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Support/Help/Advice Needed - I'm Facing a Very Tough Situation With My Wife

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Bipolar Disorder
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Posted 2/18/2009 1:22 PM (GMT 0)
Hi, my name is Mark and I’m new to this forum, and am looking for support from anyone who is experiencing something similar to what I’m about to describe.

My wife has been going through episodes of being normal, to being extremely angry and depressed for quite a while now, especially so in the last 8 to 18 months. Its intensification in the last 8 to 18 months (and especially more intense in the last 3 month) is due to her having given birth to a baby girl, who is 8 months old.

When she is in an extreme anger/depression episode, she has the following symptoms:
- Hateful attitude to people (incl. people close to her, whom she loves), thinks that others don’t understand her, and have bad thoughts/intentions with regard to her
- Obsessiveness about cleanliness
- Acute sensitivity to sounds and smells (i.e. gets fired up easily by certain sounds, and annoyed more than a usual person by certain smells), this can also fire up an anger/depression episode if she is in a public place around people, mainly in places like bustops and queues (i.e. waiting areas where there are other people who annoy/anger her)
- Uncontrollable thoughts about what other people think about her (i.e. thinks what others in society think about her more than an average person thinks about this, and usually in negative ways)
- Yells for a good 30 min. period at me in order to make me feel bad and guilty of myself
- Strong desire to control over people close to her (i.e. in her immediate environment), and make them feel bad and guilty of themselves
- Poor concentration
- Headaches
- Back pains and tender points in her spine (this is less of a problem after buying a supportive bed for her back)
- Sleep disturbance, inability to relax, sometimes has nightmares during sleep
- Mild fear of whether a person is in the vicinity (usually at night time)

These outbursts can cycle through a few hours of extremity to a few days, cycling between a constantly-enveloping depression to furious anger outbursts.

It is important to note that other days, she is usually in a good mood. When her environmental conditions keep her calm, active, happy and free of pressure, then she can be in a good mood for quite a while. Her last good mood state lasted about two weeks. When environmental conditions start pressuring her, she can erupt into a cycle of extreme anger outbursts to a hateful depression and dissatisfaction with everything around her for about one week.

The frequency and intensity of these outbursts have significantly increased in the last 8 to 18 months, and especially moreso in the last 3 months, and we are looking for something to do about it ASAP.

We went to a psychiatric clinic during her last outburst (i.e. two weeks ago), and they suggested immediate hospitalization. But she is strongly against hospitalization, and wouldn’t sign to it. She went through a process of psychiatrists and psychotherapy four years ago, where she was put on courses of chemical medication for two years, and where the psychiatrists advised to keep adding on the medication dosages. When she saw a patient who was on the four-pills-a-day medication, and who was literally a nervous wreck, she was against raising her dosage to four pills a day, and instead decreased her dosage against the psychiatrist’s advice – going from two pills a day, to half a pill, and then stopped taking chemical medications and seeing psychiatrists altogether.

We tried a natural course for schizophrenia over the last two weeks, which seemed to be doing a good job, but yesterday she entered another outburst of furious anger and hate. It is mostly vocal – i.e. about 30 min. worth of constant yelling hateful words to me (her husband) about how I’m not doing anything about her problem.

I simply don’t know what to do. She won’t take hospitalization. She is against taking any chemical drugs. She is generally against the treatment of her symptoms in terms of “treating her symptoms until she is calm” – meaning that she instead wants to find out what it is that she has, the cause of the problem, and then start having it treated – rather than just giving her sedatives to calm her.

We thought that it is bipolar disorder (manic depression) for some time, however, there are symptoms listed in bipolar disorder that she doesn’t exhibit (e.g. hypermania). Then, we found out about neurasthenia, which much better describes her symptoms, almost exactly.

We live in Israel, and are looking for a psychotherapist to treat her. We also want to run tests on her hormone secretions, whether she has any physical problems that are also irritating her and being a part of her outbursts.

I am here simply to find others who experience things like this, because we don’t know of any others. She has pretty much been ostracized from all communities she’s been in, because no one likes a hateful and depressed person around them, and she has no friends. Her mum has come from the Ukraine to be with her for a month, which helped a lot, but her mum is going back to the Ukraine in a couple of days. I am hoping that there is some kind of understanding in this community for this situation, and any advice or words you have will be appreciated.

Mainly, I’m looking for any advice on how to approach this thing from the start, any words of warning for getting getting into any treatments, what should we look out for? Are there any good experiences with treatments? Any bad ones? Are there any doctors out in the world who are obsessed with wanting to be a genius in treating these kinds of symptoms, and who are worth looking up?

Thanks for your time,
Mark
Posted 2/18/2009 2:27 PM (GMT 0)

Mark;

Welcome to our community. You will find a good mix of people who have BP & people who are the spouce of someone with the condition. My wife was diagnosed with BP2 with rapid cycles & psychosis about 6 months ago, although she has had the symptoms of it for several years. She has been on various anti-depressants over the years but the symptoms of BP didn't come on real strong until about 2 1/2 years ago.

A lot of the symptoms you are desribing are very much the same symptoms my wife has shown as well. But a lot of them are also sighns of post-partum depression. Keep in mind, I'm no doctor, just giving an opinion as a person whose wife has went thru this. From what I have read on your post, I would bet that your wife is also a BP2 (which is someone who is mostly on the depressed side of the condition) & also rapid cycling. You mentioned the lack of hypermania, but she does seem to have it a little with the cleaning obsessiveness & the controlling of situations, keep in mind a BP2 will have mania only occasionally (my wife only gets it a couple times a year). She may also have some psychosis going on as well, as you have mentioned the paranoia, nightmares & such.

The best thing you can do for her is to try to convince her to stay with the treatment plan her docs map out for her. You can't be forceful, just supportive. She has to deide for herself that she wants to get better, you can't do it for her. Yes she may have to take a handfull of pills every day, my wife is on 4 or 5 a day, but she is doing much better because of it. This is a slow process, it will take finding the right medicine & dosage for her, & yes sadly it may take hospitalization so the docs & staff can observe her progress. My wife was in & out of the hospital 3 times between sept & nov of last year. She didn't want to be there, but she had hit rock bottom & knew that was the only way that they were going to be able to help her.

Believe me, I have been thru exactly what you are going thru &  so have a lot of others on here. We are all here to be supportive for each other & try to help each other as we are heling ourselves. This forum is an amazing place & I can tell you honestly that joining here is one of the best things I have ever done. Try to stay calm when she is going thru one of her phases, she will say some awful things to you, try not to take them to heart, although it is hard not to sometimes. Try to encourage her to go to her psychiatrist & get into some therapy, & to follow their treatment plan for her, whatever it may be, no one can help her until she decides to help herself.

Take care

Rocket 

Posted 2/18/2009 3:49 PM (GMT 0)
Thanks for the quick reply Rocket - it really helped a lot to read your answer, and find another person who seems to have been through this.

One thing you wrote about the hypermania gives another perspective about what hypermania is, and makes it seem like she does have a bit of that. I also didn't realize that having symptoms of hypermania only a couple of times a year (like what you wrote about your wife) constitutes its presence. I was under the impression, from what I have read on the Internet, that hypermania is something that comes after the "down" state, and that a person with bipolar disorder is either in an "angry/depressive down," or in a "hypermanic up." So what you wrote gave some more perspective on this.

However, I'm more interested in what you wrote about how your wife "was diagnosed with BP2 with rapid cycles & psychosis." This is exactly what my wife is looking for - a diagnosis - something that tells her "We have checked you, and concluded that this is what you have, because of X, Y, and Z, and this is what you need to do about it."

You said how it's "a slow process" to "find the right medicine & dosage for her, & yes sadly it may take hospitalization so the docs & staff can observe her progress. My wife was in & out of the hospital 3 times between sept & nov of last year."

Can you pls say something about how that process begun for your wife? Did it start by having her go through all kinds of tests, like blood and urine tests, before starting on any medication? That is the kind of approach my wife is looking for, but the approach she is offered by the psychiatrists is that of offering her medication and hospitalization from the get-go. That is what's turning her off.

Thanks a lot Rocket. Your message has already helped a lot.

Post Edited (markzimmer) : 2/18/2009 9:54:24 AM (GMT-7)

Posted 2/18/2009 5:04 PM (GMT 0)
Hi Markzimmer,

Welcome to HealingWell and to the Bipolar board.

I certainly can't diagnose your wife, but I don't think you expected us to be able to. The only way she's going to get that is from doctors, obviously. The problem is, with psychological disorders, the way you get diagnosed isn't through blood and urine tests, it's through a thorough sit down talk with a psychiatrist or a stay in a hospital. There are no "tests" to tell you if you're bipolar or schizophrenic. Only a qualified psychiatrist can really determine that by talking with your wife about her symptoms and complaints.

Mental disorders are sticky things too. If one psychiatrist isn't willing to spend the time talking and diagnosing your wife, then I'd say talk to another doctor. I had a doctor who diagnosed me depressed (this happens a lot, incidentally) and refused to consider any other diagnosis even though I wasn't getting any better. I switched doctors and was diagnosed bipolar. I started a new medication and instantly improved. If you can, try another doc and see if you get more satisfactory results.

The next sticking point is that if your wife is diagnosed with a mental disorder, whatever the diagnosis is, most likely the prescription for improvement is going to be medication. She's undoubtedly worse at the moment because of the post-partum aspect of her situation, but medication is generally the way docs go. She's going to have to consider it, and for most of us, it helps a lot. It can take a while to find the right medication, but once you do, it really makes a difference. If a doc prescribes a medication, ask why. Ask what diagnosis he/she suspects, what the medication is supposed to do, what side effects are common.

I hope this is helpful. I know it's really tough living with an unstable, ill spouse. It's good of you to be trying to get her help. Thanks for joining us. I hope you find some comfort and answers here.

serafena
Posted 2/18/2009 5:51 PM (GMT 0)

Hello, as rocketman said..it is quite a process to become diagnosed and treated for bipolar.  But it is definatly doable...especially considering the alternative.  I believe that going to only a family doctor is not a good way  to search for a diagnosis.  Also seeing a therapist or a psychiatrist would be best.

Along with the diagnosis comes a lifetime of medication, patience and acceptance.  Your wife must be willing to accept the diagnosis and the treatment that goes along with it.

Just having a baby could definatly be causing some exaggeration of her symptoms, but in this case some therapy would be good to screen for bipolar, or to simply be treated for PPD, either way.

Posted 2/18/2009 6:10 PM (GMT 0)
Thanks serafena,

Your post is very helpful too. Thanks for the time you spent on it. What I'm starting to understand (together with what you said) is that you have to plan meetings with a few doctors, and when she finds one that feels right for her, she continues with her/him.

Just for the record - I was unclear in saying "blood and urine tests." I didn't mean that they could diagnose the condition from blood and urine tests (although this article called "Blood test could reveal bipolar disorder" was mildly interesting - link: http://www.msnbc.msn.com/id/23337532 - but also stated what you said), but that before giving her medication, they run blood and urine tests to check whether they could detect any other physical conditions she might have (which also might be affecting her states), which could put medical constraints on her treatment. For example, maybe she's diabetic as a part of whatever she has (I don't think she is, I'm saying it only for the sake of the example), and if they don't do some test to determine whether she has any other physical problem, and start giving her medication, that medication might not go so well together with something else she may have, etc.

My conclusions on how to continue with this (which you and Rocket have influenced) are as follows:
1) Go to a general doctor and demand some physical tests to make sure that she hasn't got anything else, and that any medication she takes will be "physically okay" for her to take
2) Plan meetings with a few psychiatrists from different practices. Go to each one until my wife feels that this is the one for her. (Note how I said I live in Israel. Doctors here are very tough - there are many types who spend 95% of the time staring at their computer screen instead of at the person they're speaking to, and others who have already made up their mind what they choose for their patient before the patient's even had a chance to speak.)

Thanks again to you both. Your words were like lights in a dark place.
Mark
Posted 2/18/2009 7:23 PM (GMT 0)
I'm sorry Mark, I missed that you were in Israel. Certainly that will affect how the doctors interact with the patients and how you see your docs. Definitely take my remarks and filter them as you need to. I'm so glad you're taking care of your wife. I hope she agrees to seek treatment.

serafena
Posted 2/18/2009 7:34 PM (GMT 0)
Dear Mark,

I went through 8 psychiatrists and psychotherapists before I was diagnosed. I did not like or trust any of those doctors and was not cooperative. As a result, I was misdiagnosed. My current psychistrist in New Delhi, India took my blood and urine tests after he diagnosed me and he also asked me to get a MRI. When hypothyroidism was ruled out, he began the medication for bipolar. Everything happened very quickly because I was psychotic at that point and need to get on medication quickly. The doctors in the U.S. did not do any tests and put me on medication before they had even accurately diagnosed me.

Natural healing does not work with bipolar. Medication is required. I used to be uncontrollably manic before I was diagnosed and trust me, I tried every diet, exercise trick to heal. Exercising and a healthy diet help if you are on medication, not without it.

Sheeba
Posted 2/19/2009 4:16 AM (GMT 0)
Hi Mark
I am from the same country and i am finding that when we started treatment.. the clinic we went to immediately excluded me from the treatment. We are going thru Misrad le Breut Hanefesh. I am concerned that because I am the spouse (being the husband may be worse) they have excluded my input. It took me years to convince my husband that he should go for help and his condition is affecting me and the kids more than it affects him, most of the time he does not even realize that his mood has changed or that he is not acting correctly or with logic. so by treating and counseling only him with out my input they probably will not get a clear understanding of what is going on There is a big problem with family abuse in this country and because he is not functioning properly and is in his down mood it may look like he is being abused. I have had to, over the years take over the house and work and decision making. I feel that sometimes i have to take control because he messes up. You can read my posts if you want... My question is how "as a Spouse" do you get the trust of the Dr's and the help your husband/wife needs? And are you finding the same?

We are just starting out with treatment so I can not advise you on any Doc’s, be strong… and as much as you love her do not forget to love yourself.

Gail
Posted 2/19/2009 2:49 PM (GMT 0)

Mark;

Glad I could be of some help. To give you some examples of her manic behavior. Like I said she has the type 2 bipolar. She is more depressive then manic, in her case when she has a mood swing it goes to the depressed downward side (hypomania) where she is depressed, hopeless, just wants to die, & miserable. Rarely to the hyper, giddy, upbeat & all the other things that go with hypermania. Like I said about once maybe twice a year for about a month she will go to the hyper side & get really accomplised (I'm gonna do this & that), then it only last a few weeks then it's over.

Some of her more memorable episodes are:

The dollhouse- I've always wanted a dollhouse so I'm gonna get one, bought all the stuff. House, furniture, decore & everything. Layed it all out on the dining room table, worked on it a few times, didn't even get the house built, then abandoned it. I offered to help finish it but no, "I want to do it myself." It sat there for about another month untouched. I finally got tired of looking at it, packed it up & put it away. It's still in storage 7 years later.

Cosmotology- I want to learn cosmotology, I think I would enjoy it. I got a loan, she enrolled in school, went about a month, said she hated it & quit, got part of the money back & paid back a small part of the loan.

Curves- I want a Curves membership for mothers day. I want to get in shape. Got the Curves membership. She went for about 2 weeks an hour a day 3 days a week. Then 1/2 hour workouts, the 1/2 hour 2 days a week, then she strained her back & never went back. Even after her back got better, still no. So I was stuck with a 30 dollar a month Curves membership for the next 9 months that wasn't being used.

E-Bay- I'm gonna start selling stuff on E-bay, make a ton of money. We turned our sunporch into a work area. Staging area, shipping desk, the works. She loaded up on shipping stuff, UPS, FEDEX, US Post Office, (luckily it was all free) boxes stacked everywhere. Lasted a few months, sold a few things, made a little money. Then "It's not worth my time." So the packaging stuff got thrown away, the shipping desk is now in mmy storage shed being used as a storage shelf.

Real Estate- I always wanted to work in real estate. To her credit she had been talking about it for years & I honestly thought that this would be something she would enjoy & stick with. Took the home correspondence course, passed the test, got her liscense, went to work. Was all over it for about a month. Learning with the other agents, going with them on showings, showed a couple houses herself. Then she got a customer of her own. I'll bet she showed ten houses, finally the lady thought she had found the house she wanted. My wife showed it to her on a Sat. afternoon, the lady called & wanted to take a second look on Sun. My wife took her. the lady said she would make an offer monday. The lady called monday morning & said it wasn't the right time to buy a house for her. My wife was crushed, the bad thing about this is if you don't sell a house, you don't make any money. All that time & gas spent for nothing. A few weeks later she quit.

Not trying to be a hijaker here, just giving examples of how the hypermania can kinda hide itself with a BP2. I always just thought that was just an upbringing thing, as her father was the same way. But after her diagnosis, I started reading up on the condition & found that things like this are symptoms. Like I said, this kind of stuff usually happens about once a year, then it's back to the "normal" state or the severe depression.

If you want, you can read a lot more of what kind of behavior she has shown by going to all the threads I have started. Above the topics next to the new topic button there is a pull down tab. If you sort by "started by" it will sort the topics alphabeticly by who started them. Mine are on or around page 93. This might help you some as well. There are several other things that I have shared on other peoples topics as well, but I don't think there is any way to find them other then just reading thru everything.

Please don't hesitate to ask me any other questions you might have. I'll try to help as best I can & I'll try not to be so longwinded about it! lol

Rocket  

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