Marriage advice?

[HisWife]

My husband is having what his psychiatrist calls a "mixed" episode. He apparently has had this before, but this is the first episode of this type during our 14 years of marriage.

He is very angry by what he sees as me "controlling" him. The things he's angry about are real, but he doesn't connect them to his own behavior. For example, the other day he was very very agitated, moving constantly, very pressured speech. He decided he wanted to take our children somewhere and I refused, because I felt he would not drive safely. Or another night he woke me up, intentionally, every hour or so all night long. So, the next night, I slept in another room. Again, this led to him exploding. We also have struggles about his medication. I have made it clear that he if he doesn't take the medication, then I will make him leave, because the constant explosions are too scary for our children, who are currently refusing to be in the same room as him.

I am still hopeful that he will recover, and I would like to think that at that point we will go back to having a decent marriage, and he will go back to having a relationship with the kids. But I'm wondering how I can go about enforcing limits I feel are necessary, like not driving the kids when he is agitated, not waking me up all night, and taking meds, without doing long term damage to our relationship. I don't know if recovery would give him back the insight to understand my decisions, or if the anger would carry over. Certainly, before this episode he would have understood my choices.

Any thoughts on the best way to handle this?

 

[fragrant_violet]

Does he have borderline personality disorder?

 

[HisWife]

No, he has had diagnoses of PTSD and complicated grief, but his psychiatrist says that he is most likely Bipolar.

 

[HisWife]

I guess to ask in a different way, if you experience mania or mixed episodes, and behave in ways that you wouldn't otherwise, how would you want your spouse to respond?

If your spouse set limits on you during an episode, how did that impact your feelings towards them afterwards?

 

[Wishbone]

I've had mixed episodes and they are horrible, literally anything could get under my skin at such times and at the time I didn't think I was like that at all - I wasn't the one that was out of order, other people were. Of course, that was wrong. So keep that in mind, he doesn't quite know what's going on, the severity or clarity of it all. If you shout at him, he'll only get angry. Think of him as a fire that you don't want to pour fuel over. Instead you want to appease or calm it. He will still get angry but he won't have so many reasons to do so. Ride out the storm and then get him diagnosed concretely and then onto the correct medication.
People often seem like they don't want to be walked all over in these situations but lose sight of the fact that this is a person experiencing an illness, so take the high road for the short-term and then once he's well again make sure he does what he needs to, to keep the long-term free of such episodes as best he can. If you have any further questions about any part of this feel free to fire away with them.

 

[HisWife]

I know he’s miserable. I know he’s sick. My heart breaks for him. I also know that his thinking is really distorted and that he really thinks that he is fine, and I am just being overly anxious and controlling.

But even though I know all that there are still things I can't let him do. Letting him drive with our kids when he's that agitated and impulsive and angry isn't "taking the high road". If he wasn't sick, and I let his children get in the car with another driver who was in that state? He'd be furious. I feel like when he recovers, maybe he'll understand that decision.

So, there are limits I need to set. He needs to take his meds. He needs to let me make certain decisions for the kids etc . . . and I'm hoping to find the way to make that clear, that has the least long term damage. I'm not shouting at him. I'm trying really hard to be kind and understanding. But when it comes to the moment where there's a boundary I need him to respect, I'm not sure what's best. So far, the things that have kind of worked are threatening him (e.g. If you don't take your meds I will leave you), or asking my FIL to talk to him (FIL will yell at him), or bribing him although that has been a really bad slippery slope. His psychiatrist suggested that we have him admitted to the hospital, and I hate that idea, but I wonder if it would be less damaging?

I like the psychiatrist. I think he's on the right path and he's been proactive about meds. There are just a lot of complicating factors like grief, and PTSD which make it hard to conclusively diagnose.

 

[Wishbone]

Well, I think threats and yelling are not the way to go, but hey, I'm not him. Admitting him is best if he's a danger to himself and others, but if you can reason with him by simply yelling at him or threatening him then I'd say no, that's not far enough along for that.

 

[HisWife]

Well, I think threats and yelling are not the way to go, but hey, I'm not him. Admitting him is best if he's a danger to himself and others, but if you can reason with him by simply yelling at him or threatening him then I'd say no, that's not far enough along for that.

So, if you were at the point where threats and yelling kinda worked, what else would you want someone to try?

I agree that yelling and making constant threats isn't the solution. But I'm struggling to come up with another solution.

 

[Wishbone]

I honestly don't know because I don't know him, I can't see what he's like and I only have my own first hand account of such things to draw upon and much of that I can't account for properly or clearly. He needs meds inside him if he's in a mixed episode that's for sure. Is he actually on any meds?

 

[HisWife]

Yeah, right now he's on Depakote, Seroquel, and Klonipin, and tapering Sertraline. The Seroquel and Klonipin are new and they mean he's sleeping a lot, which is good, and he's less hyper, but he's still really irrational and irritable and argumentative. The doctor said that we'd see the sedation first, but fixing the other symptoms would take time.

But he only takes the meds if I or his Dad forces the issue. He says he's fine without them.

 

[HisWife]

I honestly don't know because I don't know him, I can't see what he's like and I only have my own first hand account of such things to draw upon and much of that I can't account for properly or clearly. He needs meds inside him if he's in a mixed episode that's for sure. Is he actually on any meds?

I'm not really asking what I should do. I want to hear about what works for other people.

 

[Wishbone]

Yeah, right now he's on Depakote, Seroquel, and Klonipin, and tapering Sertraline. The Seroquel and Klonipin are new and they mean he's sleeping a lot, which is good, and he's less hyper, but he's still really irrational and irritable and argumentative.

But he only takes the meds if I or his Dad forces the issue. He says he's fine without them.

That last line is all important. You get the meds into him and your problem goes away, if he's taking them intermittently then he's going to be all over the place.

 

[HisWife]

That last line is all important. You get the meds into him and your problem goes away, if he's taking them intermittently then he's going to be all over the place.

He's taking them consistently, because either I am threatening him (e.g. "I will take the kids and leave you if you do not take them") or his Dad is yelling at him and threatening on my behalf ("You better take these or you will lose your wife and kids").

But his psychiatrist says that Seroquel can take up to 6 weeks to work completely. At this point, the Seroquel and Klonipin are making him sleepy, but they aren't clearing up his thinking or his irritability.

So, I need strategies to survive the next six weeks.

 

[Wishbone]

Maybe @keith74 could have some better input for you? He's dealt with his wife having Bipolar, whereas I'm stuck on the other side of the fence blinded by previous episodes myself.

 

[HisWife]

Maybe @keith74 could have some better input for you? He's dealt with his wife having Bipolar, whereas I'm stuck on the other side of the fence blinded by previous episodes myself.

I'm sorry, I shouldn't be so rude. I'm just anxious.