Spouses of Bipolar in Active Relationships

At lunchtime when hubby called and told me that he was IOP rather than PHP starting tomorrow, he was rather matter of fact about it. "Starting half days as of tomorrow."

He called me after work - and was like another person. He just sounded so different than he had for the last several days. "This is like throwing a thimble full of water on a fire. I am not one bit better than when I started. And the thought of going back to school in September absolutely terrifies me" He told me again how he was trying to keep a positive attitude but that so far, the program looked like a waste of his time and the insurance company's money.

When I got home from work, he was in his man cave. Where else? I didn't bother to go back for at least 30 minutes - and he never bothered to come out to see what I was up to. When I finally ventured back, he was lying on the sofa staring into space with the TV on. I said hello and it was pretty obvious that he didn't want to interact with me. I said something else - he mumbled something with his eyes closed, so I left. I fixed dinner. I called him for dinner. The three of us ate without him because he never materialized. He came out about an hour later, fixed himself something to eat (not what I had prepared), cleaned up his dishes and went back to the man cave without saying a word. About half an hour later, he came out and announced that if I didn't want to go up north with him, he was going with a friend this weekend. He said "We are leaving shortly after 1 PM tomorrow. Fill my morning med container for Sunday and pack a lot of xanax." He returned to the man cave, came out about a half hour later and poured himself a rather large scotch. I haven't seen him drink (other than a toast to his dad after the funeral) for MONTHS. I decided to ignore it. I decided to ignore him. He has isolated in his man cave the entire evening. I am doing my own thing.

This program really was our one last great hope that he could get better so the rest of us could get better. I feel dejected. I feel defeated. I just don't think that I have any fight in me. I am SERIOUSLY thinking of calling the program tomorrow and telling them that when they update his treatment plan in a week or so to leave "supportive wife" off of the list of his assets. Notice "supportive kids" didn't make the list. Both of them despise him and have told me individually that they wonder if it would have been better if we hadn't bothered to call the cops to take him to the hospital when he overdosed. Neither of them wished him a happy Father's Day. When I questioned my 15 year old son about it, he replied "Why would I? He doesn't deserve it. He sucks as a father."

I'm tired of being supportive. It doesn't seem to be getting us anywhere. I am only half heartedly being supportive at this point anyway, because I feel I have no choice. He can't do it on his own. There is no one else to help him do it. And I know if I baled he would kill himself. He wouldn't attempt it. He would be successful.

Great decision today, people. Thanks for nothing.

Post edited by: WornOut2, at: 07/19/2012 06:47 PM

Wornout, I am so sorry that this treatment wasn't what he needed. I haven't been able to be online and keep up with the whole progression of events from the beginning, just bits and pieces, but I remember him dosing down on xanax. I guess things didn't work out. I don't blame you or the kids for feeling the way you do. I was there, kind of, a couple years ago. It IS a defeating feeling when nothing seems to be getting better. It makes you want to give up. I wonder if he knows how you feel? Would this knowledge help or hurt him? (assuming you haven't talked to him about how you feel) I guess the reason I ask is because it wasn't until my husband saw me finally making the decision not to support his choices anymore that really made him step it up to where he is today. He was one sick puppy, too. I felt the same way, that without us, he would be successful in his next suicide attempt. I guess I got to the point to where I didn't take responsibility for his mental health anymore. I couldn't let myself take on such a heavy load for another human being, especially when he wasn't doing all he could to be healthy and treat me like a human being with feelings and dreams. It's a journey and it really could have gone either way. What's really sad is that the kids have given up on him. But I think it might be a defense mechanism. He isn't being a father to them and that's very sad for them and for him.

I'm rambling here, but I know the pain you are dealing with right now (and have been for quite some time). You deserve a life, wornout. What you have now, dare I say, sucks. Time will tell what will develop. If he is going to give up on ever finding treatment that works, what's left in life for him or you? Drinking that glass of scotch kind of said a lot, I think. I don't blame you for not saying anything, but his drinking is kind of a f*** it attitude.

for you. for him.

Wornout, your post brought tears to my eyes. Reading that your kids despise him breaks my heart, I am so sorry you are having to deal with all of this.

I might be naieve for asking this, but where is his Pdoc? Is it the pdoc that also thinks he is better enough to go half days, I just don't get it. I would call them tomorrow and tell them his defeated behavior tonight and how he drank for the first time in months while feeling so low on himself. If he is willing to take whatever meds is given to him, why don't they get a little more agressive with the meds since this is your last resort? Once again, if I am not making any sense, ignore me, I am just so upset because I too was so looking forward to his progression this summer so you could have the break in life you richly deserve.

You are fighter Wornout, don't give up unless you truly are done. If so, I truly understand and support that, we can only take so much. I am just so extremely disappointed in the health system today, I kringe for the futre in it too.

When my mom was attempting suicide a few times, each time she went in the hospital, kind of got lost in the system, they would send her home to do it again. It wasn't until the last time, I just communicated to the dr til I was blue in the face and he finally really took a look at her behavior and finally gave her the right meds to be stable. I remember telling the dr. if you send her home and she attempts suicide because he didn't give her the right meds and diagnosis, it was on them. I had just had it and I thought to myself "God I cannot take anymore of finding my mom with her wrists cut, please take her one way or another out of her pain", so I know how your kids feel, they want their dad well, they are done and so was I.

My prayers and thoughts are with you and yours, I don't know what else to say.

It sounds like you were in shock. I know you also are traumatized by the years of being his rock, and holding everybody together.

All is not YET lost. When you get up tomorrow, call the program and fax the program and STAY ON THEIR ASS. Tell them your husband drank for the first time in years; that he laid around, defeated all night; that he went into his office and didn't come out to eat (as normal) with the family; that he feels all is lost; that he no longer cares about how much xanax he is taking. I have one more thing I want you to tell them, but I will get to that.

I am AFRAID of him going up north with a male friend UNLESS YOU TELL THIS MALE FRIEND THAT YOUR HUSBAND COULD VERY WELL COMMIT SUICIDE WHILE THERE. I fear that is what your husband wants to do. I fear that very much.

His kids....(yeah, I know, YOUR kids too)....ALL teens hate their parents and think they suck. I bet they think you suck too, even as they realize you are the family glue and rock. And if they have fleeting thoughts of "if only he had died..." that is just HUMAN. I worked with a woman years ago whose husband had MS...and she was so worn out once from caretaking and from trying to keep his spirits up while he was having problems with incontinence (all ways) and her husband was a VERY dignified professor who had been in the diplomatic service, so this was the WORST indignity for him, that she said "I wonder if it would be better if instead of helping him (he had these coughing fits where he would almost choke), I just let him go." I KNOW she didn't really WANT that. It was a fleeting thought. A fleeting thought. Your kids resent him, and that is justified in many ways. But one day they will be mature, will learn more about BP, and they will have more understanding of what he went through. I don't know HOW your husband has kept it together for his job. You know my husband is on disability and he would have been in the hospital every other week if he had to teach high school. So your husband has been heroically doing that job...however else he has failed ALL of you in other ways.

You DESERVE a better life. Yes you do. You cannot be chained to this man because you are afraid he will kill himself if you leave him.

SOOOOOO....here is the last thing I want you to make clear to these yo-yos: HE IS SUICIDAL. You have been applying a VERY strict standard, IMO, about commitment for a long time. His pdoc was VERY strict as well. He has been telling you BEFORE THIS BAD NEWS TODAY that he had a lot of suicidal thoughts since he started the program....then tonight, he was resigned and he was defeated and he wants to go to his cabin WITHOUT his family and FROM EVERYTHING HE HAS SAID, he wants to end his life. Do not get tricky or be strict when you call tomorrow. If you have ANY qualms, please have a discussion with him in the morning about whether he feels "at the end of his rope" or "like giving up" or "a waste to his family" AND ask him if he thought of harming himself. If you get ANY "yes" answers, communicate to the program that HE IS SUICIDAL.

Your husband has so many issues. He was getting a little better.... and the WHAM. This setback. YOU and HE need him to get the lifeline that is here, even if it is a crappy lifeline, and this is probably the way to get them to take you serious.

But you know what? I don't have ANY ethical problem about telling them he is suicidal. Because he IS. You have SAID SO.

I wish you were nearby...I would make you some of my lemon mint vodka martinis (I don't have them any more except when hubs is out of town, which is rare, but I remember how to make them!) and we would plot the overthrow of the health care establishment.

PS. I think it would be best if you LOCK UP or get rid of ALL the alcohol in your house for now. I really do. I just have that dread....

Please consider what I suggested. And if you think I am all wet....I have my towel, as you know, to dry off with.

LOVE and HUGS and DON'T GIVE UP YETS from me to you tonight. Prayers for your husband. Prayers that the PHP team will get their freggin' heads out of their butts and hospitalize him for the weekend or authorize the PHP again....

Yours in outrage, M2it

Yes, remove all alcohol from the house, it will at least slow him down--he'd have to go out to get more and maybe he wouldn't have the energy to do that. After reading hopeful and married's posts, I think they are right. Fight to get him admitted. He is exhibiting the criteria for that. Being suicidal while getting intensive treatment? Hello people...something ain't right! I really wish he'd do more of the fighting here. Maybe he just doesn't have the strength...

Hugs and prayers for you today, wornout.

He got very little sleep last night, he said. I looked him in the eye this morning and asked him how he felt. He said "OK." My gut told me he was lying. I asked him point blank whether he had had any thoughts of suicide lately. He looked me straight in the eye and said "Not for several days." My gut told me he was lying. I said "Are you sure, because that's not what your face tells me." He replied "I would never lie to you." I said "I'm not so sure about that." He didn't reply.

I followed him back to the man cave. "I think I put the passports and all of the stuff that belongs in the safe back in the safe, didn't I?" I told him yes - except for our passports which need to be renewed. I have NO idea why that subject came up. We talked about filling out the passport renewal app and the best/safest way to send them in for renewal. Then he told me where he had left the keys to the safe and the locked closet where the safe is and reminded me where to find the combination. I asked him why I would have need of that information today. He didn't answer.

Wife - in a nutshell in order to get you up to speed (providing you will even be able to access this thread. Still having internet issues?), he was approved for 10 days PHP. Went in for a family meeting. His GAF (Global Assessment of Functioning) was a 25 out of 100, three tiers from the lowest range possible. They rated the stressors contributing to his current mental status as severe. I don't know if there is anything lower than that or what the scale is. Anyway, his primary therapist and I spoke the morning the insurance company had to be called for auth of additional days. We agreed that he had made very little progress. The program requested additional days at the PHP level and three more were authed. Yesterday, they received auth at the IOP level. I have yet to determine whether that was what they requested or if my insurance company denied a request for additional days at the PHP level. My husband has so far been totally "unimpressed" with the program. He does not think he has made much in the way of progress and I don't disagree. They, apparently, feel that he made some miraculous progress in three days.

Hopeful - the way it works is that the treatment team (which includes the pdoc) meet and determine what level of care they feel is appropriate for the patient and then someone on the team calls the insurance company and relays the request to a clinical care manager. Based on the information relayed about the patient's condition, the care manager determines what level of care will be authorized. If the level of care is not what was requested, the provider (or the member) can file an appeal saying the higher level of care is necessary. That's why I have been trying to determine since yesterday at noon what level of care the program requested. I don't know whether I should be filing an expedited appeal. And if I had known yesterday that an appeal was necessary, I would have filed one immediately and the insurance company would have had to render an appeal determination today. While the appeal process is in progress, he would have remained at the PHP level.

Married - thank you. I'm not much of a martini lover, but I could use one - or ten - about now even though it is only 9 AM. LOL

I just got talking to him yet again this morning. He told me he was an anxious wreck. I asked him about what. He replied "Everything. I am just so nervous my hands are shaking." So, I said "I'm nervous too." He looked utterly confused (I'm "the rock" remember?) I said "I am very nervous about you going up to NY this weekend because I do not think that your head is in a good place and that scares me." He assured me that he wasn't going to do anything because the xanax didn't work. "Yeah, but that's your head talking, not the mental illness. Did you ever think that you would throw 90 xanax down your throat and try to wash it down with scotch? No, you didn't think so. But you did it. You are going to NY with clueless {friend} who isn't tuned into anyone emotionally as opposed to me who is the most tuned into you than anybody on the planet. I know the xanax didn't work, but you are a smart guy and you've probably thought of several ways that would work. Hooking a vacuum hose up to the car won't because its emissions are too low. But I'll bet you have several others in your back pocket." He PROMISED me that he wasn't going to do anything. "That's your brain promising. What happens if the mental illness takes over? You know that you are capable of turning on a dime."

As he left to go to the program, I told him that he knew why he was so out of sorts today. He needed to be in the PHP program and had been dropped to the IOP program. He didn't comment. I don't think he disagreed. I told him that when his primary therapist presented him with a document to sign that he was participating more in groups and I forget-what-else that she had bamboozled him because that was all the evidence they needed to move him to IOP. He was thinking about that as he walked out the door.

I do not know what this day will bring. But I DO know that what I would really like to do is crawl back in bed and shut out the world.

Wornout, I am so sorry this seems like a big step back. I know that defeated feeling all too well. You are such a strong person though. Sending you thought for strength today as you continud this fight! (((Hugs)))

Wornout, I am sorry. I am sorry that your hubby is STILL so sick. I am sorry that your kids have for now given up on him. I am sorry that you are getting exhausted from doing all of everything. Anyway you can take your own mental health day today? It would give you time to make the calls that you need to for your husband, and a little time to just crawl into bed and leave the world outside of your bedroom for a bit. I think you deserve it.

Wornout, I don't like the comment about the passports. Not to scare you, but the last attempt my mom made, she was at our house and told me things, little things (didn't think much as she was saying them) and where to find them for when she passes. She said these sporatically throughout her visit so I didn't get the hint. Well she went home that night and when we went over to check on her the next morning, she had cut wrists again. I felt like an idiot, because I just didn't get the clues she was giving me.

Please don't let him go away this weekend, as you said, his mind could say one thing, but his disorder could do another.

I am praying hard for both of you today, I hope he gets the help you both richly deserve.

( ( (wornout) ) )

Thanks, guys! I appreciate the support and the feedback.

I heard from my insurance company. IOP is what the program requested. I forgot to ask how many days had been authorized. Guess I need to make another phone call.

I spoke to the gentleman at the state's department for mental health services who oversees all of the services in my county. He agreed with me that if his GAF (Global Assessment of Functioning) Score was 25 out of 100 on 7/2 (ie practically non functional)it his highly unlikely that he had improved THAT much after 13 days at the PHP level and I had a right to be concerned. He also told me that if my husband had agreed that I could have access to his information (he has) that I had a right to a complete explanation and a review of the documentation the facility relied upon in requesting IOP. He also gave me the name and phone number of the administrator for mental health services and told me to tell her that I had spoken with him and he had given me her name and number.

I called and left a message for his primary therapist. Haven't gotten a call back. I have not called the administrator. Hubby asked me not to go in there "with big feet." So I though it best to wait until he had left for the day so as not to upset him. Instead, I treated myself to a little "retail therapy" (which is so NOT me!) this morning.

Hopeful - I understand totally where you are coming from. I will eyeball things when he gets home. Short of me begging and bursting into tears, I do not think that I am going to convince him NOT to go to north for the weekend. I don't even really think that THOSE drastic (and totally not me) actions would dissuade him