Bipolar: Which way hope?

[EasterJoy]

I have a friend who has gradually come to realize (and now has the diagnosis) that her husband is bipolar. He doesn’t have hallucinations or delusions on the level of the psychotic, but other than that, he checks all the boxes.

He had an affair (well, one that she knows about, because he is secretive and has large chunks of time which he does not account for), about which he says “Ok, I made a mistake.” He makes grand financial gestures to help people, without telling his wife, and continues to want to keep all his financial decisions secret. He does not want to take medication and he wavers about whether he “believes” his diagnosis is correct.

Obviously, she has the right under canon law to severe the common conjugal life, because of this long-standing affair. I’m asking those of you with this disease and those who are (or have been) married to someone who has it: if nothing changes in this scenario, is there any hope for her marriage? I’m thinking not, but I’d like to hear what people in the know have to say about it. More to the point, is there a change that would significantly improve the chance of survival for this marriage? If so, what is that?

Oh, and he has “anger issues”. That makes me think this situation is too dangerous to stay in…thoughts?

 

[mamaslo]

my opinion doesn’t count for much but if he has the diagnosis, then why not give the medicine a try to see if it helps him with all the stuff going on. If he refuses, then she will have to weigh it out. With a counselor and maybe a priest.

 

[TheRealJuliane]

I don’t have direct experience with bipolar…well, only the undiagnosed kind.

I do know a little bit about it, and psychiatrists say that bipolars are the most difficult mental illness to medicate. If the medications work, they take away the mania which is the best part of the syndrome for the person, and it may take longer to alleviate the depression, which can be very deep when it strikes. So the person is left without his or her “fun and excitement” but still has all the misery. They can be very prone to suicide and I have read that unlike some unipolar depressives, they do frequently succeed.

Sorry to be such a downer. If your friend’s husband is violent I would think separation may be necessary for her safety.

 

[Elizium23]

It will be a great hardship if he is not trying to get well.

It took me over 20 years of off-and-on therapy to find the right medication that controls my symptoms. I can tell you that those 20 years were filled with turmoil and regretful incidents. At some points, I sought help, and at other points, I ran the other way.

What it really took for me was to lose everything and to experience a thorough conversion back to God. At the time of this conversion, it was still eight years until I found the right medication, so the road was still a bit rough, but I got better and better as I tried to stay on the narrow path.

I am grateful now that my medication is under control. It is just a small, single dose that makes a world of different in my moods and my sleeping pattern. Four years on, I am not suffering any long-term side effects or resistance to the dose. I am fortunate that I found this to work for me. If the husband expects any road to recovery, he will have to start NOW and will have to persevere through a lot of trials. If he is not willing to do this then I do not see a bright future for him.

 

[PaulGH]

I do have some experience with that condition. It is a very, very trying condition, especially in marriage. One of the biggest challenges, in my experience, is that the further a person goes into a manic episode, the less they are willing to believe that they need help or that there is anything wrong with them at all.

My experience has been that time and medication can make a very big difference. I don’t mean to promise that these factors will make a difference in your friend’s husband’s case (though I hope and pray that your friend’s husband will get better!), but my experience has been that very significant improvement is possible.

 

[Julia_Mae]

I’m asking those of you with this disease and those who are (or have been) married to someone who has it: if nothing changes in this scenario, is there any hope for her marriage?

Well, all she has to do is not leave him, but I think what you are asking is: is there any hope for her to have anything like a normal marriage?

If nothing changes: no.

The “anger issues” are the mania spilling over into rage before descending into depression. Mania, which you are describing, feels much too good to want to change it. When he crashes, he’ll get very sick, possibly be hospitalized, and then be on meds. When he goes back up, unless he accepts his diagnosis and takes some responsibility for trying to control his disease by cooperating with doctors and therapists, he will go off his meds.

Of course, he hay bankrupt them by then, have fathered an illegitimate child or done something to get himself arrested.

Your friend needs her own therapist to help her realistically work through some issues, and decide what she wants to do. It could be many years and cycles before he gets stabilized. Even if she stays, she will likely have to support the family at some point and still need someone to watch the kids if there are any.

Everyone try not to hate him or blame him, but everyone has to be very tough and not be in denial themselves.

Also, she should immediately take steps to protect her portion of the marital assets. Legal advice is in order here.

 

[PaulGH]

One more thing I would add: My experience has been that it can be difficult to find a really good psychiatrist, especially because the patient ideally needs to trust the psychiatrist. Your friend should not be hesitant to seek a second medical opinion, if she and/or her husband are unhappy with their current psychiatrist.

 

[Allegra]

If nothing changes, then your friend is in an impossible situation. The question is, simply, how much is she willing to put up with? However, there are a few things which could make things come out alright. If her husband WANTS to be treated, medication can be successful. However, the patient has to be consistant and honest because it often takes several adjustments and sometimes it can make the symptoms worse. He would need the support of friends and family, and problem relationships would need to hit the bricks. During the treatment (especially the first couple years) the patient should be seeing a competent counselor frequently. He can’t only be accountable to his wife. When a spouse becomes a counselor, it often ends up ruining the relationship. Also, keep in mind that sometimes it is difficult to tell what behaviors a person has because of their own personality, and what behaviors are from their illness. As bizarre as it sounds, your friend could have fallen in love with some of her husbands manic behaviors. When these are no longer displayed, she may see him as a completely different person. If her husband percieves this, he might determine that the treatment is making him worse and stop treatment suddenly. Even though she is not the one with the mental disorder, she should probably seek some counseling as well so that she can deal with her pain over the things he’s done and learn how not to sabotauge his treatment. (If she decides to stay with him.) Finally, if he is violent, she needs to seperate and insist upon him showing prolonged success in a treatment process before she agrees to return.

 

[TheRealJuliane]

Well, all she has to do is not leave him, but I think what you are asking is: is there any hope for her to have anything like a normal marriage?

If nothing changes: no.

The “anger issues” are the mania spilling over into rage before descending into depression. Mania, which you are describing, feels much too good to want to change it. When he crashes, he’ll get very sick, possibly be hospitalized, and then be on meds. When he goes back up, unless he accepts his diagnosis and takes some responsibility for trying to control his disease by cooperating with doctors and therapists, he will go off his meds.

Of course, he hay bankrupt them by then, have fathered an illegitimate child or done something to get himself arrested.

Your friend needs her own therapist to help her realistically work through some issues, and decide what she wants to do. It could be many years and cycles before he gets stabilized. Even if she stays, she will likely have to support the family at some point and still need someone to watch the kids if there are any.

Everyone try not to hate him or blame him, but everyone has to be very tough and not be in denial themselves.

Also, she should immediately take steps to protect her portion of the marital assets. Legal advice is in order here.

This whole post is excellent, and the last sentence is very important. Critical, really.

 

[TheRealJuliane]

If nothing changes, then your friend is in an impossible situation. The question is, simply, how much is she willing to put up with? However, there are a few things which could make things come out alright. If her husband WANTS to be treated, medication can be successful. However, the patient has to be consistant and honest because it often takes several adjustments and sometimes it can make the symptoms worse. He would need the support of friends and family, and problem relationships would need to hit the bricks. During the treatment (especially the first couple years) the patient should be seeing a competent counselor frequently. He can’t only be accountable to his wife. When a spouse becomes a counselor, it often ends up ruining the relationship. Also, keep in mind that sometimes it is difficult to tell what behaviors a person has because of their own personality, and what behaviors are from their illness.** As bizarre as it sounds, your friend could have fallen in love with some of her husbands manic behaviors. When these are no longer displayed, she may see him as a completely different person.** If her husband percieves this, he might determine that the treatment is making him worse and stop treatment suddenly. Even though she is not the one with the mental disorder, she should probably seek some counseling as well so that she can deal with her pain over the things he’s done and learn how not to sabotauge his treatment. (If she decides to stay with him.) Finally, if he is violent, she needs to seperate and insist upon him showing prolonged success in a treatment process before she agrees to return.

Another great post, and a very good and subtle point. Mania can be very attractive because the person has a lot of charisma and confidence (if not arrogance). They can be generous, funny, exciting, etc. To lose that might involve grieving for the loss.

 

[EasterJoy]

I was afraid that this is what I would hear. It only makes sense. This is a very sad situation. It is like realizing that someone you know is in denial about their cancer diagnosis, there is so much to be lost by the delay of treatment. Let’s pray something changes before it is too late.

 

[ringil]

Individuals with Bi-Polar Disorder must, MUST take medication to treat their condition.

Bi-Polar is a very biologically-based disorder charaterized by chemical imbalances in the brain and will not respond to life changes, prayer, therapy alone, or anything else unless the individual is taking their medication.

Just as an individual must take meds. for diabetes or heart disease they must take meds. for Bi-Polar Disorder.

 

[EasterJoy]

Individuals with Bi-Polar Disorder must, MUST take medication to treat their condition.

Bi-Polar is a very biologically-based disorder charaterized by chemical imbalances in the brain and will not respond to life changes, prayer, therapy alone, or anything else unless the individual is taking their medication.

Just as an individual must take meds. for diabetes or heart disease they must take meds. for Bi-Polar Disorder.

My great concern is that he seems to be trying very hard to keep anything from changing, and so far she seems to have no boundaries in place: boundaries on his secrecy with their money, on his secrecy concerning his whereabouts (which has involved not just secrecy, but outright deceptions), on his willingness to take medications, and so on. She hasn’t made any ultimatuums concerning what kind of verbal abuse or angry outbursts she will tolerate without leaving. From the little I hear, it seems as if he is making all the rules, and as if she is currently going along with it all as a way of trying to keep him from going off half-cocked, with limited success.

I don’t know if she has tried to impose boundaries, or not. I didn’t have the heart to ask. She is seeing a counsellor, although not as often as she would like, and she says she does have plans for getting out immediately, if she feels unsafe. Were it me, I’d feel unsafe…now. The guy seems to be like a time bomb.

I don’t want to demonize the mentally ill, but because the status quo is marching on, realistic expectations seem to range from somewhere at least within the merely sucky to something far into the realm of a nightmare. My gut reaction is to tell her in no uncertain terms to RUN NOT WALK, TO THE NEAREST EXIT, because of all the terrible things I could see coming if he refuses to radically change this awful status quo, some selection of which seems all but inevitable. I didn’t do that because I want to respect her right and competency to make her own decisions. OTOH, I also don’t want to see her dead, broke, broken, or sucked into something he does to earn himself a prison term, either.

We have not had much time to talk so far. I’m just concerned that I have so little knowledge of this type of situation, and so little idea of what on earth to say to her, how to listen, or how to support her.

 

[tafan]

Having seen this up close and personal, here are a couple of thoughts:

1. THe advice about protecting her portion of marital assets cannot be stressed strongly enough.
2. About the comments that one may have fallen in-love with the manic. I do not agree that this could happen; something close, but very different. What was explained to me, by more than one professional is that for a person who has experienced an onset of bipolar disorder, prior to that they often had tendencies towards this for years. Think of it as bipolar light, except that there were no extremes, just an eccentric and at times a little whacky personality. But “bipolar light” is not accurate either, because lots of people would fit the description without ever becoming bipolar. This may have been what a spouse fell in love with. But when a true bipolar disorder takes hold,no one (and I mean no one) could fall in love with the manic personality. My expereince is that regardless how bad you feel for a loved one when they are in the depression stage; you invariably wish for its return when they are manic.

 

[tafan]

My great concern is that he seems to be trying very hard to keep anything from changing, and so far she seems to have no boundaries in place: boundaries on his secrecy with their money, on his secrecy concerning his whereabouts (which has involved not just secrecy, but outright deceptions), on his willingness to take medications, and so on. She hasn’t made any ultimatuums concerning what kind of verbal abuse or angry outbursts she will tolerate without leaving. From the little I hear, it seems as if he is making all the rules, and as if she is currently going along with it all as a way of trying to keep him from going off half-cocked, with limited success.

I don’t know if she has tried to impose boundaries, or not. I didn’t have the heart to ask. She is seeing a counsellor, although not as often as she would like, and she says she does have plans for getting out immediately, if she feels unsafe. Were it me, I’d feel unsafe…now. The guy seems to be like a time bomb.

I don’t want to demonize the mentally ill, but because the status quo is marching on, realistic expectations seem to range from somewhere at least within the merely sucky to something far into the realm of a nightmare. My gut reaction is to tell her in no uncertain terms to RUN NOT WALK, TO THE NEAREST EXIT, because of all the terrible things I could see coming if he refuses to radically change this awful status quo, some selection of which seems all but inevitable. I didn’t do that because I want to respect her right and competency to make her own decisions. OTOH, I also don’t want to see her dead, broke, broken, or sucked into something he does to earn himself a prison term, either.

We have not had much time to talk so far. I’m just concerned that I have so little knowledge of this type of situation, and so little idea of what on earth to say to her, how to listen, or how to support her.

You are not demonizing them at all. A bipolar person often does not want to change when they are manic; they love the manic stage because they know how horrible they feel during the depression stage.

And the problem is compounded that any medicine routine takes a lot of time to get right and to be effective. On top of that, finding a good psychiatrist is so difficult; one that will actually monitor them closely; one that will not over-prescribe anti-depressants; and one that knows not to trust the patient. Believe it or not, the last point is a common problem and bipolar people learn really quick what to tell the doctor to get what they want (typically a higher dosage of anti-depressant, even a change of diagnosis from bipolar to clinical depressant).

We finally found a psychiatrist who had a policy that she would not accept any new bipolar patient unless the patient agreed to allow a spouse or other close family member to meet with her on a regular basis. This seems to be such common sense; but it is not.

 

[EasterJoy]

You are not demonizing them at all. A bipolar person often does not want to change when they are manic; they love the manic stage because they know how horrible they feel during the depression stage.

And the problem is compounded that any medicine routine takes a lot of time to get right and to be effective. On top of that, finding a good psychiatrist is so difficult; one that will actually monitor them closely; one that will not over-prescribe anti-depressants; and one that knows not to trust the patient. Believe it or not, the last point is a common problem and bipolar people learn really quick what to tell the doctor to get what they want (typically a higher dosage of anti-depressant, even a change of diagnosis from bipolar to clinical depressant).

We finally found a psychiatrist who had a policy that she would not accept any new bipolar patient unless the patient agreed to allow a spouse or other close family member to meet with her on a regular basis. This seems to be such common sense; but it is not.

Well, if you have any ideas what a friend can do to be a friend in a situation like this, I’m all ears.

 

[PaulGH]

We finally found a psychiatrist who had a policy that she would not accept any new bipolar patient unless the patient agreed to allow a spouse or other close family member to meet with her on a regular basis. This seems to be such common sense; but it is not.

Excellent point. I think it is essential that the psychiatrist at least have lines of communication open with the spouse or someone else close to the person with bi-polar. While the person with bi-polar will probably recognize that something is wrong when they are depressed, they will think that everything is perfectly right when they are manic. (Again, this is my experience only. I am not a doctor, and I do not know whether my experience is typical of people with bi-polar disorder in general.)

 

[PaulGH]

Well, if you have any ideas what a friend can do to be a friend in a situation like this, I’m all ears.

Involuntary (and temporary) psychiatric hospitalization of the husband is an option that could be considered, if the situation is bad enough (e.g., if the husband refuses treatment, is having severe manic symptoms, etc.). I don’t know what would be necessary to make that happen, and I don’t know if it is the right course of action in this situation, but it is something that could be considered.

 

[tafan]

Well, if you have any ideas what a friend can do to be a friend in a situation like this, I’m all ears.

I wish I did. THere are few simple answers. If you are just a friend of hers: lots of support and help with research, etc. If you are a close friend of both of them; then more direct help might be in order.
More from my experience that you may be able to share with your friend (but she may have figured a lot of this out):

-It is easiest to get a bipolar person to a doctor when they are depressed, as opposed to manic. So take advantage of that. Now, they have to agree to allow the doctor to share information with even a spouse (I believe) and certainly a brother (I know). They are more pliable when depressed, so will often agree to this when depressed, but not when manic. Take advantage of that. This list goes on; eg. when they are depressed, they want a load taken off;so its a good chance to get them to reliquish some financial control (“honey, you have to let me handdle this so you don’t have to worry about it”).
However, when they are depressed, it will be up to the spouse or family member to convince the doctor how bad the manic episodes are.

• some level of precaution from STD is in order. Inline with Church teaching of course.
• protect the kids, especially from emotional abuse. I am not for sure that bi-polar will cause someone who was not violent before to become violent, I have seen a very bad case of bipolar, yet there was never any physical abuse of wife or kids. But there was a lot of emotional abuse.
• Tell your friend to start going to mass everyday.

 

[EasterJoy]

I wish I did. THere are few simple answers. If you are just a friend of hers: lots of support and help with research, etc. If you are a close friend of both of them; then more direct help might be in order.
More from my experience that you may be able to share with your friend (but she may have figured a lot of this out):

-It is easiest to get a bipolar person to a doctor when they are depressed, as opposed to manic. So take advantage of that. Now, they have to agree to allow the doctor to share information with even a spouse (I believe) and certainly a brother (I know). They are more pliable when depressed, so will often agree to this when depressed, but not when manic. Take advantage of that. This list goes on; eg. when they are depressed, they want a load taken off;so its a good chance to get them to reliquish some financial control (“honey, you have to let me handdle this so you don’t have to worry about it”).
However, when they are depressed, it will be up to the spouse or family member to convince the doctor how bad the manic episodes are.

• some level of precaution from STD is in order. Inline with Church teaching of course.
• protect the kids, especially from emotional abuse. I am not for sure that bi-polar will cause someone who was not violent before to become violent, I have seen a very bad case of bipolar, yet there was never any physical abuse of wife or kids. But there was a lot of emotional abuse.
• Tell your friend to start going to mass everyday.

Thanks. I think that might help her. No kids in the home, so there is that.