pain

Q. I know this is really lengthy, but I am in desperate need of help, my self-esteem is shot, and I am paralyzed with fear. I don’t know what to do. I wrote enough to set up the scenario and my history for you, to give you a better picture . I hope you *will* reply, I really need help.

I was diagnosed with BP1 in 2005. I have a long family history of bipolar disorder and depression as well. This is part of what led my dr. to this dx., along w/ other clues. I have worked with a good psychiatrist from the get-go to try to find a medication that works for me, and resolve some issues regarding the bipolar disorder.

Right now,I’ve been taking Lamictal for about a year, 200 mg. daily. It has taken a long time, but the dose I’m at now is helping more. It’s my opinion that I should try a higher level, since, while I don’t have the psychotic or manic symptoms as long, badly, or frequently, and the depressions are also not as long, frequent, or deep, I am still having “hiccups” so to speak. I am a rapid cycler who has mixed states as well. But it’s all starting to tone down a bit. With that established, here is my dilemma.

My husband of 20 years, who is a great skeptic of all things psychiatric, and believes meds are unnecessary, and that I am just looking to excuse my behavior with a diagnosis & medication, has recently began making snide comments and innuendos about my medications. He has repeatedly questioned, what is this? what does it do? This mostly began recently, when my gen. practitioner prescribed Darvocet for a herniated disc, and Relafen for my increasing arthritis (have had arthritis since age 36.) So, my side of the medicine cabinet has been filling up a bit. I was taking– Lamictal, Trazodone only as needed for insomnia & anxiety, Relafen, Darvocet on as needed basis, and two different antibiotics for gum disease and an infection. This began really bugging my husband, and the remarks began.

I have had trouble with bingeing on beer on occasion in the last three years, since my last breakdown (’04, before my diagnosis). I have been much better, allowing my meds to do their thing, and not running for a beer when stress hits me. It does feel better not to. I have a very low tolerance for stress, & we’ve had a LOT lately. Plus, I’ve been trying to find a job for two months, with no success, and feeling very low about this. I’ve been a stay-at-home mom for 16 years, and I think this is affecting my search.

T. and I had a blowout the other night, after I had finally had enough of his comments and his recent treating me like a five year old (to the point of even accusing me of *acting* like one.) Probably because of some financial issues I caused when manic and depressed two years ago (from which we are still recovering, & almost there), he has really been on my case about money & spending. Aside from some forgetfulness and my disorganized filing habits, I have let a bill or two escape payment, but I only spend what is needed for the household, the kids, or whatever unforeseen thing that may come up. I am not a “big spender” or an “impulse shopper,” I have no “shopping addiction.” However, he recently started questioning every penny I spend, and I then have to account for EVERY penny.

He took a loan out against his 401K last week, so we could — together — catch up the last few late bills. He called me immediately and told me sternly “DO NOT spend ANYTHING until we can sit down and work the budget out together. I do not want to blow this money. DO NOT go to the bank or the store!!” He repeated himself a couple more times, and I assured him I wouldn’t . He made such a big deal of it, and even when he got home. Well,I finally had reached the breaking point, and sent him a sarcastic email asking permission to buy these items, and saying he’s right, I’m a child and must be monitored at all times. I wasn’t very nice. Our blowout the night before had been a yelling match in which he had the upper hand, and shot down *anything* I tried to say with “Oh, here we go again — the ‘woe is me’ crap from you!” “Oh, THAT’s appropriate behavior for a five year old!” and similar things. I snapped, and went to bed crying myself to sleep.

I am tired of this. In my email, in my anger, I also said angrily, fine, I am quitting ALL my meds — the back pain meds, the psych meds, ALL of it — since he so disapproves of my “drug use.” Well, I realize, that’s stupid (although tempting) and now I want to just tell him, You know what? My search for stability is important to me AND to this family, and I have decided NOT to quit after all. I’m sorry if you disagree, but I feel this is what I need to do. The back pain med was prescribed to help me avoid surgery for as long as I can, since we have kids and horses, and financially, surgery and my layup would not be a good option for us.

So, I am not sure what to do now. There are also some issues he has with jealousy, and thinking I’m cheating or sneaking around — he checks our emails constantly, asks me “Who’s this? What’s that?” and gets really mad when I forget and leave my cell phone at home or in the car & he can’t call me. I’ve done nothing to warrant his behavior. I’m tired of being monitored like a child or a criminal. But that’s a whole other issue! Mainly, I am scared to stand my ground at this point, & take back what I said, and stay on my meds. My back is already hurting me *a lot* after three days, and I’m still on my Lamictal, only at a tapering off dose in spite of my p-doc’s recommendation.

I really want to talk to him, but i’m afraid he will turn it all around to make me feel bad about it. By the way, please don’t suggest marital counseling. We’ve already done it twice; he turned it all on me, saying everything was my fault, and thinks it’s all a crock anyway. He won’t go again. I am desperate, and feeling belittled, and have little self-esteem or confidence here. I really need some help or encouragement. I hope you will reply. Thanks for reading anyway.

Thanks for your detailed letter. Of course, you should stay on your medications. It sounds like you have finally found a regimen that works for you and you have done this in tandem with your doctor. Many people struggle for years to find a medication that helps regulate their symptoms. Also, many people find it difficult to find a doctor that they like to work with. You have both, a good doctor and medications that work for you; it would be foolish to forgo what is working.

If your husband does not understand why you are taking medications, or why you need them, perhaps you can inform him. Have the two of you sat down and had a real “heart-to-heart” about what it is like to live with bipolar disorder? Have you communicated with him precisely how the medications work for you? I know this seems like common sense, but maybe, being that we all seemingly live busy lives, these basic facts were never communicated to your husband in a way that makes sense to him.

Also understand that many people do not understand bipolar disorder and this can and often does include family members. Some family members find it difficult to believe that their loved one has the disorder, as in your case. This may be due to ignorance about bipolar disorder. Bipolar disorder is difficult to fully understand. Some family members, this may be true for you as well, are angry at their loved one for being “sick.” It is human nature for this to occur and very common. It does not make it right to be angry at a loved one for being ill, but it does happen. It is likely that your husband is at the very least not informed about the disorder.

I know that you do not want me to suggest marriage therapy and that’s fine, although it is necessary and with the right therapist, you could have had more success.

I am going to suggest individual counseling for you. It is also clear that your husband could benefit from individual therapy but it does not sound like your husband is open to the idea. Even if he is unwilling to get counseling, you still should.

I am suggesting individual counseling for several reasons. The first reason is because you could use some guidance in helping you build your self-esteem, and this can be done with a therapist. The second reason is that you (and your husband too) could benefit from working with a therapist on your relationship issues, and here are a few examples of why:

Your husband yells at you and you feel like a child. There is something clearly wrong with how he treats you. In this case, he is in the wrong.

He hounds you about taking medications; medications that seem to be helping you. Again, he is in the wrong.

In the last fight that you wrote about, he tells you that he wants to save money to pay the bills, asks that you not spend any money and you reply inappropriately, as you already know, with a sarcastic letter, egging him on, and a statement that you are going to quit taking your medications. In this specific case, you were in the wrong.

Your behavior (as well as his) within the relationship needs to be analyzed. A therapist can help you analyze how each of you behave within the relationship and help you correct your behavior and help you see how the both of you contribute to your “blow outs.” Every fight that occurs between the two of you hurts and damages the relationship. And that is why a therapist, even if it is only you that attends, is very important in your situation.

I hope this helps answer your question. Take care.