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05/16/2012 05:29 PM

Communicating (or not) with medical professionals

suzaan
suzaan  
Posts: 46
Member

My husband is often (although not always) able to keep the manic behavior under control until he's done speaking with the psychiatrist -- who really doesn't appear to have the time or interest to delve. ("Oh, the police played copies of his cell phone conversations over the loudspeaker all night. Really? Interesting."Wink No further questions, no follow-up appointment.

Any advice on how to handle communicating to the doctor when I can only speak in the presence of my husband? If I say nothing, I feel that I'm not helping him or me. But if I say what I believe, the doctor just nods. For his part, my husband looks wounded -- and then yells at me when we get home. I'm being intrusive and innacurate, and I have to meet him in the middle (except I haven't a clue where that might be).

While my husband is, from my perspective, paranoid, he's not coming up with any major new delusions but he's not letting go of the old ones either.

I'm told he says almost nothing in his group therapy session. When I hear him in short conversations talking to his friends, he sounds pretty much okay ... although sometimes he'll get distracted and start talking about conspiracies or whatever. The mandatory portion of group therapy ends this Friday, and he has no plans to come back.

A big problem is that he thinks that I'm part of the conspiracy against him, and that I'm directly to blame for all the awful things that have happened to him in the past several weeks. This got even worse when I called the group therapy leader to ask for strategies to get him to go back when his required time is up. Not only did she not have any suggestions, she shared our conversation with him, so now he really considers me the enemy. Actually, she did have one strategy: give him an ultimatum -- "either you go to therapy or we're done." This did not strike me as a good idea. Maybe it's just as well he's not going back there. But shouldn't he be under some sort of care?

I've also started seeing a therapist (first visit yesterday) in the hope that she can help me cope, and am trying to apply what I can from a book that came highly recommended ("I'm Not Sick. I Don't Need Help."Wink But I'm not doing very well. I had planned, per the doctor's advice, to work from home for several weeks, but I'm in my office today, just to get away from him.

I don't believe he presents a physical threat to himself or to anyone else. But I find myself crying a lot. I'm not a doctor. I can't judge whether he needs to go back to the hospital -- and I don't want to do that to him (he desperately does not want to go back) ... especially if I am wrong. He's decided he had one "trivial" manic episode and he's all better now. I'm trying to listen, empathize and ratify his feelings. But I don't think it would do anyone any good to lie to him or to his doctor.

Sorry for the long, rambling rant, but I'm at an impasse here.

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05/16/2012 07:24 PM
marriedtoit
marriedtoit  
Posts: 11201
Group Leader

I am not so sure her ultimatum was a bad idea. A lot of us have a "no meds, no marriage" ultimatum. Mine (and I think the other GLs too) is a bit broader--my husband owes us stability before anything else.

( I am disappointed that she shared with him the fact you talked to her. She is interpreting the privacy laws very very strictly--and in a way that is overall bad for his stability. )

About the "trivial mania," you might try a modified form of those LEAP techniques-- "So, I hear you saying, honey, that your manic episode was a trivial one. What makes you think that?" (And listen.) "What do you think a major episode would look like?" Instead of just telling him "Look, dunderbuss, there is no such thing as a trivial manic episode" lead HIM to that conclusion?

Reassure him. Tell him you have been doing a ton of reading and research and you have learned that people with the most successful outcomes work as PARTNERS with their spouses in achieving stability. You are on HIS team. It is very very common for an unstable bipolar spouse to blame the other person for everything, including blaming them for the manic (or depressive) episode.

As far as reporting to the pdoc, I would use very neutral and unemotional language. I don't know what you need to report the the pdoc, but let me try to show you what I mean just inferring from your post. Instead of "He is still very paranoid and thinks everyone is out to get him" list very specific things he has said "He said that the police were playing tapes of his cellphone conversations all night when he was in jail. I don't think that is possible, is it?" or "When the landlord needed to come in to change the heating filter, my husband said 'He is just coming in to spy on us.'" You don't even have to say "I found this disturbing." Just report.

BUT here is the thing that is most bothersome that you report--WHAT IS WRONG WITH THIS DADGUMMED PDOC???? Your husband reports a serious DELUSION and the pdoc doesn't say "Well, that means you need an antipsychotic." !!!!!! This pdoc sounds like Wifeonbpexpress's husband's former pdoc, who we not so affectionately nicknamed the CHURCH LADY. Is there any way to get a different pdoc? I realize that with your husband in such denial of what his mental illness means, everything is really really touch and go right now.

Which also means you probably aren't nearly ready to say "No meds, no marriage" yet. You want to try to convince him to get the help he needs. Let me share a technique I used that met with some success and helped (it was a factor, probably not the most important one, but a factor) convince him that he needed meds to get stable. Instead of insisting he admit he had "bipolar disorder" or a "mental illness," I insisted that he stop certain behaviors. I waited till he was calm and (relatively) lucid and I said "I see that you don't agree with the psychiatrist's diagnosis, and I respect your feelings about that. But we both know that things have been really bad around here with you. I want to be here for you. I love you. But I have to respect myself and I cannot become sick because of what you are doing. So I have to insist on (I think there were 5???) 5 things." FIrst on the list was NO RAGING. (This meant no yelling at me unless it was to tell me to duck because I was gonna get hit by a falling anvil.) Second was NO sarcasm or name-calling. He had to talk to me respectfully. Third was NO calling me at work to do anything more than say hi. Any problem could wait till I got home. Fourth was to STOP following me around the house as he talked nonstop about something. It was making me claustrophobic! Fifth was....I am not sure!!! But you see what I did? I focused on things that seemed SO reasonable and SO expected between partners and SO easy.... And he discovered that he had a really really hard time with ALL of them, when he was unmedicated. He knew they were reasonable, but he couldn't stop....

About the raging? I actually started hanging up on him if he raised his voice. Yes, this probably made him angrier, but I turned off my phone. He couldn't stop calling me at work to either suck me into some manic obsessive conversation or some other manicky thing, so I went for some months of telling him he could not call me at work! He had to email me.

I don't know if this is helpful at all, but please know many of us have been in your shoes and we understand how tough it is....


05/16/2012 07:45 PM
wifeonbpexpress
wifeonbpexpress  
Posts: 4891
VIP Member

It is totally worth it to find a new pdoc. We finally did and have never looked back. There are better pdocs out there, you just need to get out there find them. You need quality services and from what I just read, you aren't getting them.

BTW, married's post was awesome. Listen to her, she knows what she's talking about.


05/16/2012 08:47 PM
suzaan
suzaan  
Posts: 46
Member

Thanks so much for the insights and the information -- as well as the reality check. It helps tremendously. (I'm going to save your post and use it for reference ... and reassurance. Smile -- as well as try your strategy with my husband. All the things you describe are things that he has been doing.

I also think you're right that he needs a new doctor; Will have to investigate that ... and figure out how to get him to go. A part of me hopes that, suddenly, everything will go back to "normal" -- but that's not going to happen. Until I come to terms with that, I

don't think I'm ready to present him with an ultimatum. For one thing, I think I need to be sure I can follow through with whatever that ultimatum might be.

Again, thank you so much!


05/17/2012 03:47 PM
suzaan
suzaan  
Posts: 46
Member

Here's an interesting turn. When my husband was taken by the police to the ER, the doctor immediately assumed he was on drugs and placed him on a Narcan IV (to counteract opiates). When the drug screen came back clean, they decided that, since it didn't show anything, then, of course, he must have been taking Ecstasy.

My husband is arrow straight, and does not use illegal substances at all. (He considers taking ibuprofen a big deal, which is one reason getting him to stay on the prescribed medications has been a challenge.) He has, perhaps, a glass of wine every other day.

Nevertheless, the hospital ejected him with a diagnosis of "Intoxication - drug" and he was put into jail.

He's outraged by this and, I think, justifiably so. I don't know what we're going to do. But the even bigger issue is -- he views the hospital's erroneous results as proof that he is not bipolar. Yet, he was clearly manic, disoriented, confused, incoherent and delusional before he entered the hospital. And it's made him even less amenable to going back to a doctor (for which I really can't blame him).

Any thoughts on what to do? How to handle?

Thank you!!


05/17/2012 03:53 PM
hopefulcb
hopefulcb  
Posts: 3933
Group Leader

I would hire an attorney if you havent yet. He will probably want your husband to see a pdoc to get diagnosed because if he has bipolar and it was an episode, he could fight it and that would help your husband to see and accept his diagnosis.

05/17/2012 04:00 PM
suzaan
suzaan  
Posts: 46
Member

We do have an attorney since he was arrested (no drug charges though). And he was subsequently diagnosed by two other hospitals as bipolar. So I'm not particularly worried about the legal ramifications; I think we can handle those. But I do think 1) his rights were grossly violated and 2) this experience is going to make it much more difficult for him to accept his diagnosis.

05/17/2012 04:54 PM
hopefulcb
hopefulcb  
Posts: 3933
Group Leader

What does your atty say about his rights being violated? How else does your husband explain his behavior if he didnt take drugs? I would think the diagnosis would be a relief in some way to him for an answer on why he behaved that way.

05/17/2012 04:58 PM
suzaan
suzaan  
Posts: 46
Member

The attorney wants more information.

My husband is bipolar and had a major psychotic break brought on by lack of sleep and stress. He does not do drugs.

You would be wrong -- it is not a relief. It makes everything more difficult. He was given a narcotic drug to counter drugs he was never on. All the tests the hospital came up negative. They found nothing at all in his system.

But now he has his chronology confused, and thinks his initial break is a result of the drugs he was given at the hospital.

Post edited by: suzaan, at: 05/17/2012 05:26 PM


05/21/2012 08:25 AM
Just4kicks
Posts: 227
Member

I've struggled with this lately as well. Ever since she was released from the hospital about 6 weeks ago, she was supposed to be to an outpatient therapy thing organized by her social worker. She didn't go, went out of town for a few weeks instead, and now, to the best of my knowledge, is back. We had a bit of a fight while she was gone (see my other posts). Communication since that point has been very brief. IDK if it's because she's trying to protect me, has her own things to work out in her head with her behavior, her family, her future. Or, if it's testing me to see how long I'll actually stick around with crawling too far up her ass for attention. She hasn't been rude to me, more like distant, and sarcastic. I sent her an email a few days ago to let her know about some bills that got paid and some idle chit chat, hoping to engage in a conversation; I got a 'thank you'. Which I was thankful for, as it's more than I often would get in the past, whether I paid the bill on my own and told her, or handed her the $ to take care of it.

Anyway, tried speaking to one of her family members, who I'm friendly with. He hadn't talked to her as of last weekend, and said I need to do what I think is right, and try to give her space. That if I can't/don't want to pay her bills, to tell her, and if I am going to continue, than to just do it as silently as possible, keep her in the loop and leave it at that. Quite a tightrope, but I get what he's saying.

I thought about contacting her social worker and another family member to ask their thoughts and do a bit of recon. The family member was a big help to me while she was in hospital and was willing to fill in some blanks I didn't know about. But I don't want my desire to figure out where her head's at to backfire and put me in the enemy camp. Same goes for speaking with her social worker.

Part of me feels guilty because I know that at least some of my desire for info is a bit selfish. No one likes the silent treatment, and that's what I've been given. It hurts to know she's back in town and hasn't made an effort to see me at all. But, on the flipside, she's been through a lot and I guess I can't expect things to just go back to how they were in terms of multiple daily calls, hanging out, etc. Because I'm not getting the attention from her that I'm used to; I like attention as much as the next guy. Though the deeper reason is because I do want to know if she's talking to people about things, to get a different perspective if you will.

Thoughts? Or am I overthinking as it is (which I'm prone to do!)

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