Expert: Libby Bonner - 1/24/2006

Question
Libby,

hi. i'm trying to diagnose my wife. i narrowed it down to bipolar disorder due to her extreme changes in mood. my problem is that, to me, she is not depressed.

her mood change is mostly anger. (at the flip of a switch she can become completely enraged. it's so bad that she makes up excuses to get angry, lies and sometimes completely makes up a story in order to get angry (dellusional?).)

i dont know, im no Dr and she barely admits she has "anger issues." can you point me towards a diagnosis? maybe is's not even close to bipolar disordre. thanks for any help you may provide.

tom

Answer
A good resource:  www.mentalhealth.com

Couldn't begin to guess a diagnosis....not even whether she has a mental illness, a personality disorder, or - maybe - "issues" about life or marriage.....  Could be anything.

However, in thinking about your wife's symptoms [if they are symptoms], always remember that mental illnesses involve disorders of thinking, perceptions, and behavior.  A person whose brain chemistry is out of whack sees their own thought processes and consequent behavior as coherent and consistant.   For instance, the finding excuses, the 'lies' may all be quite in line with her reality -- she has entire trust in the workings of her own mind, and I would guess that the "excuses, lies" are manifestations of actual perceptions of hers and that the anger naturally follows.  [That is, you would be angry yourself IF you were perceiving things in the way that she does.]

She and you may be living in two completely different realities.

IF you are busy arguing w/ her, or trying to rationally tell her why her perceptions are WRONG....save yourself some wear and tear....and save yourself from additional angry confrontations.  Explaining to someone who's ill what is rational is a HUGE waste of time.  

Since anger is her main mode, and regardless of her size or yours, you should take this quite seriously, that she could become more angry or even dangerous.  I would advise you not to provoke this anger.

You likely will have a problem getting her to go to a doc, since she probably sees nothing wrong [except maybe w/ you!]
If so, maybe you can go w/ her to a family doc appt or an OB/Gyn appt and these problems can be brought up in that safe environment, w/ someone she trusts.  [She perhaps trusts the doc, but trusts you less and less.]  If you can't go w/ her to her appt, make a fam doc appt for yourself and ask her to go w/ you.  The appt can be about headaches you are having - whatever.  Then we hope the doc will refer her to a psychiatrist.  --  IF she actually will go to one without fuss, then this charade is unnescessary.

Pls do this to keep life liveable, until you can get her into treatment.  Pls buy the book by Woolis called When someone you love has a mental illness.  It is about daily life w/ the mentally ill, about effectively communicating w/ those whose reality differs from ours.  It is the very best help you could have right now.  Your finding a diagnosis is far less important than handling the problem now, in a peaceable way, and in a way most likely to get her to agree to treatment.  This is the single most important thing you can do RIGHT NOW.

Pls realize that if may be necessary to call the police at some point.  Don't hesitate for any reason:  do it.  It may save some grief and it may, in the end, be the fastest best way to get your wife into treatment.

Try to find a local NAMI group - www.nami.org   Go to meetings and you will find other family members who can offer support and suggestions.

Good luck.  Hope you will give up on the diagnosis and concentrate on how to get your wife to a doctor.