How to Care for and Cope With a Bipolar Spouse

[Daniel E.]

I am going to try to make sure my husband never goes back to the VA for psychiatry, even if I have to pay cash. The pscyh doctor of some sort he talked to today -- a different one than before -- didn't even know about Depakaote being worse than Abilify for black box warnings concerning most individuals. In any case, she wanted to give him Depakote instead of his regular Abilify, and I was raising hell about potential liver concerns since my brother had bad liver labs from Depakote. She was even dismissing his own conerns about his previous experience with Depakote years ago of swelling feet. She did not even tell him about any potential side effects before prescribing Depakote.

 

[David Baxter PhD]

That's appalling.

 

[Daniel E.]

On the positive side, I got to personally experience my own manic rage I already left a negative review for the VA on Google.

 

[Daniel E.]

BTW, found out today the VA provider who was prescribing was a PharmD (doctor of pharmacy), not a psychiatric provider. Husband complained to psychiatrist, who was very understanding. Apparently, at the VA, the PharmD is the gatekeeper for getting approval for certain (non-formulary) medications.

 

[Daniel E.]

More good news from the VA. His psychiatrist was on the phone with him today to make sure he is doing well, and she is calling him again tomorrow.

Incidentally, I went to pickup his Zyprexa refill today at the VA (since he is switching again from Abilify to Zyprexa), and it feels like a military base over there. I had to go through two security checkpoints since they are still on semi-lockdown. The first checkpoint was to make sure you are supposed to be there, and the second one was to make sure you have a mask on.

 

[David Baxter PhD]

Hospitals up here are like that. You are funneled through only manned entrances where you need to be wearing a mask, use sterilizer on your hands, and answer a series of questions before you are cleared to enter.

Then you are double checked when you get to your destination in the hospital to check again that you were screened at the front, still wearing a mask, and again use the hand sterilizer (since you came up an elevator or through some additional doors).

At the pharmacy, I wear a mask anyway but I'm pretty sure if I wasn't I'd be given one or asked to leave until I got one.

 

[Daniel E.]

Happy update:

Husband has not yelled since switching back to Zyprexa.

Even if he is just at a good point in a cycle, I am happy for the break

But if he does get acutely manic, he can take a higher dose again for a few days. The psychiatrist has him at 20 mg twice a day for acute episodes, and 20 mg a day otherwise.

 

[Daniel E.]

Another post of venting and processing:

The problem now is that some other symptoms have come back or worsened. He is more restless (wanting another dog, complaining of boredom all the time), smoking marijuana more (almost twice as much as before -- he is reaching his legal limit every week), and has gone back to sneaking in cigarettes.

I think another reason he is smoking more marijuana is we have more disposable income now and/or the cost of the marijuana has gone down to some degree.

After he refused again to call his psychiatrist (due to his almost-zero insight), I told him I am done, but we are already smoothing things over. But I also told him: Would you want to live with you? Someone who complains about being bored all the time, who spends a lot of our money on marijuana, and smokes cigarettes even though his sister is dying from lung disease?

I called his sister to let her know that is more bipolar than usual.

I told him I think he needs to see a psychiatrist outside the VA. His answer of course: "I have nothing to say to a psychiatrist," and of course I replied "I have plenty to say about you ."

 

[Daniel E.]

The VA psychiatrist told my husband that his restlessness could have been a side effect of the Zyprexa. So she lowered his dose a week ago. So far, so good.

 

[Daniel E.]

OMG. Looking forward to Phoenix traffic after spending a few hours with his sister and her husband, who also seem to have bipolar disorder. He and them are so loud together today since they are arguing over the past. I would go insane if here much longer.

Update: The traffic was about the same level of dissatisfaction

 

[gooblax]

I guess noise cancelling headphones would be an inappropriate response to others arguing.

 

[Daniel E.]

Today was also his birthday. He later said I ruined the day for him and it was the worst birthday of his life because of me. It's like being an unappreciated employee where I have to understand my boss's challenges, but he doesn't understand mine.

When these bad days happen, I feel stupid for staying with him, and I wish I was dead. Even if he has no choice but to act this way, I don't have the resources to deal with this on my own.

Hopefully, I can use this as an impetutus to get a local job since my fear of COVID-19 has vanished after the way I was treated today -- since life seems quite unhappy now.

 

[David Baxter PhD]

I’m sorry to hear that, Daniel.

Relationships are not easy. Relationships which include bipolar disorder can be especially difficult since you are often put in the position of being a caretaker and a peacemaker as well as a spouse.

I don’t want to over generalize my comments. Some bipolar relationships do certainly work but they work when the bipolar partner is consistently compliant with medication, doesn’t mix it with other substances, and remains in regularly scheduled therapy. From what I understand, when that happens, if it happens at all, it’s because you insist on it and monitor it, putting you essentially in the role of parent as well as caretaker and spouse.

It’s not an enviable position for anyone to be in.


Sent from my iPhone using Tapatalk

 

[Daniel E.]

Since I am losing hope, I think I am done trying to be his caregiver for mental issues anyway. The resentment just continues to build, especially since I often feel just as lonely as I did before I got married (if not more so).

The marijuana or his own self-focus also makes it hard for him to remember things, causing arguments. He angrily told me earlier this week to return a $20 foam roller (that my doctor recommended) to Amazon since I have never used it, even though I have used it in front of him before (and when he was sleeping). And I told him, even if I never used it, I bring in way more money than you do anyway, and I don't spend $100 a week on marijuana. He later apologized, but he doesn't understand what I have to go through with my own mental health issues. (Who tells someone with a history of suicide attempts to stop wasting money on seeing a therapist? At least now, there are no-copays on mental health for the rest of the year, and next year the co-pays will only be $20.)

In any case, I "see" my new psychiatrist on Monday, and I will be asking him to refer me to a therapist. My biggest problem now may be a general sense of hopelessness -- being tired of dealing with OCD and depression along with "problems of living."

 

[gooblax]

Sorry to hear that Daniel, it sounds like a really difficult situation. Putting yourself first is definitely for the best. Him being unwell doesn't mean that you have to put up with being treated poorly or being blamed for things that are his responsibility.

 

[Daniel E.]

Next time there is a blowup, I think I am going to try to reframe his symptoms as anxiety or OCD so I can relate to him better. He does have a laser focus like I do for things that are not ideal.

 

[Daniel E.]

I am angry at myself for staying -- again. He yells at me on the way to the vet (what he calls talking loud), angry at me for me insisting we take the 11-year-old cat the vet (because the cat is having problems breathing and won't eat as of last night). Then, after an x-ray, we find out the cat is dying of advanced lung cancer and may die within a day or a week, which can be a painful death of being unable to breathe. So we had to put the cat down this afternoon.

Then, after we get home, he yells at me that I don't have the heater ready in the bathroom for his shower -- like he requested (which I have no memory of).

Even as the vet was putting the cat down, he even complained to the vet about something she forgot to do years ago concerning another pet we had (getting paw prints done before putting our dog down). And that is not just from grief since that is his bipolar disorder (and being abused as a child, etc).

Now he is all calmed down. Like nothing happened.

So I guess I will just stay with him like always, but the resentments are there and I don't know what to do with them.

The crazy thing is he says I am acting like a child for yelling FU after he continues to yell at me.

I guess I just will put it all down as stress making his bipolar worse. He didn't want to take the cat to the vet because of the cost of diagnostics. Before we saw the vet, he blames my OCD for worrying about the cat. I told him he was just living in denial since cats hide their illness very well, and by the time they have symptoms, it will only get worse without treatment.

And our senior dog who is living with chronic bronchitis/COPD probably got that too from my husband smoking cigarettes in his house forever before I met him. But he still smokes marijuana in the house even though he has mild COPD himself, which is why I got two air purifiers and now keep the COPD dog and myself away from him when he is smoking dope.

Back to taking one day at a time... But with my existential anxiety, nothing makes sense (or feels "just right") much of the time anyway.

 

[Mari]

So sorry you are going through this Daniel. I am having a bad day also and it is like 'what the hell?' Good that you can talk about it and hope you can figure something out. I do not have any expertise on illness so can not do much except offer support because everything I hear from you makes me think you are a great person and your posts have often cheered me when I am down.

 

[Daniel E.]

your posts have often cheered me when I am down.

ditto

 

[Daniel E.]

The Burden of Sympathy: How Families Cope With Mental Illness

Quite simply, what do we owe each other? In this vivid and thoughtful study, David Karp chronicles the experiences of the family members of the mentally ill, and how they draw "boundaries of sympathy" to avoid being engulfed by the day-to-day suffering of a loved one...

Powerful cultural messages spell out two contradictory imperatives: pursue personal fulfillment at any cost and care for the family at any cost.