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I believe that I can help.
Can you tell me what medications he is taking?
Can you mention any other symptoms he has besides being angry, having no interest in your needs or feelings, and being completely unable to have any motivation to help. Does he have any other interests? Does he watch TV while he is lying in bed?
What are the criteria for his diagnosis as bipolar 2?
On what basis do you say that his psych doc is really good?
(I suppose you mean psychiatrist.
I want to give you the best service possible, which will require a dialogue between us. Right now you are offline. I shall save this chat and exit for now. When you get back on line please answer the questions I have asked thus far, as completely as possible. I will work with you until we can find some positive approaches.
Right now, I am not convinced that he has Bipolar 2, and need more information.
I shall be be back early tomorrow morning, and then after a "break" to see a couple of clients in office, I will return in the early afternoon.
Until then, I wish you well and shall keep you in my prayers.
I understand the terrible pressure you are dealing with and know that you deserve much better. You are quite a fine person and you need to be treated so much better than this.
Warm regards XXXXX XXXXX later
Elliott, MAE, LPCC NCC, CCMHC
Elliot: He is taking abilify and celexa. I say he now has a really "good" doc for several reasons. Yes, she is a psychologist. She has been in her field for more than 30 years and is with the VA. She has been willing to talk straight with my husband and lay down some basic ground rules with him like 1. He must be willing to attend his appointments and speak honestly with her 2. He must be willing to take his meds 3. He must be willing to make some changes in life to help control this disease. He and I both appreciate her talking straight with him. She has also told him that this disease can be manageable, but he has to put the effort into it. No he is not on a "mood stabilizer". That is not the Doc's fault, that is my husbands. He has tried several and declines them d/t the side effects. The Doc is trying to work with him on this. As we are both aware, psych meds do have several nasty side effects. As to his bipolar type 2. Bipolar is a devastating diagnosis. The phych field is not a science. There is no specific blood test. There is no specific med that works for all and the disease sneaks into ones life and tears it apart from the very stitches that is supposed to hold it together. My husband spends most of his time in depression. His occasional ups are always met with a crashing down at some point. When he is in an upswing, he does not reach full psychosis but does become very grandiose, loud, and expressive. He does have pressured speech. He went through several Docs and meds for years before finally receiving this diagnosis. I can tell you he would rather be told that he has cancer.
Elliott: He is on Abilify and Celexa at this time. He declines mood stabilizers d/t the side effects and the doc is trying to work with him on this. He has tried them all over the years and even I understand the overwhelming side effects. His doc is a psychologist and has been in her field over 30 years. Before meeting her he was switched from doc to doc every 3 months and they never got a good handle on his case. Partly not their fault as they never had the time to really develop a proper client relationship, but partly not. I felt they were never completely honest with him and they never spoke straight with him about what was going on. They would see him for 20 minutes change his meds, and out the door. This doc REALLY spoke with him and laid down some rules like 1. He must be willing to own his disease and commit to attending appointments and taking medications 2. He must speak honestly with her about what is going on 3. He must be willing to work at making positive changes and stick with them. He and I both appreciated this direct honesty and willingness to commit to him.
Elliott: I am sorry for a repeat of the information. I did not realize that when it would disappear it was being uploaded to the reply. I just thought it was disappearing. Yes, he watches TV in bed, but mostly he does sleep. My problem with that is that he does get up and go to work fine. He should be able to help some in the house. I only ask that he mows the lawn, do laundry, and vacuum every other week. I do it on the opposite weeks and considering that he does not pay any bills I believe that this is more than fair. Im going to get off for now. I appreciate your reply. I just thought perhaps, why not give this a try? What do I have to loose besides a bit of cash? I really pray you can give me some insight. I love him very much. At his core, he is a very kind and loving sort. I do not expect perfection. I just feel like if I do not stand up for myself Ill be freeloaded for life. I want to give a quick disclaimer as to why I married. I truly did not realize how ill he was and he was in college to be a teacher at the time. I found out about a month after marrying that he had quit college without even telling me shortly after marrying. As a Christen I do not believe in divorce except for infidelity. This is a brief explanation, but the most accurate. I just did not realize what I was getting into and I will not divorce. Even if he las to leave, I will not divorce.
I am so sorry to be answering you question this late but this was a day fraught with emergencies: mine and others. I have survived but I have wound up very tardy in helping everyone who needs help (although I have been so busy today).
Your husband has a much better chance at survival with BPAD2 then with cancer. Let me tell you a hopeful story.
Let me tell you about one of my two supervisors during my internship. He was a young, very effective psychiatrist, and had been the chief resident in psychiatry at a major teaching hospital. He was brilliant, steady, effective, and beloved.
HE HAD BIPOLAR DISORDER. He was under treatment by his own psychiatrist. I saw him for hours every day with patients. He was always steady and solid. He took his medications everyday.
When a new bipolar patient would come into his office he would say, with a smile, "Welcome to the club".
I tell this to instill hope and confidence.
I am not a big promoter of psychotropic drugs, but sometimes they make a huge difference.
The combination of Celexa and Abilify could be what is making your husband so drowsy. Look at this report on combing the two:
Hypomania often reduces the need for sleep although depression could also be the cause of his drowsiness.
Sometimes psychiatrists will add a stimulant to the medication cocktail in order to give the patient more energy and motivation. You husband has only enough motivation to go to work but not to do anything else to share in the responsibilities and burdens of the marriage.
I recently read an article on Bipolar anger and would like to pass it on to you for further enlightenment.
BPAD2 is just as burdensome as BPAD1 (bipolar affective disorder) and carries more risk for suicide.
The best treatment is a mood stabilizer with an antidepressant. The Abilify is an antipsychotic medication but is is not mentioned as often as some of the others in the literature, but it is used to control mania.
He must follow the strict guidelines of his psychologist. His medications, however, are not fully addressing his depression, it seems and he must try something that will energize him more (addition of bupropion or a stimulant?).
He has a good therapist but I believe that he needs a better psychiatrist as well, one who is willing to try something else to break through the depression.
I wish him, and your family great success.
I shall continue to keep you in my prayers.