Expert: Libby Bonner - 9/26/2007

Question
QUESTION:  My wife and I have been married for 26 years now. She was diagnosed with bipolar disorder at the age of 16 and she is now 47. Her depression seems to have gotten worse over the last few years. She goes from one mood to another in a matter of hours some days. Mostly now it is a consistent two week low with me being the cause of everything. She can go to love making one day, to, I want a divorce the next day. She used to take only Litium, but now she takes both Litium and Lamictal. She gets free psychiatric treatment and counseling which I think are 80% worthless. Her depression is very bad, and just blames me for all her inadequacies as she is a procrastinator and I am not, I am detailed oriented and she is not, etc. I try to help her, she lies to the doctors and councilor sometimes, and is a great actress. she told me today that she gets nervous when she is around me. What is next as I am really tired of this and it is effecting my health also. I just do not see why someone does not have the desire to help themselves. Meaning her. Is this common to blame / hate your spouse when chronic depression takes over. She acts like a child of 12 years old.

ANSWER: Again, any hope of a private psychiatrist?

She is still pretty sick, it would seem; I can see why both of you have lost hope. Pls do connect w/ NAMI and PLS DO get the book.  Both will [I promise] change both your lives.



Your question needs hours of answers, but this will have to be the shorter version.  I certainly would urge you to get connected w/ a NAMI group, www.nami.org, and esp to attend any family support that they offer. Also their indispensable class, Family to Family - 12 weeks, free, excellent.

Adding the Lamictal was a good move.  Maybe she could benefit from a higher dose?  Are you able to go w/ her to any appts?  That can be a huge help to all three of you.

Meds.  Could be also that she would benefit from adding a med like Zyprexa - but I'm not a doc.

How is it that she gets free care?  Medicaid?  Could she see a private doctor???  Usually private docs can see patients oftener, esp when meds or med doses are changed, which can be very helpful.

She is a procastinator because she has depression.  She CAN'T help herself - that's depression also.  It's not that she wouldn't wish to help herself.  Lying, acting -- all can be part of the territory.  Long story.

Bipolar depression is treated w/ different meds than 'regular' depression, but the symptoms are much the same.  Do you have good info on her illness?  I hope you know that mental illnesses are disorders of thoughts, moods, and behaviors -- and, like the symptoms in medical illnesses, they are outside the control of the patient.

I suspect that your wife has PMS, maybe always has had?? but that it is worse now.  Possibly that's because she is likely, given her age, in 'perimenopause,'  the years before menopause.  A visit to a gynecologist might be in order, to check hormone levels and to see if anything can be done to level them out.

Until and unless you can get to NAMI, and if you want stay in this marriage in a more peaceful, satisfactory way, please do buy the book by Woolis called When someone you love has a mental illness.  You will feel more in control of things, and will have much better ways of truly helping your wife, and of communicating w/ her successfully.  

Please do get it as soon as you can - it has helped tens of thousands of people.  And it will help you.

Pls write again any time.

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

QUESTION: Hi Libby;
    Thanks for your reply as it was helpful. Well, my wife went shopping yesterday, then to my daughters and Grandsons house, what else as this is her escape for me and this house. She said she would be right back and never did. I called as I was worried and she said she was going to stay at my daughters house, but will come home to get her meds, then go back. She walked in the door rather "happy" laughing unusual like, got her meds, a few cloths, and left. She seemed to me to be somewhat in a manic stage. I just do not know which direction to go from here. Thanks. I did forward your reply to my daughter, and my wifes sisters so they might have a better understanding of what is going on, I surely do not at this stage. Thanks again.

Answer
Thanks for writing again.

This can smooth out some, or even a great deal, it really can.  I am mainly concerned w/ your stress level right now.
If you can't find a NAMI group - your very, very best bet, and worth traveling to, if necessary - then you MUST have the Woolis book.  MUST have it.

I am wondering as well if you have any way to change your  routine a little - can you take a day off now and then, but not say so at home and just go somewhere for the day?  A park?  Fishing?  The library?  Anywhere to just chill in a good way for a bit.

My other suggestion will be tough to do, w/ your wife unwell and you pretty stressed - BUT - you can help yourself considerably if you can do a little mind thing w/ yourself.  If you could allow your wife to BE sick, and not 'grade' her behavior, and not pursue negative stuff that she starts, and not start any yourself, you'd be amazed at how the stress level could fall.  

Probably you are too close to it to do it now....I just wish you could take a break somehow.

Botttom line:  The Woolis book, read and re-read, plus the question, always, of "how much does this matter, REALLY?" will change your life.  Your wife is sick and will probably never behave as you would wish....but she is not thwarting you for a reason, she is behaving as her illness directs her to.   

I would hope that some tinkering w/ meds could help some, or maybe a good bit.  

The other factor operating, tho, is the length of her illness and the length of time that she may have been under-treated [mostly because not much was known about the brain until quite recently]- this itself will have caused some damage over the years.  I am seeing this now w/ my daughter, who does have proper meds and doses, finally.  But too much time elapsed when she was really pretty sick, and undertreated, and it finally catches up.....nothing, now, could take her to where she was even 5 years ago.  I give you all credit for a long marriage that has been difficult, so I am not criticizing, just stating:  it may be, even if she were to reach whatever her max wellness might be, that a good bit of compassion would be needed....and a good bit of making allowances.  That's what's happening here, w/ us.

But a marriage is far trickier, and much more difficult.  I offer you my admiration and my hope for a better outcome for both of you than your current situation.