Expert: Libby Bonner - 12/7/2006

Question
Thank you for your reply... I was pretty upset and your words calmed the beast.

You mention your husband/family... did your marriage last?  

My husband is home now-- it took three weeks for a break in his behavior.  The true culprit at this time is the paranoid state he seems to be constantly in and knowing how to behave myself.  This is my problem;I feel like we walk on eggshells.  If I had the NAMI support group it might give insight on how I can react to some of his actions.   How do you know how to react-- I read books, but it does not give information on how to treat the BP or react to them; this is an ongoing problem.

Although I was angry-- it has been my goal to support my husband.  That is why I am so angry with the medical treatment he recieved. I wish I had someone by my side during the breakdown.  When he was first diagnosed with BP the psychiatrists seemed ill prepared for the paranoia. I would have done anything to at least be pointed me in a direction to recieve help for our family.  We were both being seen. During visits (myself alone)I spoke with them and they actually told me several times to forget him and leave. Is that practice, or were they preparing me?  I don't know.

I mentioned several times that I wanted to be apart of his treatment, but when I say they shut me out, I am quite serious. They continued to tell me to worry about my sons; to focus on them and not his own children, and if it came time to leave--Just leave them too.  Several times, I almost did leave, but again the children (our family as a whole) brought me to realise that this was hurting us all. His children were even more fearful than I; they thought he might abandon them, because of his actions 6 months prior to the meltdown. I was ill prepared to handle this-- Never once did they tell me about NAMI, refer me to a therapist for our family (one that would have BP or mental illness information or knowledge). The only things that kept me there, were his two sons that were as confused as myself.  His family never stepped in, nor did the doctors.  It baffles me.  But then-- now knowing what I do, his family just thought it bad behavior (I guess). Being the spouse meant nothing and in reality-- the outcome and the lack of knowledge almost sent me over the edge myself.

I contacted NAMI (trust me that was the first Org. I contacted after a long hard internet research), unfortunately there is nothing close or far other than a 3 hour drive.  My next route is looking for a good counselor for "us", one that is educated in BP + mental illness.  We were in marriage counseling, but in retrospect-- the therapsit was treating a mid life crisis, how could anyone  help us as a couple, if one did not know what was truly going on.

I will continue to ask--or read, read, and read more until we have either a good safety plan/therapist, or this relation is something that is not workable. I wish I would have found these pages 8 months ago!

Thanks again for your support.

Ann
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The text above is a follow-up to ...

-----Question-----
After being shut out of the initial stages of treatment I am very skeptical of my husbands treating Psychiatrist. However, he wants to keep seeing him because although he feels not sure of him himself, he thinks he should =give him a fare shake. It was during my husbands first melt down and after only 3 years of marriage did I start questioning if he might be Bipolar.  At first they were treating it as stress related and when my husband told his doctor that I mentioned bipolar, that is when they started treatment.

When he had a meltdown and was finally seriously treated. However, because my husband became paranoid, I was totally shut out by the doctor because he said my husband had a problem with me-- (He would not discuss the problem, only that he did not trust me, and then he told my husband that I might have a problem.  It gets better--but then this would become a book rather than a question.

Regardless, I was left in charge of a combined family (his and mine) and left to care for his natural children while in treatment.  Not once did the doctor involve me. I was never allotted a time of release, nor allowed to visit.  Although my husband did call home, he would not give me any information to tell the children, because the doctor would not tell him.

My actual question is this--During the initial stages he had an affair-- Since I have not been involved in treatment, I only know what I have read and researched regarding the infidelity.  I am very concerned about the infidelity because of what I have seen in the past years and , husbands background and because he suffers from low self esteem (that is my assumption only).  

What do I do?  Are marriages that impossible for a BP person?  I also have friends who are BP, but I have never seen them treated like my husband psychiatrist has done, by uninvolving the partner.  Who better knows a BP than the one living with them?

Financially, he also put everything under his name.  In the beginning I thought it endearing-- now I find it frightening. I also learned from hardship that this must change and it is.  For two weeks it became a nightmare thanks to the doctor. I wish I could turn this doctor into the proper authorities, because in fact I do not believe that he had any prior experience and any good doctor would know his limitations and not see the patient as a $$. This doctor should have referred my husband to a doctor who had more experience.  If so, our marriage might not be so far gone.  I do not trust my husband nor his doctors advice.  

IT is horribly frightening to imagine that you loved one can be taken under by the influence of a doctor.
-----Answer-----
Been there, done that, including the children.

I will touch on several of your remarks, but better help is, I hope, at hand where you live:  you MUST make every effort to get w/ a NAMI family support group immediately.  Worth some travel time, if necessary.  Not all NAMI chapters are terrific; smaller ones may not have support function, formally.  But go.  Go anyway.  www.nami.org  

You have arrived at the exact point where you might be expected to by now:  not trusting your husband, not trusting the doc’s advice, barely afloat emotionally, bewildered, shut out, ignored, angry.  Wondering.

More than you believe now [and, trust me, I prayed for many years for my husband’s doc’s death, preferably in some hideous manner], it ain’t the doc, probably.  It is:  the nature of psychiatric illness; the family fall-out from/during hospitalization; and the PRIVACY wall that goes up exclusively in psych situations.    [And/but:  even were it not for the above, things go badly asunder if the patient becomes paranoid.  The doc, who may even have been slightly forthcoming w/ you to that point, cannot and must not share info now….the paranoia will increase if, for instance, you quote to your paranoid husband something the doc shared w/ you, no matter how innocent.]

I am relieved to hear that you are getting a handle on financial matters.  That is, one way or the other, ALWAYS a likely problem w/ bipolar.   [But I am unclear of what the nature of any $$ malfeasance on the doctor’s part was….]

I would guess that if you had a transcript of every word spoken by and to your husband [by anyone] since his hospitalization, many of your beliefs about the doc’s competence would fall away.   Your husband is an in-patient for a reason, and rationality and honesty are not his strong suites right now.  [Are there bad docs?  Of course….but we have no good way to judge him now, perhaps…..we lack info.]

Now.  As to your husband’s calls.  You need a very high index of suspicion  -- things that he reports to you and honestly believes to be true may or may not be. You must take everything he reports w/ an enormous grain of salt.   Maybe the doc does or doesn’t tell him things.  We have no way to know.   --  And, because he is now paranoid, he will conceal, more than usually w/ this illness/situation, info of all sorts, trivial info even.

Among the things we may not know now are your husband’s diagnosis or diagnoses.  It/they could be changing under the 24/7 scrutiny of staff, at a time when he is displaying a lot of symptoms.  So – more could be going on than bipolar, or bipolar may be sliding out of favor altogether as a diagnosis.

And….the kicker…..unless your husband signs a release of information, you will have no access to the doc, to info.  WHEN your husband is better and IF you want a continued relationship, THEN it is possible he will sign a release.    

Now, the infidelity.  Goes w/ the territory, has nothing to do w/ you.  Hyper-sexuality and sexual indiscretions are almost diagnostic of bipolar disorder.  If/when his disorder is stabilized, [but not knowing your husband] it likely will not recur.

I’m not there, and have only the feelings and words you chose to share, my own personal experience, and my long experience facilitating NAMI support groups….BUT…
and even allowing for the nightmare of this hospitalization…… your marriage would likely be “this far gone” regardless….or well on it’s way……because mental illness takes such a huge toll on one-to-one relationships.

Are marriages possible w/ BP?  [Or, “that impossible?”]  Depends.  Depends on how much effort the well person makes to understand the illness, and to make necessary accommodations to it.  Depends on how much of a recovery the pt makes [usually a better one if the illness comes later in life, as seems to be your case.]  Depends on the pt’s willingness to adhere to taking meds, or doing other prescribed activities [cognitive therapy, maybe.]  Depends on how much emotional energy you each can muster…or how soon you can.  Depends on your level of commitment to each other at the last times when things went well.  Depends on the children’s needs.

An almost-last thought.  Your husband is quite likely – insurance, and the nature of recovery – to be discharged in quite a fragile state and w/ a good amount of recovery [and meds tinkering] still ahead before anything like real stability reigns.  You need to know that it’s unlikely that you will be able to address Issues for some time [a good long while]….they must be put on hold….and then maybe brought up in the presence of a good counselor.  There are no options here:  he is incapable of undergoing the stress of Issues discussions now, and may be even not thinking clearly enough to have a valid discussion about issues….and is likely has some memory impairments:  he may honestly not recall some of the things that have caused you the greatest pain.  [He is also probably adjusting to a fairly heavy-duty meds load, and to meds side-effects.]

Among the things that will help you both to heal is to try, in every way you can, to stop blaming your husband.  [I know.  I really do.]  He is, and has been for some time, terribly ill…..and most of the things for which you blame him – and certainly I am NOT blaming you – were/are illness symptoms and not chosen behavior.   This is the crux of continued successful interaction w/ someone w/ a serious and persistent mental illness:  knowing AND believing that the disordered thoughts, moods, and behavior ARE the  illness symptoms.   It takes a tremendous amount of faith and hope and determination – and luck – to Get It……Getting It is THE toughest part for loved ones.  Could take you months/years…. You could Get It and then wobble w/ events and lose it and Get It again.   It’s hard.

I hope you will try to find and get seen by a very very good therapist ASAP…so that you can vent, so someone can maybe help you decide What Next.   And please, should you decide to stick around, or decide to stay and see how things go, rush out and take the free NAMI classes [12 wks], Family to Family.  Could be the decider.

Shining forever lesson:  it’s [his behavior] really, truly not about you.  [But being on the receiving end of a lot of bad behavior still feels like heck, even if you Get It…something we discussed in support two weeks ago.]

Good luck.  Maybe let the answering machine take his calls for 24 hrs.  Give yourself tomorrow off.  Take some time from work if you can.  Do something to soothe your soul.  Try, if you can, to get some help w/ active mothering…. I would love to have you able to get away for a couple days, even if it’s to a local motel.

And, if you are there when he is released, do not plan a big celebration, or have other than family present - unless he has strong feelings otherwise.  Everything low key, especially expectations:  have none, for awhile.  Look and listen.

If you want to get a head start on doing well w/ someone fragile, buy a copy of the book by Woolis called When someone you love has a mental illness.  Lifesaver.


Answer
Get, please, get - buy - the book by Woolis, When someone you love has a mental illness.  It is ABSOLUTELY  what  you need now.   Don't try to have many meaningful conversations now.

I think maybe NAMI has "boards" where family members can be in contact on the Net.  Check it out.

His kids are going to have major abandonment fears, for some time.    Not sure how whomever it was expected you to walk and - what -- leave them w/ a stack of sandwiches?   His parents are going to have to be let in on this sometime..... or a sib or someone.

Our time together was very brief, since he started displaying symptoms almost at once and became psychotic at 7.5 months.  2 children each at home, ages -13, one of mine at college.  He was discharged on a Friday and we - my son and I - were given til Sunday to be gone, so off we trooped, in the RAIN, on, yes, Mother's Day.....many more soap opera elements.....    My son refused to return, probably a very good thing for me.....but hard to ever get closure w/ it.  We each tried to get back together a few times, but the other one was never willing at the times.   We only divorced when I started dating and was uncomfortable being "married" and dating.

We have, in our support group, a woman whose husband became ill when she was pg 14 yrs ago w/ their only child.  He worked w/ an understanding boss and finally was fired by one not-so, and he got disability after two tries and an appeal.  She is a rock and says she is an optimist...is generally very cheerful and has long ago accepted the new terms of her marriage.    Woolis tryly saved her, just as she came into NAMI. His last period of illness lasted nearly a year.....and tried her severely.....but she stuck it and is glad.   I think they do love each other, still and in spite of it all.

The more you know of mental illness and the more families you know w/ mental illness - incl patients - the easier it will be for you to continue w/ your husband.  An entirely personal opinion.

I am mainly just rambling.  Write again if I can help.