My husband's bipolar delusions are back

[get the red out]

I have discussed my own depression and anxiety in this forum and you have all been such a great help to me, my husband suffers from bipolar disorder and despite taking his meds properly, has gone into a fantasy world that must not be questioned. His old therapist left for another job last year, and the new guy is caring and good, but he hasn't seen Mike go through this before, and I feel like he is getting fooled into believing the situation isn't as bad as it really is. He and I have been in regular contact through this, which started Thanksgiving weekend, but things are getting worse and I don't know what to do since the therapist says my husband isn't nearly bad enough to be forced into the hospital. Mike has been in a hotel since Thanksgiving because he believes the hotel has hired him unofficially to oversee a renovation taking place there, this is definitely false! He is deep into believing this, but can sound absolutely well when discussing other things. His therapist told me to tell my husband what I need, which is him home, of course that ended exactly like I predicted, with him telling me that if I am not completely ok with what he is doing, I should go ahead and file for divorce.

I am so afraid this will not end well, and I worry it is my fault for not finding a way to get him committed to work on his meds. I am having trouble doing much right now from all the worry.

[TEB]

1. Sending you compassion

[get the red out]

2. Thanks

I need all I can get, I am too emotionally spent to do any training with my dogs, which adds to how helpless I feel.

[HumblePi]

3. I'm no Mental Health Specialist

.... I'm only a nurse but what I'd do in that situation is get an opinion from another therapist to see if they concur with each others advice. If you're seeing him together as a couple then it should be the therapist that asks the difficult questions. 'Why aren't you living home?' Therapist aren't fooled very often and he may be able to get into deeper and more confrontative questions with your husband like 'why is it necessary to live in a hotel?' or 'what about your wife, have you considered her feelings about you living in a hotel?' or 'are you taking your medications as prescribed?' Living with someone bipolar must be a very difficult challenge particularly if the med regime they've been on just isn't working for them anymore. It all could come down to simply being a matter of adjusting, adding or replacing his current meds.

Take care of yourself first. If you are already fearing that it's not going to end well that means you know better than anyone else and it may happen that a divorce is the only way. His depression is showing when he suggested that if you're not completely okay to go and file for divorce. A good marriage is always worth struggling for but a marriage that seemed to be doomed to come to an end can't usually be saved unless both parties are trying to save it.

[marylandblue]

4. Two thoughts, both from experience

First, contact his psychiatrist and put him on an antipsychotic. They are good for acute mania.

Second try to talk him down in a calm, logical way. Don't disagree, follow his story to it's logical conclusion. If this is your job, who is paying you? Where are they? Why would they hire you "unofficially" when it would make more sense to hire a regular contractor? Don't disagree with him, just try to lead him to see the truth for himself.

[arithia]

5. This

I have type II rapid cycle with psychosis. This is exactly how my partner snaps me back when I'm stuck in my own head about something.

Lead, but they must connect the dots. Its a neural pathway they must establish or reinforce.

Feel free to tell me to bugger off, get the red out, but you mentioned something about working on his meds and a new psych. Did they change his meds before this hit him or is it the usual BPD self-medication?

[get the red out]

10. His Therapist is new

He has had the same Psychiatrist and medication regime for quite some time, same meds for over 8 years with no problems. He began acting a bit manic in the spring but the episode didn't come to full fruition and he got back to normal, but he had no delusions then, just some mania.

[marylandblue]

12. Brain chemistry can change and cause breakthrough

So he might need a medication change after he's stabilized. Or, if you are alert for early signs, a small dose of antipsychotic can nip a breakthrough episode in the bud.

[get the red out]

14. Wow

I had no idea that there could be a breakthrough! That makes sense! I wonder if his psychiatrist could prescribe him the antipsychotic on the word of his therapist? Mike really does take his meds, he doesn't want this until he is in it.

[marylandblue]

15. If they signed HIPAA forms for each other, then yes.

If not call his pyschiatrist yourself. Did your husband sign anything allowing you to talk to the psych? If yes he might do it based on your description. If not, he might do it based on talking to your husband over then phone.

[pnwmom]

6. Bottom line: THIS IS NOT YOUR FAULT. NONE OF IT.

Your husband's condition is no one's fault -- bipolar is a disease.

But I would consider getting a second opinion from a different therapist, since you're afraid the new one might be getting "fooled."

And in the meantime, please try to take care of yourself!

[marylandblue]

8. +1 Not your fault

It's very common for bipolar people to refuse or go off medication. When they feel fine, they think they don't need it. He has to learn to be responsible for their own mental health. You can't do it for him

[get the red out]

13. Thanks

I will call my own therapist tomorrow, I really need to touch base with her anyway.

[Scarsdale]

7. Very stressful.

Does your husband try to direct the renovations at the hotel? If so, maybe someone there could consider speaking to the therapist for you, explain things from their perspective? So sorry to hear about your problems. Terrible affliction.

[get the red out]

31. Right now not

He blistered his foot badly with excessive running around so he has been letting it heal and staying off of it, otherwise, I have no idea, but I suspect just talks about being hired for the renovation rather than doing anything.

[kstewart33]

9. Some thoughts.

I have a family member who is bi polar and it is a very difficult illness to treat. Question: Has his current therapist contacted his previous therapist to obtain a complete understanding of Mike's condition? This should include a discussion, not just the therapist's notes and prescriptions. If this hasn't happened and you were confident and satisfied with the first therapist, then consider doing this. Therapists sometimes do not talk with each other.

Second, if Mike is taking an antidepressant, that can exacerbate bi polar disorder. My family member's psychiatrist emphasized that an antidepressant is like pouring gas on a bi polar fire. You might want to check on this. This physician is well regarded in the psychiatric bi polar community.

I suggest these things based on experience with a family member only. I am not a doctor/therapist and have no personal experience with the disorder.

Wishing you the best.

[get the red out]

11. Thanks

He isn't on any anti-depressants, I don't know how much written history his new therapist got from the old. Our lives had been going along normally for over 8 years since his last episode. I need to find out how much of the old info the new guy got, since it has been over 5 years since this last happened.

[DRoseDARs]

16. Wait. The therapist is telling you to divorce him instead of ordering a psychiatric hold on him?

Edit: Already stated by others, get in contact with the old therapist and find out how much prior information made the transition to the new therapist. They may not be working with your husband with a complete picture of his care needs.

I don't have any background on you or your husband so pardon my ignorance. It sounds like as far as the hotel is concerned he's there as a guest, not part of the crew working on renovation. If that's true, get in touch with your husband's boss (if your husband isn't self-employed or retired) and the hotel manager, get statements and contact info from both of them stating clearly your husband is NOT in charge of renovation there or even involved, and present that to the therapist. If they're smart, they'll order your husband into a psychiatric hold immediately. If they're not, they're putting themselves in civil/legal jeopardy and at risk of losing their license. If an incident occurs at the hotel, and you've already put it on record with all parties that your husband shouldn't be there involving himself, the therapist's name WILL be included in the police report and s/he'll be on-record as having been told there was a problem and not having done anything about it.

I had a housemate who's Dr. Jekyll/Mr. Hyde game was on-point. He could present as absolutely charming and funny and polite to a fault, but it was a ruse. He was an abusive motherfucker that treated his live-in girlfriend like shit and made life hell for myself and the other housemate as well as the landlord. He was attending court-ordered counseling which the girlfriend went with him and this joker was fooled, had no idea what she and us others saw when this asshole was home behind closed doors. He even had his parole officer fooled.

Your husband isn't violent or abusive, else you would have said, so my point is people such as your husband and my former housemate can somehow manage to deceive the right people, intentionally or not, to avoid getting the treatment they absolutely need.

It sounds like if your husband interferes with hotel or construction staff, he is on a fast-track to getting the cops called on him. If you can't get your therapist to take this seriously (Um, divorce? What?) then you need to speak with the hotel manager to head-off disaster. If all parties understand he's in a bipolar delusional state, they may be able to coordinate an welfare intervention with the police to get your husband into proper psychological care without any kind of arrest.

Something needs to be done, this situation is untenable. Waiting for something to happen isn't a good course of action, you need to be proactive for your husband's sake. The therapist needs to made to do something more than tell you to divorce him (Um, WHAT?). Your word and pleading appears to be not enough, so getting statements from others seeing this behavior may be necessary.

[marylandblue]

17. Her husband threatened divorce, it didn't come from the therapist

But it's just him mania talking, trying to preserve the delusion.

Don't get the boss involved. Too much stigma and he will feel humiliated when the episode is over.

I wouldn't call the police unless he his violent. A misunderstanding can end in tragedy.

Psychiatric holds can only be done when the person is a danger to himself or others. If she can get him to the ER, and he is willing, they could do a voluntary commitment. But he doesn't sound ready for that.

[DRoseDARs]

22. I'm saying the hotel might call the police and she needs to get ahead of that before it happens.

Again, if he interferes with hotel staff or construction, and they don't have the context of him needing help, he could be heading into a disaster. It may help to actually enlist their assistance on a welfare intervention if the therapist is worthless.

So either he's just saying to her this delusion so he can have alone time and is being a dick, or he's actually having the delusion. Two very different things.

[marylandblue]

23. He has a history of bipolar, and this type of delusion is almost classic bipolar

She could let the staff know, if she thinks he would interfere with them. But hotel staff don't really have the training to deal with this sort of thing, so it might just scare them.

Therapists are usually useless in psychiatric emergencies. Most just tell you to go to the ER.

[DRoseDARs]

24. An interesting and disheartening response.

I would have thought therapists would have a bit more training to handle situations beyond giving no-duh advice. And that's kinda my point, if the husband decided to involve himself the hotel might take action absent context. He needs to knock this shit off and come home before he does something stupider.

The best course for her is to start with contacting the old therapist and go from there.

[get the red out]

32. That was my thought

That alerting hotel staff to his illness might make them afraid and that could make it all way worse. So far I don't feel he has actually interfered with the renovations at all, I believe most of what he is doing is talking about his delusion.

[Thunderbeast]

28. NOBODY can "order a psychiatric hold" unless

they are an immediate danger to themselves or others. The law takes a narrow view of that test. One has to be in the act of causing injury in order to trigger a limited 72 hour involuntary hold. Longer commitments are nearly impossible to sell to the courts. This is why many of the mentally ill end up sleeping, untreated, on the streets.

Best of luck to the wife. IT IS NOT YOUR FAULT! I hope you find an experienced prescribed who is able to find medications that are effective and tolerable.

[mgardener]

18. Call his psychiatrist

Tell him what is going on. Ask to attend a session with your husband.
Unless the psychiatrist is informed as to what is going on, he has no idea that your husband is decompensating.
His delusions need to be addressed.

I know this is difficult for you. It might help to write down every thing you can thing of that you want to tell his doctor.
He may not be able to talk with you because of privacy laws, but the Dr should be told and he can then decide what to do.
You have done all you can at this point. Good Luck.

[ginnyinWI]

19. my brother is bi-polar.

He is divorced and 64 years old. Let me tell you what has happened in the last year or so. He had been on lithium for about 25 years and doing fine. Then suddenly, not so fine. His son found him sitting in a chair doing nothing, not eating, drinking, or taking care of himself Was having hallucinations--people walking around his apartment.
He was hospitalized and evaluated and they told him he was on too much lithium and should cut his dose in half. Well then he decided that meds were BAD and that he would be just fine without any! Got back home and did just that. He decided to go ahead with is plan to move several states away and began preparations.
Well long story short, he got worse and worse. Out of control spending, making friends with a bunch of grifters who stole from him and got him kicked out of where he was living. Eventually his other son, who lived nearby, got him evaluated and the court judged to be "seriously mentally ill" and unable to be responsible for himself. He of course disagrees!
Now, six months later, he's living in a group home and only can go out with supervision. He is back on meds but he still isn't stable. Something has changed--whether his illness is worse now, or whether there is some dementia added to it. I guess you can have more than one thing going on at the same time.
They are working on getting him stable with meds, but he is permanently under the guardianship of his son and our brother for his care and financial matters.
I hope your husband can be brought back, but sometimes it just isn't in the cards. My brother still thinks he can get out and move somewhere with more freedom, have a car and driver's license again, and start that business he'd been dreaming about. The reality is that he is going to stay right there under the care of the state and his family, or somewhere similar with just as much supervision. He's getting medical care now, at least, seen a dentist finally, and has gained back some of the 40 or so pounds that he'd lost by not eating, sleeping. But he's still not back.

[Jarqui]

20. My best friend developed bipolar hypomania in 2013

We're still fighting it.
I talk with him every day. I take him to doctors appointments.
For a while, we were spinning out wheels. Took three commitments to different psych hospitals to get good help.
After he got out, he was on a roller coaster.
A positive change happened when I started attending some of the follow up appointments. He was not remembering to tell the doctor everything that had been going on.

Another thing was changing from 3 month to monthly follow ups with telephone consultation in between. If you are only see the doctor once every 3 months, then you only get four shots to get the meds adjusted and if he is not successful, you've lost another year of his life. I kicked the snot out of his doctors over that and they relented. When he is in trouble, he needs more frequent attention.

We're human - not machines. Adding a quart of oil now and then won't keep the human brain motor running smooth because things change. His care has to be able to be there for when things change. Sometimes a medication loses it's effectiveness. Sometimes, a side effect builds up over time. Sometimes a new medication for another condition affects the mix. There is not a one size fits all medication solution for bipolar. And there is probably not one size fits forever solution either.

Get a blood work up done to check his levels for nutrition and physical functioning. You can reduce bipolar symptoms by getting the other parts of the body running better. His doctors/blood/medical tests dictate what needs to be done. A focus should be considered for supplements like vitamins or homeopathic treatments (that are backed up by medical study) to get him functioning as well as we can without the meds. This minimizes the bipolar meds needed to manage his condition and the side effects that go with them - which reduces the amplitude of the mood rollercoaster he is on. Hibicus tea for example really helps his anxiety.

I liked the posts above about getting a second (or third) opinion.

I liked the post above that talks him through without upsetting him - leading him to reality through his own answers. Like any human, he has strengths and weaknesses or comforts and discomforts - play the discussion towards his strengths and comforts - maybe using metaphors or reasoning that he could more easily relate to.

It can be a very challenging condition. But there are a lot of things we can do to help them.

Hope that helps.

[iluvtennis]

21. In this delusional state, can't it be determined that he may be of danger to himself/or others and

get a 5150 order. I know you can do it for teens cuz had to have my daughter put on a hold a couple of times. I called the police department, they came out talk to her and other family for a bit and they take her to the mental health hospital.

I found it wasn't what was happening in the moment with her that made the decision for them, it was the history of her issues. Same may apply for your husband.

Sending good karma to you.

[mopinko]

25. def talk to the shrink, not the therapist.

this is not an issue for a therapist. it is an issue for the md here.
he may not be able to talk to you, but he can listen. make him listen.

also, how is he paying for the hotel? talk to them. cut his credit card.
they may not be the best place to put pressure, but trust me, hotels see a lot of shit. i have no doubt they dont want this to get any stickier.
they may well help out by calling the cops.

:hugs: to you my dear. this is all so hard on families. we are here for you.

[InAbLuEsTaTe]

26. Oh my, so sorry to hear what you're going through... sendin' you BIG hugz

and best wishes that everything works out for you okay.

[dlk]

27. My Son is Bipolar - I Can Relate to Your Difficulties

I hope your husband is being seen by a licensed psychiatrist. A counselor or PhD therapist can't prescribe the Lithium or the psychiatric meds he requires and they often don't have the training or experience to adequately deal with serious psychiatric disorders such as Bipolar Disorder. Adding to the complication of the situation, often those with serious mental health issues don't like taking prescription psychiatric meds to begin with, and even when they agree to take them, as soon as they begin to feel a little better, think they don't really need them, and stop taking the prescription meds altogether. Some don't like the way the meds make them feel and use that as a reason not to take them. Since any slight change in a person's biochemistry can impact their Lithium balance, it's critical to have the patient's levels regularly checked with a blood test.

As you probably already know, Bipolar disorder is progressive and it is possible the stresses of the holiday season has brought on this episode. Depending on where you live, there may be a psychiatric hospital or clinic with available beds where he could be taken for an evaluation. Could you possibly contact his health insurance provider for assistance? Are there any local state or county mental health services that might provide assistance? Is he a veteran and eligible for VA services? My heart goes out to you because I know, firsthand, how incredibly difficult this type of situation can be.

[Laffy Kat]

29. Not a mental health professional but I've plenty of experience with bipolar people.

At this point it sounds like psychosis more than delusion. If he's not already, I'd see if doctor can prescribe anti-psychotic. Hopefully, that will at least get him back home where he can work further on his health. The holidays can really trigger relapses. So sorry you're going through this, GTRO.

[Bayard]

30. You are a kind and compassionate person

From a bipolar sufferer's perspective, that is hard to find. So many people just don't get it. They can be very cruel.

Sending good vibes your way.

[get the red out]

33. Thank you

My own history of depression and anxiety disorders have given me intense experience with desperation.

[get the red out]

34. Update

Mike called me and began to cry over remembering the original owner of the hotel, who he knew well since he had flown in the same squadron in WWII with his uncle. This is a typical thing for him when he is going through this. Then later he came by the house to pick something up and pet the dogs, and he said he was coming home on Tuesday to continue to let his blistered foot continue to recover at home (it became blistered because of his manic running around when this began). One thing he has been hanging onto is that he had to stay at the hotel, first because of his new "job", and then he said it was because it wouldn't be able to heal if he was having to get up and let the dogs out and such.

This is kind of a mixed bag of behavior that is new, the crying, which usually indicates a deepening episode, then saying he is coming home. I will have to see how this turns out.

[marylandblue]

35. Have you contacted his psychiatrist yet?

Also, you can offer to take him to the ER for his foot. Play it up, look at and and say it looks terrible. If you get him go, they can give him an antipsychotic injection, which can bring him down very quickly.

[irisblue]

36. How are things going for you and for him?

[get the red out]

37. Getting a divorce

I haven't updated here in a little while because it is all so surreal. We had some sessions with his therapist and it appears he wants our marriage to end, after him being gone since Thanksgiving I have come to realize this is what is best for me also. Before the delusions he would get depressed and incredibly irritable, he doesn't like the way his life has gone and his therapist thinks that has brought on the delusions. I was realizing for some time that I was trying desperately to find ways to make him happy, and blamed myself when he wasn't. I blamed my own horrible depression relapse of last year. I can't keep on, when/if the psychiatrist does reel him in medically I can't live with the potential hatefulness that ends up being directed at me. When it comes down to it, he has not taken responsibility for telling his doctor when he gets incredibly irritable to me, I can no longer accept that life.

It is so strange, he is acting like the darling man I fell in love with so far as his personality right now while he has his delusions, not that we are back to being in love or anything, I feel somewhat guilty for not continuing to try to get mental health professionals to get him out of his delusions, but I tried.

[irisblue]

38. I'm sorry this is happening for you.

Long term relationships, mental health issues, both partners, history and grieving loss of the dreams, that sounds very complex & complicated.

Are you consciously doing something for your self care, legal and personally?

Wishing the best for you

[get the red out]

39. Trying to

I plan on getting a lawyer after the new year. Today I am going out of town to run my Layla in a dog agility trial this weekend. The hoast dog training club is going to have an early New Years party tomorrow night after all of the dogs have run. Since this competition is only a couple of hours from home I have gotten to know a lot of the people who will be there (and their dogs, love all the dogs!). I am fortunate to have picked up a hobby that has given me friends in three states.

[irisblue]

40. I love all types of dog shows!!!

I'd go with you in a hot minute. I am glad tjat you're taking care of yourself with a dog and friends.

[get the red out]

41. Dogs are amazing blessings

This precious girl is always there for me, has been for 8 1/2 years and counting. She went three for four this weekend.


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[irisblue]

42. What a pretty girl 😍

My heart dog, Alex the Wonder Dog was part border collie. They are such good friends to humans. I miss that dog.

[get the red out]

43. She came into my life

right after we buried my Dad, went to the humane society as soon as we got home from the funeral, they had two female BC mix puppies available and Mike has always had herding breeds, though I had no dog experience as an adult. Thank God we got there in time to adopt her, the people who had adopted her sister decided they wanted Layla too. Not long after we brought her home Mike had a dramatic bi-polar episode brought on by a change in meds. Having her to take care of really helped me, then she helped him with cuddles when he was on anti-psychotics for a while trying to bring him down out of the mania.

Layla turned out to be an active girl, and that is how we started agility. I was practically a hermit before that, it was the first thing that got me out in the world in about 20 years. I also finally gave in and accepted help for my depression about the time we got her. My younger dog, Shelby, has bad hips and can't do agility, but we are starting to complete in Rally obedience, which is getting to be fun. Without having first gotten Layla I wouldn't have Shelby, who is a lapdog in a Border Collie suit.

[get the red out]

44. Update

I hope I don't sound awful, but Mike wants a divorce and I threw my hands up and agreed that it might be best. What has started making me angry two weeks after the fact is how this came down with his therapist, who had us fill out an extensive questionnaire about our relationship and what we each wanted in general then didn't even go into any of it since I had agreed to a divorce. Looking back, Mike isn't exactly in his right mind. But I also know I can't keep trying to find a way to manage this relationship. It hurts and I have gone from being relieved to not be living with him, to anger, and sadness (both at once now). I felt defeated and didn't try to contact his Psychiatrist, his therapist said he was going to do that. His therapist even got the contact information for the "princess" (hotel night manager Mike said he was in love with, he said she was a descendant of royalty in that last "marriage" session), he was going to contact her and tell her Mike's situation, I think. I gave up and stopped trying to control this situation, I am not that damned desperate for a man! I want him to get well, I will always love him, but since I am on the way out of his life he is just going to have to be helped by the professionals, if that is possible.

No offense to men, I LOVE men and always have, but after all of this I can't imagine having a "man" in my life that doesn't have 4 legs and pees on light poles.

Thanks to all of you for this space where I can relay my tale of woe.

[irisblue]

45. Sending you hugs

You know you'll be flipping in & out the stages of grief. Grieving is a fluid state.