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Dr. Steve
Dr. Steve, Psychologist
Category: Mental Health
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Experience:  19 years conducting therapy; book author; newspaper columnist; former co-host of radio show
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My husband has been diagnosed with affective peronality disorder.

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My husband has been diagnosed with affective peronality disorder. I really belive that this is not a true diagnosis. Up until 2 years ago he functioned normally. But around this time I had a miscarriage and 6 months later my husband was told he had a low sperm count and it would be very difficult to have anymore children, a year before that his nan and grandad who he was very close to both died of cancer. His dad was dianosed with msa a terminal illness around the same time, and he has gone down hill rapidly. In this time my husbands behaviour has changed alot from the way he used to be, he has become very argumentive and frequently flies into rages and has developed nervous ticks, he has never had counselling for it, the psychiatrist just put him on antidepressants and mood stabilizers. I belive he has severe grief issues and not a personality disorder what do you think?
Submitted: 7 years ago.
Category: Mental Health
Expert:  Dr. Steve replied 7 years ago.



Excellent question, thanks for writing. Let me say right up front that "Affective Personality Disorder" is not a real diagnosis - you are absolutely correct about that. I don't know exactly what was discussed by the psychiatrist, but the diagnosis you took away from the meeting was not accurate.


Having said that, I also fully support your armchair diagnosis of unresolved grief and issues related to masculinity (you know your husband pretty well, after all!). In fact, the symptoms your husband is demonstrating are all signals to indicate masculine depression. When men get depressed, they do not typically follow the "classic" path of behavioral manifestations. In other words, men do not tend to get frumpy and downtrodden... rather, they tend to get angry. They grow argumentative, snarly, and irritable (sound familiar?). So yes, I think he is seriously internalizing the frustration and helplessness he feels from the situations you described - driving the needle into the red zone regarding stress and depression. Further, once these feelings are trapped (think about shaking a sealed coke bottle for too long - the pressure has nowhere to go), then physical complications almost invariably follow. You husband is having ticks, but it would not surprise me if he also develops gastrointestinal problems, tension headaches, or hypertension.


In any case, the treatment protocol that the psychiatrist is following is not out of the question, and may help a lot. Regardless of the diagnosis, antidepressants are the way to go here. I would add that a talk therapist could serve your husband well - particularly a male therapist who understands men's issues. The low sperm count, the losses, and his father's illness are all salient and need to be addressed. The talk therapist will be able to let some of the pressure out of the Coke bottle, and in conjunction with the medication, prove to be very effective.


The only caveat you may wish to have the doctor keep an eye on is the need for the mood stabilizers. If the antidepressants begin to alleviate the depression, then he may not demonstrate and of the bipolar symptoms the physician is treating.


If you are satisfied with the response, please hit "Accept." That is the only way I can receive credit for my answer. Thanks-

Dr. Steve

Customer: replied 7 years ago.
The word Bipolar scares me alot, would it be advisable to ask if he can slowly come off yje mood stabilizers?, I don't think anyone should have to be on such a medicine for such a serious worrying illness if in fact they havent actually got it. By putting my husband on these mood stabilizers it is like them saying that this is a life long condition that can never go away and can only be managed. When if it is posible just depression this can go away and can get better. What o you think should be the next step from here?
Expert:  Dr. Steve replied 7 years ago.

Hello again:


A couple of things: (1) IF your husband has NEVER had symptoms of bipolarity, it would be almost unheard of for them to "pop up" out of nowhere at his age. I realize you never said how old he is, but there are almost invariably signs throughout adolescence that point in the direction of bipolarity. (2) It is absolutely appropriate to discuss stepping down from the mood stabilizers with the prescribing physician. S/he may not agree, but at least open the duologue about what the choices are and why. Arm yourself with information - WebMD is a great place to begin, but don't deny the utility of a site like Wikipedia to fill in some of the information. (3) Given the brief snippet you provided, I would be more inclined to examine depression rather than bipolarity, so yes, his condition may not be lifelong nor might it be severe. While I cannot know for certain, I think (again) discussing the possibilities with the psychiatrist just makes sense. S/he has the best information because s/he has examined your husband, and has more information from which to draw a conclusion... but your opinion and your husband's history are relevant, and important.


I do wish you well-

If you are satisfied with the response, please hit "Accept." That is the only way I receive credit for my answer. Thanks-

Dr. Steve

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