Expert: Libby Bonner - 8/30/2006

Question
My husband is on absolutely no meds. He took himself off cymbalta. He has tried several others with bad results. He feels that because he is super human that he can deal with this without meds. I will admit that he did a "healing" on himself and his headaches, anxiety,stomach pains and nausea disappeared instantly. But that's the same time he went off his meds. However most of those physical symptoms were present BEFORE he started taking them, they had been becoming increasingly worse.

Actually, unless he is having a full scale episode, he can convince anyone he is totally sane and very smart. That is unless you know him well.

But when he goes completely off he does not try to hide it. He has freaked out most of our close friends and my family members. The frustrating part is that he can act totally normal around the neighbor, come home, and go off into his fantasy world on me. I suppose it is because he knows he can. That's the part where I was wondering, if he has that much control, why does he not control it when he is around me?

I continue to research and talk. I have extended family who is a psycologist. My husbands entire family is on the same page as I am, but we are all at a loss...-------------------------

Followup To

Question -
My husband is diagnosed bipolar. I think that he has other conditions as well such as ocd, some schizophrenia, anger problems, etc. Not sure I know the difference any more. I could wright a book. Anyhow, mostly he is just irritable or complaining. Can't make plans, puts everything off until tomorrow then tomorrow never comes. Forgets everything except the things he is really into which he focuses on to the point of no sleep. But the biggest problem on a day to day basis is his anger. Every little thing, sometimes things I don't even see coming.  If something bothers him he will obsess about it all day, can talk about nothing else, gets himself all worked up...... Spends his entire life on the computer, delving into every little nook and cranny obsessively for days on end, arranging and
rearranging things. He thinks he is super human and no one is as smart and talented as he is. He has to have total silence when he first gets up. He thinks he channels a spirit from biblical times. Sometimes it talks to him and he talks back, sometimes he talks about himself like he is not even in the room. And then sometimes he is perfectly normal. He changes personalities like some folks change their clothes except more often. I never know what today will bring.

The worst part of the mania and accompanying depression is cyclical, about twice a month for at least a week to two weeks. Sometimes all he wants to do is argue. Anyhow, he has decided to try to get along without meds. Can't change his mind!

What I want to know is just how much of this he REALLY can't help and how much should he actually try to take responsibility for. The Anger and arguing is the biggest ongoing problem and I wish that there was something that could be done to make this stop or at least lessen. Is he capable of training himself thru discipline not to go off the handle over every little thing?  Or is this too much to ask?

Answer -
He really can't help ANY of it - and if he is on any meds at all, I have no idea what symptoms they are controlling.  I wonder if he takes his meds.

You have described [I would have guessed] an unmedicated rapid-cycling bipolar patient w/ delusions and possibly occasional psychosis.  And moreover, someone who is very very sick.

Stop arguing w/ this guy.  This book will save your own sanity.  BUY a copy.  DON'T share w/ him to 'prove' he is sick/wrond and that you are right: just use the book, and your stress and arguments will decrease.  Author is Woolis and title is When someone you love has a mental illness.

You can also reduce arguing - maybe Woolis says this - by just saying "Umm" to his nuttier talk....it shows that you heard him but doesn't carry the conversation forward.

Also, don't bother to spend time arguing w/ him about whether or not he is sick.  Waste of time.  You are rational.  He is not.

Pls try to get w/ your local NAMI group and definitely go to their separate support group meetings if they have them.  www.nami.org

I hope that you can arrange, w/ him, w/ his doctor, to go w/ him to some of his next appts.  [I wonder if he is keeping his apppts.]  You can become acquainted w/ some of his meds - which are being given for what - and you will probably provide some info that the patient forgets to say.

Get the book.  Try to see that he actually goes to appts.  Try to find out whether he takes meds and what meds.  Stay out of the fights if you can.

Every single thing he does and says is illness behavior, even things like thinking he is super human.  It isn't clear to me - from what you say - that he is ever rational, ever able to be rational.   There is NO doctor, even a family doc, who would not know this by spending 5 minutes w/ him.  As I said, whether he takes meds or goes to appts is a mystery to me.  [I hope he is being, or will be, treated by a psychiatrist.]

Write again if I can help.  

Answer
When he goes off completely he does not ty to hide it -- because he couldn't possibly hide it.   [As you imply, tho, and I failed to note, when not as sick they can briefly present another side to others, for short periods.]

There is no research to be done:  he needs psychiatric care.  You can consider legal solutions, possibly, but researching and talking only delay his treatment.

Your very biggest problem is the same as everyone's:  how to get him into care.  That's where an atty or the courts can maybe help.

Pls get the book by Woolis.  It is the best help you could have whether or not someone is on meds.