After my last post, I realized there are many details to fill in. My wife’s depression crisis started gradually in May 2014, and got really, really bad in Aug/Sept – severe anxiety, hopelessness and even suicidal thoughts. Once the situation got this bad, she finally lost all strength / resistance that she had against getting help from a psychiatrist. While an earlier psychiatrist assessment raised the possibility of cyclothymia – a mild, subthreshold form of bipolar disorder, this current crisis apparently met criteria for bipolar spectrum disorder (Type 2 Bipolar Disorder) – as my wife has never experienced a full manic episode. She reluctantly agreed to start on venlafaxine and lamotrigine, which was always a struggle to get her to take. But after 6 weeks, by end of October 2014, there was a DRAMATIC improvement. Her mood lifted, becoming less irritable, anxious or distressed, and her day-to-day function rapidly returned to near normal levels.
BUT, our relationship had been severely shaken by the crisis, and she continues to be in denial about the diagnosis and need for medication or therapy. We worked really hard on our relationship in couple therapy for 6 months, to repair some of the damage, but tension remained about doctor appointments and taking the medications. Also, my attempts to talk and ‘process’ the events during the crisis period were constantly rejected, as part of her overall denial. I finally decided to take a break from that topic and stepped back from supervising the medication. This lessened the tension and our relationship repairs went more smoothly.
THEN, about a month ago, I noticed some subtle, relatively minor mood swings and irritability, so I enquired whether she was still taking the meds. She admitted that she stopped all meds 2 months previously – I was not surprised but significantly worried. Her only reason for stopping the meds seemed like that she didn’t think she needed them, which was a constant theme from the beginning. I was hoping that with time on the medications, she may gradually gain greater insight and acceptance, which would help immensely with working together on a treatment plan to tackle this challenge, but this news seemed like a step in the opposite direction. A serious talk by the psychologist and psychiatrist had no affect on changing her mind.
FINALLY for now, I should add that my initial gut reaction to this news was to express an ‘ultimatum’ request, that I cannot continue in this relationship without her sticking with a treatment plan, as recommended by the psychiatrist. After discussing this with the psychologist and close friend, I decided to put that response on hold to give more time to trying to encourage greater insight into the mood swings and need for treatment. This led me to start reading up extensively on Bipolar blogs and books.
In my next post, I plan to clarify how the Bipolar II Disorder is affecting our relationship, to start thinking about what I can work on first, even while my darling wife remains in her denial phase.