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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
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Experience:  MD Psychiatry
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My husband has intense mood swings, anger and seems to be disconnected

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My husband has intense mood swings, anger and seems to be disconnected from what he believes is going on and what is actual. Certain environments or words will trigger an episode. He is usually more manic than depressive. Do you have any idea what this might be? he is 49 years old
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 5 years ago.
Hi there ,

Welcome to Just answer !

Well, from the symptoms of your husband , that you have mentioned , it seems that the fact that he gets angry very often and with a little provocation and also he is otherwise happy and this behaviour alternates with his depression , so it indicates towards a Bipolar disorder diagnosis , probably a Bipolar 2 , as he seems to be having Hypomanic episodes rather than full blown manic episodes , which are severe in intensity and effect the person's ability to judge and functiion well professionally as well as socially ,and since this is not the case with your husband so it seems quite possible that he has hypomanic episodes , which alternate with depression, and thus giving him a Bipolar 2 disorder diagnosis.

So, i will suggest you discuss this with his psychiatrist and ask him to add a Mood stabilizer such as Lithium or Valproate to the ongoing treatment regime comprising of lexapro ( anti depressant ) and lorazepam ( anti anxiety ) . A Mood syabilizer will not only control his hypomanic episodes but also will prevent mood swings , anger and will calm him down.

And you mention that despite his fluctuating mood and at times odd behaviour it is surprising to see that he functions well professionally , actually there are many successful and world renowned people of past and present who had Bipolar disorder but , they functioned very well professionally and socially , due to the drugs they were maintained on, and in case of your husband he is not go into full blown mania , and his symptoms right now are quite controlled ,and suitable for a hypomanic diagnosis ,and in hypomania , the person is able to function quite well professionally and socially , in fact as normally as any other normal person would do.

So, i suggest you discuss this diagnosis of Bipolar disorder with his pscyhistrist and discuss the addition of a mood stabilizer to the regime . I am quite sure adding of a mood stabilizer to the ongoing regime will relieve his present symptoms.

I wish your husband best of health.

I hope my answer serves your query according to your satisfaction.

Please press the ACCEPT if you are satisfied with the answer as only then will i be credited for my service.

Regards...
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4070
Experience: MD Psychiatry
Dr. Kaushik and 2 other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.

Thanks Dr. K

i have another quick question. Could it still be bipolar 2 if all of this behavior is directed to no one else but me. He has jealously issues, but there has been no infidelities in our marriage. He is fine around his kids, his work and his family. These reactions seem to be only directed toward me. He saw his psychitrist yesterday and he told him that he does not have a chemical imbalance and that he just has issues that he needs to seek counceling to overcome. that may be true also but what I see at home is similar to a Dr. Jeckyl Mr Hyde. when he has an episode his eyes glaze over and it is if I am looking at someone else. His eyes get really dark and his voice changes.....its kinda scary. Any more insight? I appreciate your help

 

sarah

Expert:  Dr. Kaushik replied 5 years ago.
Well, as i mentioned earlier , Bipolar 2 disorder has Hypomanic episodes , instead of Manic episodes , and because the hypomania is much less severe than mania , as a result the person can very well keep his / her symptoms under wraps , that is hidden from others , and these symptoms are expressed in front of the near and dear ones , in this case it is you who is having to put up with his odd hypomanic behaviour . Many times it is seen that undiagnosed cases of Bipolar disorder 2 with hypomania , for years at a stretch keep functioning well professionally and social with outsiders considering the person as normal as others , but it is the family members who have to bear the brunt of hypomania , which remains concealed from others.

I really feel sympathetic towards you ,as the psychiatrist is missing the whole episode of hypomania , may be you can ask his psychiatrist to look at this angle , as it is you and not any other person who is having to bear all this , and you never know , when his hypomania gets converted to mania.

So, i suggest you consult his psychiatrist and express your concern about him being hypomanic and request him to re - evaluate your husband without any bias , and i am sure the doctor will look through your point and will offer appropriate treatment and advice .

I wish you all the best . Take care.

I hope my answer serves your query according to your satisfaction. Keep me informed about the outcome , i will be more than willing to give my inputs.

Regards..
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4070
Experience: MD Psychiatry
Dr. Kaushik and 2 other Mental Health Specialists are ready to help you

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