Expert: Libby Bonner - 1/18/2007

Question
I have been trying to find information/advice on how I should handle things with my wife. I have known her for over three years and married for about a year and a half. Recently she was hospitalized for some anxiety, anger and depression for about 5 days.  This is the first time I have had to deal with this. Her son has gone through this before and he seems to taking it in stride. While I am find myself depressed, lost and confused.

She gets really quiet and "zones" out as she calls it. She really doesn't get angry, but she won't initiate any conversation. When I start one she will talk, but as soon as the conversation is over, she clams up. She says that zoning out is how she handles her feelings of anger and depression. She had a job for a year and a half, but was let go, when she was hospitalized. She says that her new medication may take weeks or months to be effective.

In the meantime I do not know what I should do when she"zones" out. Do I ignore her, do I get angry with her, do I leave the house?

I did have a conversation with a co-worker today who said he is bipolar and he said he didn't have any suggestions for me. I feel like I am lost.

Answer
"Lost" is how everyone starts, but things are likely to get better as you learn more about BPD and have the chance to talk w/ other family members who once were also lost.

I will share some thoughts, but would appreciate some clarification from you - when and if you have time. I take it that her diagnosis is some years old - when?  Was she taking medicine when you met and, if so, do you know when and why she discontinued?  Does she have the same doctor now as she did the last time she was taking meds?

Also, I'd be interested to know how you became aware of her illness and/or that she had discontinued meds.  [Actually, she may not have discontinued.  It is not unusual for meds to stop working...and/or for illness to become worse despite meds....but one hopes that either the pt or the doc catches on while a meds change will do it, without hospitalization being required.]

It's quite true that both the "art and science" of medicine really come into play w/ psych disorders.  One size does not fit all, and it can take a good bit of tinkering to get the right dose/s of the right med/s....with one or more maybe having to be abandoned along the way [because they are not working, unacceptable side effects, etc.]  And these are, as she indicates, somewhat slow to fully become effective...so it can be long-ish, and difficult for both patient and family.

My daughter spaces out and it is involuntary....your wife's may be as well, the zoning, but her explanation, that it's a protective mechanism, could be true enough.

My daughter spaces for relatively brief periods during which she misses whatever is said to her.  If she is spacing at all, it will usually recurr multiple times within a day or half day.   This zoning/spacing is pretty common among patients.  They do also, many of them, have a heavy med load, and that can cause some of it, I think.

What should you do when she zones?  This is your first big learning hurdle:  it [behavior that you dislike, or behavior that excludes you ] isn't about you.  Has nothing to do w/ how she feels about you, and everything to do w/ what she herself is feeling within her illness at that time.  Takes a very long time to integrate this belief, but truly - it has nothing to do w/ you.

How will you deal w/ zoning and other behaviors that have to do w/ her, that do not harm you directly nor intentinally?  You will learn to guage her moods more accurately over time; you may modify your expectations for your marriage to some extent.  

That's not as dire as it sounds, but there will be times, when she is changing meds, or getting worse, or getting better, when some apart-ness is necessary and appropriate.  I hope you have some hobbies, interests, whatever, that are truly interesting enough to you to be good alternatives when her attention is less directed to you.  Also recall that she has been attentive before and likely will be again, as she recovers and as her meds begin to take hold. So spend time reading/at the computer/gardening - whatever you genuinely enjoy alone - if the zoning goes on very long.

What else should you do?  I'd do several things.  I would learn about mental illness, maybe at www.mentalhealth.com or www.nami.org   I would use the latter website to locate a local, or nearby, affiliate of NAMI and start attending meetings, and definitely attend their family support groups, if available.  If no support groups are around, ask at a NAMI meeting whether anyone there w/ a bipolar spouse or adult child would be willing to talk more w/ you - by phone, email, in person.   --  I'd do what it took to get to these meetings; they are you very best source of practical info and support.    --- Your bipolar co-worker likely lacks the self-awareness needed to be helpful to you - I'd bet his family would have many ideas and suggestions [tho I doubt the family is are available to you.]

One good way to stay very involved w/ her as she deals w/ her illness is to plan to attend some of her psychiatrist appts.  Nothing very private gets said w/ psychiatrists these days - it's nearly all about symptom management and about meds....and, if you are there some times when either she or the doc need time without you, you can return to the waiting room without, I hope, feeling rebuffed.   

If she resists this idea, or any other ideas you develop through NAMI or elsewhere, or if you feel there are daily problems in addition to zoning, I would heartily recommend a book that has helped so many.  Author is Woolis, and title is When someone you love has a mental illness.  Do buy it - I think you will use and re-use it.  You will pick up excellent communications suggestions and will have a better notion of what are realistic expectations....AND you will feel less helpless.  Guaranteed.

That's it for now.  I do know that you are in a world turned upside down right now.  Thank you so much for writing and good luck.  Write anytime.