Expert: Libby Bonner - 10/3/2007

Question
My husband is just turning 33 and was diagnosed with bipolar II about 5 years ago.  At that time he was on trileptol and an antidepresent but things were good for only about a year and started a slow decline.  About a year and a half ago, he returned to a previous addiction to ephedrine, starting out using occasionally at first and then from Dec to early April, began using heavily.  During that time, he also turned heavily to porn and mastrubation.  Our sex life has always ebbed and flowed but almost came to a total halt during that time.  Once I had things in place, I confronted him and he got help.  His meds have been changed to prozac and depekote and he seems to be improving slowly.  He still has trouble forgiving himself for what he put me and the children through and for his actions and he is seeing a therapist again.  My question is how do I get past my own hurt and not feel that he turned to things like porn because I wasn't good enough,etc (verbal abuse has crushed me and this only made it worse) and how do I help him to forgive himself so that we can move forward?  Our sex life has shown little improvement but some and our communication has greatly improved.  I'm so afraid this had damaged our relationship to much and am looking for any help I can get.  Thank you

Answer
I may not be your best expert....but I can make some observations, ask some questions.

You are quite sure this is bipolar II, mainly depression, no manic episodes?  I am surprised to hear of so much sexual behavior w II.

I wonder if he has a private doctor or uses a public clinic.  Also, how often he is seen?  When was he last seen and were any med changes made at that time?  Do you know that he takes meds as directed?  The verbal abuse of which you write related to sex or to many of your attributes?  

For all your questions about forgiveness....it would seem that you both need to have joint therapy [tho sometimes the therapist might see only one of you for part of the appt] to resolve those issues.  Or you might consider separate therapy for yourself, initially, and then go, as a couple, to a new therapist.

The only thing I can add is that mentally ill patients do and say terrible things to loved ones during times when their illness is at its worst.  Those ARE the symptoms of the disorders:  thoughts, mood, behaviors different from what the patient would choose when well, and behaviors, etc., not under the patient's control.

From that standpoint, your husband's apologies and remorse should be directed to having gone off his meds, thus allowing himself to get sick and abusive....and the best route to new self-esteem is to promise his family that he will try his best to keep doctor's appts and to take meds.

Being a spouse whose ill husband has handed her a lousy self-image.....that's harder: even if you know in your head that you're hearing symptoms that may not be his true beliefs, your gut feels very different..and it's very very hard to not remember the terrible words.  For that reason, I really would suggest that you consider therapy.

It may help you both to know more about mental illness.  See www.nami.org.  There is info at the site, and also a list of local affiliates.  Yours may have programs for famiies and for patients [consumers in NAMIspeak.]  That would be a good avenue of continuing help for your family.

I would try to get the kids past this as fast as you can - unless one or more needs counseling, which might be available at school?   If there are still family discussions about "what Daddy did/said," it's probably time to just stick w/ the formula that it was a bad time when Daddy was so sick; that it scared everyone, even Daddy; that Daddy is getting better with medicine; that we hope the medicine will help him get better and better.  One talk like that...and then go on w/ family life, in the children's presence, even tho the two of you may continue to be having private dialogue.  -- but of course leaving this a a topic that any child can bring up again if he gets worried or scared about it....But let them get past it.

Hope this will be a help.  Do try other online or local sources.  Good luck to you and your family.