My son in law has Cyclic Vomiting Syndrome and after a period of remission he has gotten worse. He and my daughter live 2 hours away. I have noticed that my daughter seems more stressed and flat and she has seemed to have distanced herself from the family. I have asked her many time if there is a problem other than the vomiting disorder and she has said no. I visited her last weekend but was asked to stay at a motel. She came to visit me at my motel early one morning and told me the truth. Her husband has been diagnosed with bi polar disorder, she said he is a rapid cycler, has had psychotic episodes, hallucinations and black outs. He is very irriatble and verbally abusive to her. He has up till now now allowed her to tell anyone. As a result she is having panic attachs which her counselor said were PTSD. She said he also suffers from paranoia and extremely low self esteem. She said he has not gotten physically violent yet but she thought he was close at one point. They have 2 daughters 6 and 12. My daughter has had to explain to the older girl. My son in law is being treated but the drug that seemed to help affected his liver and he has trouble keeping drugs down because of the vomiting disorder. I have suspected hostile behavior on his part for over a year. After getting upset with me last year he walked out of the house, later that night I found that my car had been keyed. He owns many guns. My daughter has made me promise not to tell anyone. I am wondering if I need to be concerned about the safety of my daughter and granddaughters and if so, what would be the best way to deal with the situation.
Yes, I do believe that it is reasonable to be concerned about the safety of your daughter and your granddaughters. Your daughter reported that she is experiencing verbal abuse. She’s also very fearful of her husband. He has prohibited her from even speaking about his behavior and what goes on in the home.
Additionally, there are other concerning factors. These include the fact that he has a serious mental illness, which because of a health problem cannot be adequately medicated. This means that her husband is actively symptomatic. In addition, he is a “rapid cycler,” psychotic, easily agitated and irritable. He has a history of blackouts. These could be linked to his medical problems, psychosis or to his anger episodes. He also owns guns and has come close to physically harming your daughter. It is possible that he has already physically harmed your daughter but she is reluctant to tell you. Research has shown that family members are often the target in cases where violence occurs. Finally, while he has not physically harmed you, he has vandalized your vehicle. These are all major red flags associated with the potential for violence.
Simply having bipolar disorder does not make an individual more likely to be violent than an individual without bipolar disorder. What primarily increases the risk for violence is an untreated psychotic disorder.
Your next question is what should your daughter do about this situation. That is a difficult question to answer. Below I will list several suggestions.
You said she has a therapist. She should ask for his or her advice. If you believe that your daughter is less than forthcoming about this situation with her therapist, then call him or her and report what you know. The therapist, due to confidentiality laws, cannot reveal information about your daughter’s case to you but there is no law against you providing information to the therapist.
She could also do several other things. You mentioned that her husband is unable to digest or sufficiently consume his medication because of a medical problem. This tells me that he has a psychiatrist or has at least has been in recent contact with mental health professionals. Your daughter could report his behavior to his doctor or treatment team. They may be able to advise your daughter about how to handle this situation.
Other ideas include calling the police or mental health crisis team if his behavior is out of control. If he is actively psychotic and threatening her, he would likely be admitted to a psychiatric hospital. Calling the police or the mental health crisis team can expedite the process of hospital admission.
The safest and most appropriate way to proceed, given the current circumstances, is for your daughter and your grandchildren to move out of the home until his symptoms are under control. Domestic violence shelters can provide a temporary safe house. It is a very volatile situation and your daughter and your grandchildren need to be protected.
My final recommendation is to review the Treatment Advocacy Center website. They provide information to family members dealing with psychiatric crisis situations. They also provide a great deal of other educational information that I believe you and your daughter would find relevant and beneficial.
I hope this helps. Please take care and don’t hesitate to write again if you have additional questions.
Dr. Kristina Randle
