Expert: Libby Bonner - 11/19/2006

Question
I am trying to make sense of this but it is very difficult.
how do you know which actions are hers and which is the disease. My wife has always been very manipulative, controlling as well as explosive over the years. We have been married for 17 years. My wife is 35 years old she was diagnosed with bi-polar 3-4 years ago but she never told me, I thought it was simply depression. She would always try to hurt herself.
10 years ago after I found out she cheated on me she tried to overdose on pills and had her stomach pumped.
5 years ago her grandpa died and she became very moody and on one of those moods she tried to cut herself and I called 911. She was Baker acted (which means she was placed in a mental hospital for a few days) This is when she was diagnosed but no-one told me. When she was relesead she became very abusive and told me that she would make me pay for sending her there (although I didn't know that is what would happen at the time). She was taken to jail for domestic violence twice. We have 2 kids which had to go thru this and are still dealing with this. We live apart. She has been unfaithful and has had men around her in front of our boys while we were apart one of them lived with her (I didn't know this at the time). I can see now that she is sick but at the same time when is it her and when is it the illness. I tried to go back with her earlier this year because she was sick and my youngest still wanted a family. That was a BIG mistake.
She is taking medication but she abuses the meds as well as drinks alcohol with them at times. I try to understand her illness but she does things that are hurtful to me and the boys. I try calling her mother but even she doesn't want to deal with her moods. Is there a point of no return and does that mean this is who she is ?

Answer
I'm terribly sorry about all the hurt and confusion that you describe.

Let me start by trying to sort out some of the confusion, and then I'll go on to offer some thoughts.

From what you describe, I suspect that she has been ill for some time - years - before being diagnosed.  I also suspect that she has more than one diagnosis, esp w/ regard to trying to hurt herself, which is not at all a usual feature of bipolar illness.

No one told you her diagnosis because she is an adult and had a pychiatric diagnosis [one or more.]  If she had any other serious illness, the doc would freely discuss it w/ you, but there is a huge privacy wall that only goes up w/ mental illnesses....and it is horribly confusing and vexing to others in the family.  You can only be brought into this if and when she becomes well enough to see some benefit [to the children, for instance] in agreeing to a "release of information" to you [BUT she could revoke that at any time.]

Most, but not all, of the meds that are used most often for bipolar are not usually abused by patients because there is no high or any other result from taking extra.  MOST of their meds. So I am uncertain whether/how she abuses her meds.  I also think, tho patients are told not to drink w/ the meds, that probably very moderate social drinking likely leads to no or little harm most of the time.  Just a layman's opinion.

Now we get to my thoughts.  Right now, she does appear to be quite ill and, yes, the behavior and abusiveness, the sexual indiscretions, all are illness symptoms....and, right now, they are "who she is."  [Remember that mental illnesses are characterized as being disordered thoughts, moods, and behaviors that are caused by brain chemistry that stops working right.]  

Your description leads me to think that:  she is perhaps not taking all of her meds, all of the time; or that she perhaps needs different meds, or additional med or meds, or different doses of one or more that she now has.  BUT I am also pretty convinced that, depending on her second  diagnosis, it is likely harder to treat, and maybe not as easy to treat w/ meds alone.   {Not that treating bipolar is easy.  It can be terribly difficult and challenging, and not everyone, regardless of how carefully medicated, will lose most, or many, of their symptoms; some could remain quite ill.]

IF your wife's only contact w/ "providers" is to see a doc from time to time, I can't be too encouraging about improvement because: she seems to need a meds adjustment that she maybe isn't getting [it may be that she is convincing when w/ the doctor and claims to be functioning well] - and - or - she is ONLY seeing a doc, and may be not getting the social services that a community mental health center could provide....including the sorts of classes or training that might help her w/ any diagnosis where medicine is not enough, or one where no adequate medicine is exists.

I am assuming that, at this time, both children are in your custody?  I wish I had, right now, a list of books for children, about mental illness.  I don't, but if you have access to a library of any size, they could show you what they have available.  Or you could go to amazon.com to see what books are available for chilren, and see how they are rated by reviewers and readers....and you could purchase some OR then go to the library to look for the ones you like.   ---  I wonder if you have any source of family counseling for the children? that maybe would sometimes include you as well.

Things that you can do on your own to aid your own healing, or to help you in the necessary contacts you maybe still have with her, because of the chilren.  One would be to start attending the nearest NAMI affiliate [www.nami.org] and certainly to go to their family support group, if there is one locally or nearby.  Everyone there will understand your story and help you to understand it....and they will always be there to talk over new problems, or to help you plan necessary contacts w/ her - how best to handle contacts, etc.   You may also want to see if the free NAMI Family to Family class is offered near you.  

To guide you in communicating w/ her, I would so strongly urge you to buy, not borrow, a copy of the latest edition of a book by Woolis, called When someone you love has a mental illness.  You will feel less confused and powerless after reading it, and can use it forever as a guide in dealing w/ her.  I can personally testify to its tremendous usefulness to family members.   And it will diminish so much her ability to hurt you:  you will understand many things better; and you will also find ways to speak w/ her [or know when not to] so that simple transactions stay simple and don't immediately escalate and get completely out of your control.

As I said earlier, she sounds mighty sick to me.  BUT her horrible behavior IS the illness and, though all that abuse and anger are directed, seemingly, to you, they are NOT really about you, or about anything that is real and rational.  However, knowing that is not necessarily the same as really believing it for yourself.  AND, if you do get to where you do really BELIEVE it, hurtful words do always hurt....whether there is intention or whether there is illness causing them.

And so I would do what I could to minimize the kind and amount of contacts you have w/ her.  About your children - I don't know.  I am thinking of things like asking a court that she only have supervised day visits, no overnights...for instance.  But I myself would certainly not want to be the person doing that supervising.  AND if the person supervising were required to report honestly to a court, perhaps, it could cause her to lose all visiting privileges, which is perhaps NOT an outcome that you think is desirable from one or more child's standpoint.  SO - I think I would, myself, want the advice of someone else - someone who might be counseling you - about the pros and cons of altering visitation... and about whether damage to your children appears to be ongoing.

I hope you will write back for clarification on any of my remarks, or w/ any new information, or any new questions.  I am most heartily sorry that your poor family has been so battered, and I will hope that something happens to bring your wife to a better state of health.