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Nancy
Nancy, Psychotherapist
Category: Mental Health
Satisfied Customers: 746
Experience:  ABD for a PhD in Psychology, Psychotherapist for over 20 years
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Help, My wife has been diagnosed as having bipolar disorder,

Customer Question

Help,
My wife has been diagnosed as having bipolar disorder, and her current psychiatrist is still experimenting with medications. Due to her current extreme manic state, she will not allow me to communicate with her psychiatrist, and has stated that she intends to get where she can go off the meds. I am worried for her safety, and the safety of my grandson who she provides care for. Her current doctor will not communicate with me, nor even acknowledge when I call to leave an urgent message about her irrational and possibly self-harming behavior.

I have spoken with counselors who state they do "couples counseling", but that this requires that both parties be rational and constructive. My wife is currently neither.

How can I get things steered to a more effective treatment plan that involves the family and her support network, rather than letting the patient let her irrational fears make the decisions? Where can I get help?????
Submitted: 5 years ago.
Category: Mental Health
Expert:  Nancy replied 5 years ago.

HiCustomer

 

The way in which you can participate in your wife's treatment is to get her to sign a Release of Confidential Information form (ROI). COnfidentiality is a Federal Law and the Dr. is only doing he is required to do - you should be able to leave messages for him, but he cannot even acknowledge that he knows your wife unless she has signed a release for you - so you can the Dr. can talk.

 

Couples counseling *would* be a good idea - if for nothing else than you have another person monitoring her behaviors and manic states on a weekly basis - the Psychiatrist will not do that - eventually he will see see her MAYBE once every three months...

 

Bipolar disoder is extrememly hard to stabilize sometimes and the patient can NEVER go off the medication. It is a lifelong illness and requires medication monitoring always - the other thing that will happen, is every once and awhile, she may become unstable on the meds that were previously working and her meds will need to be adjusted.

 

Most people who are bipolar do try to get off meds - have manic episodes, get rehospitalized, get stable again and do it again in a year or so. It is important that you do whatever you can to make sure she remains monitored.

 

How else can I help you today?

 

Nancy

Nancy, Psychotherapist
Category: Mental Health
Satisfied Customers: 746
Experience: ABD for a PhD in Psychology, Psychotherapist for over 20 years
Nancy and other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.
Nancy,

Thanks for the reply, but I'm still stuck.

She refuses to sign the thing to let me interact with her psychiatrist, and the couples counselor we just went to said there is nothing she can do until my wife gets her meds stabilized and can participate in a rational and constructive conversation. At the moment, she just flies off and rants for long stretches at pretty much anything that is said - even if it just reminds her of something else. Essentially the counselor said don't come back until the wife is normalized.

A previous couples counselor completely validated her rants and never considered bipolar as a cause. He was looking for classic passive-aggressive male behavior that would justify upset wifey. Not the case here. She has now been diagnosed, and the manic stretch has lasted about 6 weeks with no signs of abatement.

The current stretch began almost immediately after the psyciatrist added a medication (Lorazapam). She went in yesterday for a scrip renewal, and I was allowed about 2 minutes of supervised face to face with the doctor - all of it interrupted by her outbursts. The outcome was that he doubled the dosage of seroquel, and left the Lorazapam in place.

It appears the spouse has no rights except to stay or go. Suffer the manic and depressive outbursts, and stand idly by while the relatively detached psych plays with the dosages.

Is it me, or is this process a picture of insanity? How can someone treat a fairly extreme case of bipolar without any input from the people that are closest and able to watch what happens. Certainly the patient in a manic state is a poor choice to be the objective observor.

You mention hospitalization. How can I arrange that if I'm not allowed to talk to her doctor?

Thx.
D
Expert:  Nancy replied 5 years ago.

Hi,

 

I completely understand your frustration. And I know exactly what you mean by the Psychiatrists don't take any input -- you are right, they don't. The only thing they are looking for, like you said is an abatement of symptoms. Nothing else matters - and not in a mean way - but in a clinical way. Mania is mania and all the doctor needs to see is that symptoms are subsiding. The patient's rants and raves are nothing but symptoms and the doctor is simply trying to find a medication combination that works for the patient. It's not pretty, but these are the facts. All cases of bipolar are extreme - and so the 'details' of what the person is doing is really not new to the Psychiatrist. Those details are also not helpful - what is actually more helpful to the doctor is when she is getting better... then he knows he's on the right track.

 

For someone to be hospitalized they have to admit to being a danget to themself or others - in other words, they need to verbalize to a person who is able to Baker Act them (a pscyhologist, psychiatrist or police officer) that they are going to kill themself or they are going to kill another person. The only other way people are involuntarily held is if they are clearly incapable of caring for themself - typically during a psychotic episode where they are clearly disorganized and floridly psychotic.

 

Make sure she is taking her meds without being intrusive, keep her on a med schedule and know that this will get better. And don't be afraid to set limits if she will remotely listen...

 

Finally, keep in touch. If nothing else, I can listen to you and offer daily support. Just keep these emails - write back every day (you are only charged once) but we can still talk.

 

Nancy

Customer: replied 5 years ago.
Hello Nancy,

Ah, it sounds honest - if far less than encouraging.

In the present state, my wife won't take any sort of input or even discussion of anything. If it weren't so horrible, it would be funny. Like this morning - I said "thank you for cleaning up the play room", to which her reply was "I didn't do it for you!".

No - she will not "remotely listen" to anything.

She has specifically told me that she will not discuss her medications with me, and that I must not even ask about it. Perhaps this will change someday when she is "normalized" and some semblance of a discussion can be had with her, but not now.

The "has to admit to.... danger to themselves or someone else" sounds like a great recipe for disaster. The other night she suddenly announced at about 7 pm that she was going to drive over to spend the night with her friend. There was no fight between us, this was just an impulse. Her friend lives about a 2 1/2 hour drive away over and through the Nevada Sierra mountains via two-lane treacherous roads with many unguarded drop-offs on a night when it was raining heavily and the winds were forecast to reach 90 MPH along the peaks. Fortunately, after driving around for a while (I guess, I don't know what she was actually doing - probably drinking or smoking marijuana) she came home. I'd say there is a distinct risk of her doing serious harm to herself or my grandson (she is the stay-at-home caregiver for my 6 year old grandson). Her judgment is clearly leading her astray in potentially fatal ways.

I can imagine myself saying later "I kept telling people she was at risk!", but by then it will be too late.

It appears our society does not really provide a comprehensive way to deal with this situation. I have been reaching out wherever I can, and there seems to be know answer other than to attend either the divorce proceedings or the funeral. Quite distressing.

Thanks,
Don
Expert:  Nancy replied 5 years ago.

Are the parents of your grandson aware of how bad this situation is? I'm surprised they would leave him with her in her state...

 

Nancy

Customer: replied 5 years ago.
Hello Nancy,

Ah, interesting question.

The bipolar disorder has probably been with my wife all her life - by her own admission. However it was only diagnosed within the last 6 months, and never exhibited the divergence that is going on now. However...

My wife and I have full legal custody of my grandson (she and I have been married about 2 1/2 years). The mother has far worse problems, both medically and psychologically, and the father is working on finding maturity and meeting his responsibilities. They are not an option. In fact, I would say we are the best option, and these recent developments are a bit of a surprise. Both live thousands of miles away from us.

I find despair in the almost total absence of resources for a spouse that simply wants to get help and do the right thing. I am witnessing what I've read about - the bipolar person in the midst of a manic episode is NOT going to cooperate or be rational on any level. Makes for quite a challenge.

Thx.
Don
Expert:  Nancy replied 5 years ago.

Hi Don,

 

Can you have the child put in daycare, or make *any* other arrangements for him? Clearly your wife is a danget to him... and it would only be temporary - as her meds will kick in.

 

Nancy

Customer: replied 5 years ago.
Nancy,

Alas, not immediately. There are a couple of other stay-at-home moms who check in every day, with a variety of kid-swapping things where kids play at one place or another. I'm off to Germany for a week, and can't do anything until Friday May 15th. We go back to a couple's counselor on the following Monday.

As I just responded to a very close friend of my wife's, I don't doubt her total love and commitment to the grandson. It is without a doubt the single most focused and dedicated element in her life. I don't trust her behavior, however. The psych has upped the medication starting yesterday, so perhaps during the week she will mellow a bit.

Thanks,
D
Expert:  Nancy replied 5 years ago.

Her love and her capabilities are two different things though. This is a safety issue - and a few people checking in a few times a day is really taking a chance.

 

Nancy

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  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
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