercoaster.  That's a pretty good one-word definition.  But - she seems to be stable on current meds?  Things may be getting better.

There are a lot of issues and information needs here.  Hard to know where to begin.  Let's get sex out of the way first.  [It WAS the disorder that made her do it.  True.] On the manic side of bipolar disorder, you can be hypomanic, manic, or have manic psychosis, hypomania being the mildest but a sure sign that things are going off the rails.  Probably the hypomanic person will feel less inhibited and more gregarious....which could lead to her BEING more attractive to others, not necessarily seeking someone out, AND, unlike the manic - who is too far gone to care - w/ enough of her 'real' self intact to have the notion to take off the ring.  That's actually pretty good news and sounds to me like your wife loves you and means to be faithful to you.

But now, let's talk about mental illness.  [Your wife, by the way, has a serious chronic illness....which probably will remit and relapse to some extent but can be fairly well controlled w/ meds.]  Unfortunately for everyone, the symptoms of the serious mental illnesses are disorders of thought, mood, and behavior. The cause is brain chemistry that becomes faulty...for reasons yet unknown.  [In case I forget later:  stress, even mild stress, is tough on people w/ mental illnesses, even those doing well on meds.  So it's important to try to limit stress, and watch out for signs that unavoidable small or large stressors are not tipping someone out of balance - time then to reduce stressors and/or make med changes.]

So now we have disorders of thought, mood and behavior.  These symptoms are most definitely NOT under the control of the ill person - they are the symptoms that indicate the person IS ill.  The problem - for spouses, families - is that the moods may change fast and you get that great rollercoaster ride [sometimes it doesn't feel good to them either, not being able to depend on who/how they are], but sometimes it leads to really hurtful things being said - that the patient, if well, would neither be thinking nor saying.  THAT is the big problem for families - telling yourself and, hopefully someday believing, that this dreadful stuff is the illness and not the words of the 'real' person.

Some concerns.  Who can help w/ your children whenever your wife is awfully sick?  Does SHE have any support group available to her?  She/you could check www.nami.org to look for an affiliate; she could get much support from other 'consumers,' NAMI-speak for patients. Does she live near either of your families?  Getting them, and you, all on the same page is terribly important.  You don't want anybody aboard who can't buy into the reality of her having a serious illness.  Anyone who wants to blame either of you for anything should butt out for awhile.  And welcome anyone into your larger support group who is willing to understand mental illness, or get active in NAMI.  As soon as you are able, it will be a big help to take the free NAMI class, Family to Family.

I hope you will get, immediately, a book by Woolis called When someone you love has a mental illness.  There is a new edition out and sellers seem confused about which is which - don't worry.  Either edition will give you what you need, which is a successful way to communicate w/ your wife that 1] leaves you feeling less helpless and 2] makes your communication more effective and less likely to be accidentally damaging.

Gotta get the Woolis book.

These sites have info on mental illnesses.  www.nami.org   www.mentalhealth.com   I wonder if you have a psychiatrist available to you, who could take some time to describe bipolar and its symptoms and treatment w/ you.  I have spent some time online and I can't find any good support group to recommend to you.  My only other thought is to ask the psychiatrist and/or a chaplain whether they could start a NAMI group there.  The people you know and work w/ may have a spouse w/ a mental illness - but that same group definitely has people w/ siblings, parents, and other relatives w/ mental illnesses.  To the extent that these relationships/illnesses are still a mystery and/or problem to them, they might very much welcome the opportunity to be within a NAMI group, sharing experiences and problems [and successes, even.]

What to do right now.  I would assume that the marriage and family are worth saving and are very saveable.  I would limit, right now - and until you get the Woolis book - communications w/ your wife that have typically ended badly.  If phone calls almost always go bad,  give up phone calls for a bit, saying just that they've been leaving you both feeling bad, but that you'll still email, or whatever.   Bottom line: don't make things worse right now.  Stick to what works OK and give up the rest.   Do try to start again from RIGHT NOW and go forward.

Try in your heart to get rid of blame. Very hard w/ mental disorders, since the symptoms are mood, thoughts, behavior.  But start w/ your head, not your heart, and realize that you would never blame someone for their heart attack, or for the insulin reaction that made them pass out in a public place, or for having to walk slowly with someong because of their congestive heart failure.

But - w/ good med control you aren't going to have to do a lot of that in the future - excusing behavior and words - if the right meds in the right doses are in place.  More on that another time - tweaking the meds goes w/ the territory.  It's an ongoing thing; unusual to get it right and it just stays rght, forever.

And last - your wife's illness is relatively recent and her brain and central nervous system are still doing some healing from this major assault, the onset of the illness.  Some behaviors that linger and seem odd may gradually disappear.  Other small changes may always be there....just mild personality changes, nothing scary -- but enough that she may not be 'exactly' the very person you left.

Also - the very last - your return home will be a BIG stressor.  Good AND bad stuff can be stressors.  Try NOT to have the whole family [everyone] there, try to keep it kind of private and low key in the first days.  Make sure her psychiatrist knows when you will return and that the doc and she have discussed how that might affect her.  -- I'm hoping that your return will not be tied directly and immediately to a change of residence/location......way stressful.  You'll need to plan these things carefully, ask for help from others, not expect all the strength or resilience from her that you might once have.

Probably will be writing a PS if something else occurs to me.  Pls do write again while we get this sorted out.  I'm so glad you wrote....   [Throw the sex thing away as soon as you are able and DON'T re-hash w/ your wife: it had
N-O-T-H-I-N-G to do w/ you.  Truly, truly.]

Well - PS already.  There is an international group that deals w/ mental illness.  All mental illnesses, despite
their name: www.world-schizophrenia.org  I would definitely contact them to see if there is anyone where you are who could help you start a support group.  Or they may have online support.  Forgot to check them earlier.  But they are an excellent group, Canada-based.

And another PS.  Definitely, before you go home, let's talk about Psychiatric Advance Directives.  Also about getting a release signed so that you and the psychiatrist can exchange info about symptoms, meds, etc.  Big big privacy walls here that wouldn't be there if we were talking gall bladders.....