Advice for Supporting Husband With Type2

Hi. I need some advice on something that has happened recently.

My now-husband and I met in 2016 and got married in 2018. Until this year, I always knew that my husband had Type II Bipolar. He always warned me to look for signs and what to do if he hit a low phase, manic phase, or a crash. Before February of this year, the last time he had Bipolar symptoms and phases was March 2016, a month before we became a couple. He also was diagnosed with depression and social anxiety before we met.

He does not want to take medications, for he doesn't want to disrupt his creative process (musician). I am okay with this. Something that we disagree on is him getting professional help. He doesn't want to talk to one because "There's nothing to talk about".

I myself am learning to cope with his Bipolar reappearance. I myself was diagnosed with depression and anxiety before we met, and I want to learn what I could do to cope with these mood swings not just for his sake, but for mine too. We both have mental health struggles, and when he's struggling, I struggle too.

I do not want to force him to do anything, and I love him with all my heart. I want to know if there's much I can do to support him, and support myself when times are tough.

Please help. -Caitlin

As a bipolar, which has full blown mania, and your husband has bipolar II (meaning reduced mania), one of my curiosities is whether those two are medically treated alike.

The net says, they are with the same medicines.

Meaning, to both they give an anti-depressant, and to both, they then give a stabilizer, such as the lithium that I take, to treat the mania side (calm it down) and to keep the anti-depressant from pushing the depressed patient into mania.

If your husband goes in to the psychiatrist as depressed, he may get diagnosed incorrectly as depressed only, when you already know he is manic-depressed. Now that you know he is bipolar, you have to watch the psychiatrist and remind him or her, that he is bipolar, not just depressed. How did you come across the diagnosis of bipolar?

You say, “He does not want to take medications, for he doesn't want to disrupt his creative process (musician). I am okay with this. Something that we disagree on is him getting professional help. He doesn't want to talk to one because "There's nothing to talk about".

HT, as a bipolar himself, has talked in the above post about the problem of your husband not wanting to take his medicine, and I can relate to the same as a bipolar when I didn’t take any medicine. It’s like a car going 100 mph, the medicine will slow you down but your probably won’t crash, either.

I’m going to guess you are about 30. At those ages you might get away with it and the medicine does have some side effects. But not taking the medicine has side effects, also, such as increased problems at home and at work.

To see what kind of trouble he’s going to be getting into with no medicine, here is what the mayoclinic.org says about the manic phase:

"Both a manic and a hypomanic episode include three or more of these symptoms:

• Abnormally upbeat, jumpy or wired
• Increased activity, energy or agitation
• Exaggerated sense of well-being and self-confidence (euphoria)
• Decreased need for sleep
• Unusual talkativeness
• Racing thoughts
• Distractibility
• Poor decision-making — for example, going on buying sprees, taking sexual risks or making foolish investments"
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In addition to the trouble the untreated bipolar causes for himself, he also causes trouble for others. So, in a way, we’re being selfish when we don’t take our medicine, but it doesn’t bother us.

So, in addition to watching out for his behavior, you’re going to have to watch out for how much of his misbehavior you’re going to put up with. He has a right to not take his medicine, and you have a right to leave if he doesn’t take his medicine.

So in addition to the illness--bipolar--expeicailly untreated, it can cause “Complications,” as Mayoclinic.org says, such as:

• Problems related to drug and alcohol use
• Suicide or suicide attempts
• Legal or financial problems
• Damaged relationships
• Poor work or school performance

And it can cause other health problems, such as:
• Anxiety disorders
• Eating disorders
• Attention-deficit/hyperactivity disorder (ADHD)
• Alcohol or drug problems
• Physical health problems, such as heart disease, thyroid problems, headaches or obesity

As far as being a musician, webmd.com noted some other musicians who were bipolar such as Brian Wilson who they said, “wrote and produced nine albums and 16 hit singles in a 3-year span with the Beach Boys.” It added, "his bipolar disorder, which he'd learned about years later, left him physically and emotionally unable to compose or tour for decades.”
Also Jimi Hendrix “The rock guitar legend got expelled from high school, once stole a car, and lasted just a year in the Army after his commanding officers suggested an early discharge. He died at age 27 in 1970” from taking a girl friend’s sleeping pill which had the same milligrams as his, but was twice as strong.

In these cases, irresponsible behavior, which can begin with not taking your medicine and expand to other areas.

Some things are falling into place. That is, as a bipolar I (with full mania), when I was 17 I was in a stressful situation, something very tense had happened and then I was supposed to read out loud in class and I had a break down of sorts, a "psychotic episode."

I was bipolar, but there was no diagnosis of that, and I went from 17 to about 27, we'll say with a lot of anxiety but no diagnosis of Bipolar and no medicine, except some tranquilizers, which did not solve the long term anxiety which was connected with Bipolar, I strongly believe.

One of the websites said something about, Bipolars not doing well in stressful situations. The stress for me at about 27 was, I lost my job and couldn't deal with that. Didn't get psychiatric help for I was living by myself and didn't know what to do.

After a couple of weeks of no treatment, I had a nervous breakdown, which goes with, not doing well under stress. What I'm saying is, he may be doing OK as long as everything is going alright. But if he should lose a job type of stress, and he's already bipolar and on no meds, he could have some sort of collapse, like I did.

I was still not diagnosed as Bipolar, not on a long term med like Lithium, and had another nervous breakdown from job trouble when I was about 29. Misdiagnosed again as only depressed, not manic depressed, and put on only an anti-depressant, but not on a stabilizer also, which threw me into panic attacks.

So, I'm saying, he could do OK unless some major stressor comes along and then he could be in for a collapse, which is what happened to me. In a way, being on no meds from 17 to 27 was good in that there were no side effects. But the collapse can be horrible. A nervous breakdown is gosh awful and you don't know if you're going to recover and it can depend on if you're able to get medical help quickly enough.

So having bipolar, not taking medicine, having a very stressful situation, getting older, in my case 23 to 27, can be a stacking of stressors and can have a disastrous consequence. You are wise to reach out and ask about this, and if you've never been down that road, you don't know what's out there.

And you did ask about this, saying. "I do not want to force him to do anything, and I love him with all my heart. I want to know if there's much I can do to support him, and support myself when times are tough."

"He does not want to take medications, for he doesn't want to disrupt his creative process (musician)."

I was just thinking about one of the happiest times of my life, and I was on Lithium (for the mania) and an anti-depressant for the depression, and, again, it was one of the happiest times of my life, and it lasted for some years. With the Lithium helping it last for years, because without it, there might be some good times, but maybe not for years.

You are right to be concerned about this. I was worried about the creative process being diminished also. It was not in my case. The creative process was helped in that, I was not having mania or depression, which disrupts that for long stretches.

He may have to have a really tough event, but he doesn't have to. If you see his anxiety level rising, it's sign that something overall is wrong, long term, deep seated. Not just an hour or two of nervousness for which a tranquilizer might help. But recurring bouts of anxiety, difficulty sleeping, anger, and we know what it is here, it's bipolar.

So what we need here is not a tranquilizer, but a long term medicine like, in my case, Lithium with an antidepressant, both of which can be calmatives and make life easier. So what you can do "to support him when times are rough" is notice if this seems to be getting worse. I'm telling you all of this from my experiences, most of them bad. You don't have to repeat that.

Your post sounds really familiar to my situation from a few years ago. Before my husband's diagnosis was changed to SZA, he was diagnosed as Bipolar II. He had that diagnosis for 15 years, and it had started with him in the psych hospital as a teenager. He's had a range of experiences, from wayyyy over medicated, to quitting his meds cold turkey, to being unmedicated for 6 years, to having irregular access to medication he desperately wanted. He's now back on medication that is working great, thanks in part to a correct diagnosis from a competent doctor and a more stable situation.

I know for a fact, my husband would advise your husband to try medication. He would say the idea that medication will "kill his creative flow" is bullcrap. Mental illness does not create art, it destroys life. I know my husband is having good days when he plays his guitar and sings. When he is struggling with his illness, there is no music. It's really great that your spouse has a creative outlet and the ability to pursue something he cares about. PROPER medication should not take that away from him, but should enable him to practice his art without being held back by his illness.

As far as therapy goes, I would put emphasis on medication first. Don't push him to see a therapist, but please do recommend he see a psychiatrist and try medication. My husband benefits greatly from therapy, but part of his illness (when he was unmedicated) was that he did not want to talk to anyone. It's a symptom of how low he was. He even used the words "there's nothing to talk about." It might be true! Depression and the lows of Bp II have an insidious way of stealing our thoughts away and leaving us empty. If he sees a psychiatrist, and gets started on medication -- even something low-dose-- he might be able to experience the benefits of therapy. Therapy is almost useless if the person is forced to do it, though. They have to be ready to be honest with themselves about what they need, and most BP II in full swing aren't in that place. Be patient, but please firmly push for him to seek medication. When my husband and I got married, it was a condition of our engagement that he would be open to medication. It took us a hot minute, thanks to the hellscape that is medical insurance, but I am grateful every day that he now has access to the medicines that help him.

I want to return to something you said in your post. What you said about how he "always warned [you] to look for signs and what to do if he hit a low phase, manic phase, or a crash" is a HUGE red flag to me. Please be careful. Please revisit this with your husband. This language is unfair and the expectation is wildly inappropriate on his part. That sets YOU up to be blamed the next time he hits a low phase or crashes. You might start hearing about how it's "your" fault because you did or did not see the crash coming, or even that "you" wanted this to happen to him, or that he wouldn't be feeling as low if "you" had just loved him enough and paid closer attention to him. Whether or not he even says these things out loud, you're already primed to believe them about yourself because there's the romantic notion that if we love someone the right way, we can heal them or save them somehow.

I might be completely off base here, and if so I apologize. It sounds like you have not yet been on the receiving end of a depressive outburst, but it also sounds like his cycle is slow enough that it hasn't happened yet in your relationship. But I'm saying this as a warning because it's what happened with my husband. It's psychosis, and it can become abusive and dangerous very, very fast. If NOTHING ELSE, please have a very honest conversation with your husband about what you can reasonably do for him when he is struggling. You will need to draw boundaries. Your boundaries will be predicated on conditions like "is he willing or unwilling to medicate" or "is he willing or unwilling to TRY medication," as well as what you need form him in terms of open communication about how he's feeling, how he's been doing, and what his thoughts are like.

Bi polar disorders, the main rule and standard starting protocol is medication. Yes I agree with what was said re warning sign stuff by barley. Worse will follow if not treated. Just a matter of time. HT. I live with bp 1 with mixed mood states.