Reply to My wife attempted suicide last night

Forum Index » Relationship Discussion (non-explicit)

Reply to "My wife attempted suicide last night"

Subject:

Emoticons





More smilies

Text Color: Font: Close Marks

[quote=Anonymous][quote=Anonymous][quote=Anonymous]OP, what do you think is triggering her deep depression?[/quote]

She is bipolar. And things had been going so well, she seemed really stable, until this. [/quote]

Are you journalling symptoms?  Until I started journaling, I found with my bipolar nowExDH that sometimes I thought things were going well, but I really wasn't connecting the dots on the subtle signs across time.

Medication is tricky.  Had she recently been through a medication change?  Are you sure she was taking meds?  Is she on an anti-depressant along with a mood stabilizer?  Sometimes an anti-depressant can be "activating" enough to drive suicidal thought in BP.  This happens because the AD can increase mania and the associated irrational thought patterns or because the AD can lift the almost-catatonia like aspect to depression enough to enable the bipolar person to DO something about their depressed feelings.

Standard bipolar treatment is a proven mood stabilizer (usually lithium or depakote) closely monitored to ensure consistent blood levels in the effective range and also supplemented by sleep aids or anti-psychotics or anti-anxiolytics in order to provide extra control for these symptoms (although often a panoply of meds to address a variety of symptoms really means that the mood stabilizer itself isn't the right one or the proper dose.)

I really think some of the advice above re: she has to want to save herself is harsh and wrong.  The dilemma of bipolar and other mental illnesses is that the brain is not rational and thus unable to make rational decisions about treatment choices.  Even when stable for a long time on meds, many persons with bipolar and other mental illness decide that they don't need their meds and try to go off, usually with negative consequences.  It is an open question whether this desire to go off meds is a "willful choice" that patients make due to the stigma of mental illness and/or the serious side effects of meds or whether the decision is rooted in an early phase of a decline in mental status, i.e. returning mania or depression despite medication (which happens).  Ellen Saks speaks eloquently in her book and in public  talks about coming to terms with permanent medication of her schizophrenia.  Xavier Amador also writes very helpfully on how family members can facilitate treatment choices.

That said, in the early phase when a person is nowhere near stable on meds, it may take more involvement of the spouse or other family member in treatment choices.  The scientific literature and best practices are clear that outcomes are best when families are involved in treatment.  You should be meeting periodically with your wife's psychiatrist and therapist to understand her med regime and recommended social habit patterns (social habits like sleep, exercise, diet, interpersonal interaction and self-care are also proven to improve outcomes, see studies on IPSRT aka Interpersonal Social Rhythm Therapy) so that you can support it at home.

Yes, it's true that bipolar patients have to take responsibility for their own care, but, IME, this can only begin once the person is sees improvement from meds and is beginning to stabilize.  It is only at that point that they are rational enough to reflect on aspects of their life that they can control that contribute to stability, what kind of help they need from family members and what kind of back up plans should be put in place.

OP, if this is her 3rd attempt, I have to ask -- does she have proper legal plans in place?  A will?  A power of attorney (POA) naming you as able to make medical decisions on her behalf -- and her I refer to more than just the typical living will or POA that clarifies resuscitation wishes in various scenarios, but a POA that enables you to make medical decisions on her behalf and which waives HIPAA/privacy rights, which often cause a problem for families who need to provide care and thus need to know about treatment.  Now might not be the time to push getting those in place, but if you don't have these you definitely need to seek counsel.  NAMI has info on this.

Also, OP, you and your child definitely need your own therapist to help you deal.  Feeling anger is normal, but conveying it to your wife and expecting some kind of apologetic response or change in behavior is not necessarily a reasonable expectation with this illness.  As another PP said, the thought process is very irrational.  Try to find a PhD clinical psychologist who provides psychotherapy and has lots of experience with mood disorders.  [/quote]

Options

	Disable HTML in this message
	Disable BB Code in this message
	Disable smilies in this message

Review message

Search Recent Topics Hottest Topics