I don't know what to do about my wife

This is a bit of a long story, so bear with me.

I'm an American who has been living in Japan for almost nine years. Five years ago, I started dating a local Japanese woman. We moved in together almost three years ago and last April, we got married.

She suffers from depression. When we started dating, it was an issue for her, but not debilitating. There were days when she'd stay in bed all day, but they were mostly few and far between.

Over time, things have slowly gotten worse for her. Then once we got married, things went even more downhill. The first few months together were perfect. Her daughter from her previous marriage (who lives in Australia) came to visit us for a few weeks and we had a great time. I was working a series of jobs and my wife was working at a kind of rehab center where they allow people with disabilities to perform some basic tasks, or they can opt to relax if things get stressful or difficult, and they get paid about $500 a month for that.

But then, a few months in, my wife started to go downhill. about 2-3 months after we moved in, her depression took over and she said she decided to go stay with her parents for a while (they live in the same apartment building as us—they're our landlords in fact). That went on for a month and then after that, she went into a psychiatric hospital for about a month.

During that time, she very rarely spoke to me other than some occasional text messages. She didn't want me to come visit her there at all. When she got out of the hospital, she went back with her parents and she told me she was ending our relationship.

Two months later, she said she wanted to get back together. I took her back and it was an uphill climb. But slowly, little by little, she started going back to work and things were doing okay.

Few months go by and she got bad again. She went back into the hospital. Although this time, she occasionally came home on the weekends. Though it was a longer stay, she seemed to do much better this second time around. When she got out, she was good again. Went back to working and things were going well.

There were a few other bad spots in there, but in general, she did pretty well. Then she started doing VERY well. Almost manically so. She started joining online support groups, she wanted to go out with friends, things like that. She had stopped the rehab job in order to start taking classes in MS Office so she could get a better job in the future. We decided to get married and we made plans to move to America.

Everything was going well.

Then this past summer, they started to go bad again. She started skipping classes or if she did go, she'd only go for a few hours and come home. She would stay in bed all day long staring at the wall. She would refuse to eat or she'd only eat a few bites and say she was full.

Then she said she didn't want to leave Japan. This poses a problem for us as I'd already told my workplaces that I won't be renewing my contracts. And even if I can tell them I've changed my mind, we're not doing too well financially at the moment. The area we live in is relatively rural and as my Japanese is conversational at best, my opportunities are extremely limited. I've been supplementing the income with online writing and editing jobs, but it's barely enough and it won't be enough if I can't keep these other jobs.

But I tried to be understanding. I explained to her the situation and the options. And I told her that even if we stay here, we're going to have difficulties in the future when it comes to things like taxes. Right now her mother is helping us with that, but when her mother eventually passes away, we won't be able to afford an accountant.

There's also the issue of my own family back in America. We told them we were going to move to the States and have a wedding ceremony there. Now she doesn't want to do that. She doesn't even want to visit the States. Basically, she wants us to live our life without ever even meeting my family.

She backed down from her "I won't leave Japan" stance and said she'd go anywhere I go. So things seemed to be doing better.

But then again, she kept refusing to even get out of bed. It's been over a week since she last left the house. I try to get her to go out and she refuses. I can't even get her to watch TV for more than ten minutes before she turns it off and goes back to bed.

Today, I told her we can't keep going on like this. So she told me to leave her. She says she can't change, she'll always be like this, nothing will help, she won't go to the States, she doesn't want to be a burden on me, and all she wants to do is die. So she told me to leave her.

I don't know what to do anymore. I love her, but I can't keep going on like this. She is seeing a psychiatrist, but the psychiatrist doesn't seem to know what they're doing. Mental health care in Japan is a complete joke. Her doctor just keeps filling her up with pills, changing up the dosage or the prescription seemingly at random. As an example, one time when my wife was going through a good period, the doctor upped the dosage instead of keeping things stable. The result? My wife became nearly catatonic. There's pretty much no counseling involved either. Just pills.

There is another doctor, a bit further away but I'm willing to take her anywhere. Her mother and I both think she should see this doctor, but my wife refuses to see any other doctors. She refuses to believe medication can do anything to help. Her parents are aware of the situation, but they have even less of an idea what to do than I do. The only thing they've offered to do is take the burden off me by having my wife stay with them. But when she stays with them, they just let her stay in bed all day. And there are even less things to distract her if she took the option. They don't have Internet or anything like that and all her books are here, so the only thing she can do is watch TV.

I'm at a complete loss here. The only thing I know is that our current situation isn't sustainable. A marriage where one person stays in bed all day and refuses to contribute isn't a real marriage. I can't take the burden of doing everything myself and also playing nursemaid. But she refuses to even try.

So what do I do? Do I just tough it out? Do I take her advice and leave? Or is there a third option I don't see?

Tim Tam said...
What pills is she taking?

How has she been diagnosed?

I'm manic depressive and take Lithium and Mirtazapine anti-depressant, and it keeps me level.

You describe her as being very up and very down. As a bi-polar, that sounds similar to the symptoms I had before first being diagnosed correctly, and then being medicated according to the diagnosis.

If they don't get the diagnosis right, they're not going to medicate her right. You can look up bi-polar symptoms on the web. It's going to be "racing mind," depression and excited state or mania, if it's like my symptoms.

Does she have mental illness in her family? How have they been diagnosed? That might be a tip off to what she has.

Try to stay positive through this. One problem at a time, and be positive about that problem.

Thanks for the response.

To be honest, I'm not sure what her official diagnosis is or what pills she's taking. When I've asked her what she's been diagnosed with, she just says depression. I'm not sure if that's what the doctor has said or if that's as much of a diagnosis will be given. Japanese society tends to greatly trivialize mental illness and not give it the weight it deserves (hence the high suicide rates). Japan just wants to pretend that mental illness doesn't exist and that the people who suffer from it are basically just broken and we should never speak of them.

For the medication as well, I'm not sure specifically what she's taking. Her psychiatrist switches up the medication every month or so, so she's never really been on any medication for a prolonged period. And the changes are seemingly completely random. Medication is also a tricky thing here in Japan because the drugs laws here are extremely strict. Particularly antidepressants. A lot of drugs that have been widely available and prescribed in America since the 80s and 90s are either still undergoing clinical trials in Japan, or have dropped pursuit of entering the Japanese market. Mirtazapine, for example, has yet to even pass the initial application stage of the approval process.

She had a period where she was manic. But the vast majority of the time—stretches of like months at a time, that is—she's near-catatonic. Just stares at the wall. She'll sometimes watch TV, but never for more than 5-10 minutes at a time. She says she can't concentrate on anything. When we have dinner we usually watch a movie and there is the rare occasion when she'll sit through a whole movie. But most of the time, she'll only get about 30-60 minutes into a movie and then say she's going to bed.

No family history of mental illness, so far as I know.

Luqu101 said...
Hello , sorry to hear about your wife . I just like to pass this info along . I have been dealing with many issues including mild depression and chronic migraines, anxiety. I came across this book "Hormone Balance Made Simple " while research for alternative treatments. it had been a life changer for me . The Dr recommends on the book Emerita Pro-gest cream .After reading the book it appears that I was low on Progesterone. I have been using the cream for almost a month and I still can't believe how well I feel all those symptoms are gone. Hope your wife gets better soon!!

I'll look into that, thanks.

An update, I talked to my wife after she saw her doctor today and asked her about diagnosis and medication. The doctor hasn't given her a diagnosis beyond just depression, as I thought. Here's the medication she's taking: Perospirone, Amoxapine, Chlorpromazine, and Paxil-CR.

ambling, normally I would agree with you about the move. But we're sort of on a ticking clock. I've already informed my current jobs that I won't be renewing my contracts. If we decide to stay put and I can't re-contract with those employers, then the only thing we'll have is my supplemental online income, which at the moment is not frequent enough or substantial enough to afford our expenses. And finding another job is very difficult. It took me about a year of searching before I was able to get those jobs. The area we live in is very rural with extremely limited opportunities for foreigners who don't speak fluent Japanese.

They help as much as they can, but to be honest, they don't really know what to do. They feel like their best course of action is to remove the burden from me by taking in my wife and letting her lie in bed all day at their place.

1. Her psychiatrist is female. Her mother has heard of another psychiatrist in the area who is very highly recommended, but my wife refuses to see another doctor.

2. I have gotten some calls about some potential job opportunities in the States. If they advance into job offers, then I might have to take them and see if I can convince her to come over for some treatment.