Expert: Ivan Goldberg, M.D. - 5/23/2003

Question
My husband has been in and out of therapy, on and off medication for almost 4 years now after an initial dx of bipolar disorder.  His cycles last about 3-4 months, usually culminating in me leaving with the kids after being threatened verbally.  The last time, in February, he admitted himself to the psych unit where he works after I kicked him out.(He's an RN)  This time he's taking Wellbutrin 100mg BID.  I get so frustrated, though, because I feel so hopeful in the beginning because his general behavior is better and we connect, but after several weeks when he starts "talking out", like saying sexual things in front of the kids, singing repetitively, and being extremely irritable, I lose hope and feel betrayed.  I honestly don't think I can live like this the rest of my life.  Our five year old daughter begs me not to leave the house because she's unsure of Daddy's behavior.  "He yells alot", she says, when I'm gone.  Last time I wanted him out of the house for several months to a year so there could be measurable changes that could be seen before he came back.  He manipulated himself back in after two weeks.  I fear him when he gets bad and my philosophy has become "keep your friends close, but your enemies closer".  My husband has become my enemy.  His current therapist wanted to see both of us last week.  Chris cancelled the appointment and has yet to reschedule.  I'm in counselling myself as well as a recovery group for my own issues.  What advice can you offer me?  I'm seriously considering divorce.

Answer
Hi . . .

If your husband is truly within the bipolar spectrum, he should be in a mood stabilizer such as lithium, Tegretol, Depakote, Trileptal or Lamictal.  Espepcially with the last of those, antidepressants, which are dangerous for people with Bipolar Disorder to take, can often be avoided.

To learn more about Bipolar Disorder please see:

http://www.psycom.net/depression.central.bipolar.html

I think it is important for you to meet, along with your husband, with the psychiatrist who is prescribing his medications.

Best regards . . .

Ivan
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