Bipolar: Worsening Bipolar Disorder

Hi,

I got the following email and wanted to share it with you:

“Dave, I have to tell you about my wife, because I don’t know what to do and was hoping you might have some advice for me. Susan has bipolar disorder. I knew she had it when I married her, but she was pretty stable at the time, and over the next few years, too.

Then something happened. She got really stressed out and went into an episode. She spent a lot of money, and even started to gamble. She went through all of our savings. I learned through your courses to forgive her for this, so I did. But our finances were really stretched and it took a long time to get them back to normal. Just when they were, she did the same thing again!

Now, I know I’m supposed to forgive her, but it wasn’t so easy this time. I know she didn’t do it on purpose, that it was another bipolar episode, but it was still hard for me to take. I hadn’t expected another episode to happen so soon, that was the thing. I thought she would be ok for awhile. But there she was, in another episode.

Only this time it was worse. She didn’t just spend all kinds of money and gamble – she also had an affair. She was all apologetic about it and everything, and I knew she wouldn’t have done it if she wasn’t in an episode, but this time I really didn’t think I could forgive her.

This increase in episodes, and the things she is doing really has me worried. I thought she would get better with age, but instead, she is getting worse. The mood swings are happening more often, and so is the episodic behavior. What do you think about all this? What should I do?”

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Wow. It sure sounds like this man has his hands full with his wife. Yes, you would think that with time, she should get better instead of worse. However, there are some researchers who
believe that bipolar disorder does get worse over time. And untreated bipolar disorder definitely
gets worse over time.

The first thing I would tell this man would be that his wife’s medication needs to be looked at.
It seems like something isn’t working there. It could be that some of her medication just
needs to be changed, or at least the dosages need to be changed.

I would also look at her treatment plan. Is she seeing a psychiatrist? How often? Is he regulating her medications? When was the last time her medications were changed? Is she seeing a therapist? On a regular basis?

A therapist would help her look at some of her bipolar behaviors and help her to change them.
They would work together on some of the issues surrounding her bipolar disorder. It sounds like she might still have some unresolved issues going on. It also seems that maybe his wife is still holding some things in that she isn’t talking to him about. So I think there needs to be some work done on their communication.

So it could be not just that her bipolar disorder is getting worse, but these issues that surround
her bipolar disorder that need attention. For example, if she is holding in negative feelings, and not talking to her husband or her therapist about them, they will build up inside her and eventually come out and “blow up” possibly into a bipolar episode.

Also, other things need to be looked at. For example, what are her sleep habits like? Is she sticking to a regular sleep schedule? Loss of sleep can be a trigger to a manic episode. Any one of these things can be making her bipolar disorder worse.

Well, I have to go!

Your Friend,

Dave