# How to Care for and Cope With a Bipolar Spouse



## Daniel (Nov 14, 2015)

How to Care for and Cope With a Bipolar Spouse
_Health.com
_
If you're involved with someone with bipolar disorder, the romantic relationship may be exciting, exhausting, and stressful. But it will rarely be easy, especially if the object of your affection doesn't comply fully with treatment.

Bipolar disorder can be nearly as traumatic for the partners of those with the disorder as it is for the patients themselves. The episodes of depression and mania that bipolar people experience—which can lead to emotional withdrawal, out-of-the-blue accusations and outbursts, spending sprees, and everything in between—have been shown to induce stress, sexual dissatisfaction, and money worries in their partners, as well as depression. Depressive phases, during which the bipolar partner feels hopeless and sad, can drag a healthy partner down, too.

"Mental illness is, on some levels, a contagious disease," says David Karp, PhD, a professor of sociology at Boston College who has studied interpersonal dynamics within bipolar couples. "It brings out very strong negative emotions and feelings of isolation in the partner, who struggles so hard to separate the illness from the patient."

Relatively few studies have been conducted on the effects of bipolar disorder on relationships, but the research is nearly unanimous that the disorder tends to cause both practical and emotional difficulties for couples.

For starters, the ups and downs of bipolar disorder can disrupt the rhythms and routines of a household. In a 2005 survey of people with bipolar partners published in Bipolar Disorders, more than half of the participants reported that their partners illness had reduced their socializing, required them to assume more household responsibilities, forced them to take time off of work, and caused financial strain. The participants also reported that their sex lives sagged when their partner was in a manic or a depressive phase; three-quarters of the women who were interviewed and 53% of the men complained of infrequent sex when their spouses were depressed.

Another study of bipolar caregivers found that 86% of the participants characterized the stress they experienced as a result of their partners illness as "major." And 9 out of 10 said they found it difficult to keep the relationship going.

*Building a team for support
*Many people enter into relationships with a bipolar person unwittingly, thinking it will be smooth sailing, says Adele Viguera, MD, a psychiatrist at the Cleveland Clinic who works with bipolar couples seeking to start a family. "Maybe they meet the person when the person is hypomanic, not realizing that mood can change," she says.

Tim, 37, tried for three years to sustain a relationship with a woman eventually diagnosed with bipolar disorder. "She would cycle between extreme happiness and depression," he says, recalling her paranoia, impulsiveness, and self-destructive insecurity. "She broke up with me and started dating other people, and then when I dated other people she tried to win me back." Like many people with bipolar disorder, Tim's girlfriend also struggled with drug and alcohol addiction and got deep into debt—with his credit card. Tim eventually broke down emotionally himself, ended the affair, and tried to forget the experience. "Half of me moved on, but half of me will always love her," he says.

Divorce and separation are common in relationships involving bipolar disorder, but according to Dr. Viguera, such relationships don't have to be destructive and separation is hardly inevitable. Both parties have to participate in its success, however. "Taking care of bipolar disorder is a team effort, involving the two people and a psychiatrist or other mental health professional," she says. While she would never speak to a spouse without her patients consent, such open communication empowers both parties to make treatment decisions that lead to a healthier relationship.

Mental health professionals aren’t the only ones who can lend a hand. The stigma of mental illness can make couples hesitant to look elsewhere for help, but Karp emphasizes that extended family members and trusted friends can all provide invaluable support. "Spread it around a little bit," he says. "People need support systems. By keeping the illness a secret, people place an additional burden on themselves." Karp also recommends that anyone who cares for someone struggling with bipolar person find a support group in their area.

*Bipolar marriages can work*
Fred and Kristin Finn, of Grand Rapids, Mich., describe their marriage as loving and supportive, despite that fact that Kristin was diagnosed with bipolar disorder as a teenager. Their teenage daughter has also been diagnosed with the disorder.

The pillars of their success, both say, are open communication (Fred is free to reign in Kristin's clothes spending when he thinks she is manic) and predictable schedules. Kristin says carving time out for her own sleep is crucial, as is making time for each other. "We make sure that every Friday night we set aside time for each other,” she says. “Every single Friday night he comes home from work, we turn on some music, we sit, and we talk. My family and friends know—nobody calls us during that time period. Nothing can keep us away from our Friday night, because its our time to connect."

For his part, Fred says he would encourage anyone involved with a bipolar patient to educate themselves as much as they can about the disorder. You may not always like what you learn, he warns, but keeping surprises to a minimum makes your relationship easier to navigate. For example, he says, he is worried about the long-term effects of medication on Kristin's health. And while both his daughter and his wife comply with medication and therapy, neither is symptom-free.

"No matter what you're doing, there will be symptoms," Fred says. "Once I learned about how the symptoms manifest themselves, once I started reading that and becoming more familiar with that, it gave me a better understanding of how to cope with these things. Getting angry because a person has bipolar disorder won't help anything. Bipolar is treatable, medications and counseling help a great deal, but there's still things about bipolar disorder that I don't think I'll ever figure out."

This is a perfectly healthy stance to take, according to Karp. He urges people with bipolar partners to remember what he calls the "four Cs": I can't Control it; I didn't Cause it; I can't Cure it. All I can do is Cope with it.


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## Daniel (May 23, 2018)

Related:

A guide for caregivers of people with bipolar disorder  

When Someone You Love is Bipolar


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## Daniel (May 23, 2018)

The Many Ways Marriage Can Be Exhausting - Grow With Christine

...Chronic anger, anxiety, guilt, depression, or fear in one spouse can numb the other spouse to feelings in general. This emotional detachment is a survival mechanism to cope with the unstable emotional responses. The root cause of the initial emotion needs to be addressed before the other spouse is able to open up again...


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## Daniel (May 24, 2018)

My advice (mostly learned the hard way):  

1. Avoid partnering with someone who thinks therapy is a waste of time.  
2. Do not "engage" when being yelled at.  Walk away.
3.  If overspending is an issue, secretly save some money in a separate bank account just in case.   This also gives you more freedom to leave the relationship or temporarily separate if need be.
4.  Develop friendships and spend more time with your other family members.  You will need them when the going gets tough.
5.  Pick your battles but don't walk on eggshells.
6.  Go to therapy yourself, especially if your support system is lacking or you have a disorder yourself.  
7.  Go on more "date nights" even if you have to encourage your spouse into doing so until it becomes routine.


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## Daniel (Jan 17, 2020)

Now my spouse has again the "more is not enough" syndrome.    He wanted a goat this morning.  When I told him the realities of taking care of a goat, now instead he is repeating his desire to get a fifth dog later at some point -- since he still wants a big dog even though he is the one who adopted three dachshunds and a chihuahua.  We already agreed (I thought) not to get any more pets given the cost involved. And it would be hard enough to go on a road trip with four dogs since most hotels only allow two per room.    We have no money saved for retirement.    

I am thinking of leaving him sooner than later again because it is just exhausting having these arguments every few months.  When he was insisting on getting a goat this morning, I told him I would leave him.   

Things finally got good after we had a huge argument a few months ago -- which he started when he was having another bipolar episode.    And now he is trying to rock the boat again.   After our last huge argument, I drove away and told him I was done.  But I came back after driving 300+ miles to New Mexico.    

Now he has calmed down but I'm sure he will bring up the dog issue again within a couple months.    But I am thinking of leaving him regardless since I am getting tired of it all.


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## Daniel (Jan 17, 2020)

Bipolar and narcissism: Is there a link?

The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) does not list narcissism as a symptom of bipolar disorder. However, when a person with bipolar experiences an episode of mania, they may display some narcissistic behaviors, such as high levels of confidence, feelings of self-importance, elevated energy levels, and grandiose self-perceptions.

Because bipolar and NPD have some similar symptoms, the two conditions can be confused. This can result in people with bipolar being diagnosed with NPD and vice versa.

During periods of depression, a person with a bipolar disorder might also display narcissistic characteristics. For example, a person might neglect caring duties, avoid social contact, or appear insensitive to the needs of others.

This might seem to be narcissistic, but it is more likely that the person is so overwhelmed by their own negative emotions that they may not notice others people's feelings.

To diagnose someone with a personality disorder such as NPD, a doctor must be sure that another condition cannot better explain their symptoms. So, when narcissistic behavior is due to depression or mania, the DSM-5 argues that it is not appropriate to make a diagnosis of NPD.


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## gooblax (Jan 17, 2020)

Daniel said:


> Now my spouse has again the "more is not enough" syndrome.


That does sound exhausting to have the same kind of argument over and over again.


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## David Baxter PhD (Jan 17, 2020)

Indeed. That's partly a bipolar thing for sure although some of my exes were the same without bipolar.

Is your husband on medication?


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## Mari (Jan 17, 2020)

> I am thinking of leaving him sooner than later again because it is just exhausting having these arguments every few months. When he was insisting on getting a goat this morning, I told him I would leave him.



What a difficult position to be in! Curious, why does he want a goat?


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## Daniel (Jan 17, 2020)

Yes, including Abilify.  And he self-medicates with medical marijuana, which is fortunately less expensive than it used to be.    

It's just hard to be excited about a relationship when you know for sure you will be yelled at sooner or later for something trivial.   And some of our values are still very different.   He doesn't care about me saving for retirement since he is already in retirement age.  He is 60, and I will be 43 this year.


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## Daniel (Jan 17, 2020)

Mari said:


> What a difficult position to be in! Curious, why does he want a goat?



He wanted a goat for the novelty factor and to eat the weeds.  But I convinced him the goat would ruin our cars unless he paid to fence more of our property.   So now he has no interest in a goat -- for now anyway.

(A number of people in our area have goats, but goats are good at escaping and he doesn't even like goat milk/cheese.)   

And he reluctantly seemed to agree today that he won't get a big dog.  But he has done that before.   We actually got a big dog last year, but it kept trying to run away.   So we gave it to a friend.    And then he got a chihuahua instead.


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## Daniel (Jan 18, 2020)

Does Your Partner Have Rage Attacks? Here's What to Do

5 Common Mistakes that Increase Abuse


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## Daniel (Jan 18, 2020)

Intermittent explosive disorder - Wikipedia

Intermittent explosive disorder (sometimes abbreviated as IED) is a behavioral disorder characterized by explosive outbursts of anger and violence, often to the point of rage, that are disproportionate to the situation at hand (e.g., impulsive screaming triggered by relatively inconsequential events). Impulsive aggression is not premeditated, and is defined by a disproportionate reaction to any provocation, real or perceived. Some individuals have reported affective changes prior to an outburst (e.g., tension, mood changes, energy changes, etc.).

The disorder is currently categorized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) under the "Disruptive, Impulse-Control, and Conduct Disorders" category. The disorder itself is not easily characterized and often exhibits comorbidity with other mood disorders, particularly bipolar disorder...

Bipolar disorder has been linked to increased agitation and aggressive behavior in some individuals, but for these individuals aggressiveness is limited to manic and/or depressive episodes, whereas individuals with IED experience aggressive behavior even during periods with a neutral or positive mood. In one clinical study, the two disorders co-occurred 60% of the time. Patients report manic-like symptoms occurring just before outbursts and continuing throughout.


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## Daniel (Jan 19, 2020)

Today is going well, as did most of yesterday.    I am checking his pill box each morning -- at his request -- since he forgot to take his meds two mornings in a row (on Wednesday and Thursday this week).


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## Daniel (Mar 6, 2020)

Hopefully I will be moving out soon.    I was on the receiving end of another rage/verbal attack.    It is getting real old.   I took care of him all day today and yesterday since he had a minor procedure on his foot.   And my reward is being yelled at to the point that all of the dogs are afraid and under the bed.   I was hoping he would get better with age or something but it feels like trying to expect a dog not to bark.


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## David Baxter PhD (Mar 6, 2020)

Sorry to hear that, Daniel. That’s too bad but you can’t live your life on eggshells.


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## Daniel (Mar 6, 2020)

Ironically, I would probably cope better with his BS if I were in therapy.  But he gave such "tantrums" about the cost of therapy, that I stopped going after two sessions since he agreed to save money and stop getting marijuana.    Of course, that was another lie/delusion.


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## gooblax (Mar 7, 2020)

Sorry to hear that he's been continuing to treat you poorly.


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## Daniel (Mar 7, 2020)

As usual, he apologized today and things got back to normal by late morning.    Every time this happens, I try to tell him that there is no reason to yell, e.g. who did I kill?    And I reminded him that it activates my fight-or-flight response, e.g. I was looking at apartments last night and thinking of moving to another part of the country.  

He already talks loud, so when he yells, it is really, really loud.   I did find another suggestion on dealing with rages -- to try to switch the target to something else.


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## Daniel (Mar 15, 2020)

Daniel said:


> My advice (mostly learned the hard way):
> 
> 1. Avoid partnering with someone who thinks therapy is a waste of time.
> 2. Do not "engage" when being yelled at.  Walk away.
> ...



I would add to my list: 

Remember why you liked him/her in the first place.  And as with most disorders, there is usually a positive side somewhere, like being the life of the party or being more alive/exuberant, driven, charming, or outgoing in general -- "the bipolar advantage."


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## Daniel (Mar 18, 2020)

It's a mess again.  I'm done again.


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## Daniel (Mar 18, 2020)

I drove to town to get away from him and now I am driving back home to him.    I feel like I am screwed no matter what I do.

Sent from my LM-Q720 using Tapatalk


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## David Baxter PhD (Mar 18, 2020)

Is that because you feel you have nowhere else to go?


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## Daniel (Mar 18, 2020)

No.   Now I think my best compromise is to get a job in Phoenix -- two hours away -- in a couple months once his back is better.   And then I will be out of the house for 12 hours a day (8 for work and 4 for driving).     And then I will have more of a life on my own already if I do decide to leave. 

But realistically, I still have my clothes in my SUV in case I decide to leave again today.  I am very on edge because I don't see the hope for this relationship.


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## David Baxter PhD (Mar 18, 2020)

It’s no way to live, that’s for sure.


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## gooblax (Mar 18, 2020)

Sorry to hear that his behaviour keeps triggering you @Daniel.


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## Daniel (Mar 20, 2020)

He sees his psychiatrist at the VA today.  So I will be going with him since he has very little insight into the "collateral damage," which is mostly him yelling at me.  My main complaint will be that -- from what I see -- they just push pills at him and seem to do nothing cognitively or behaviourly to increase his insight.  At which point hopefully she will recommend therapy for him.


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## Daniel (Mar 20, 2020)

I just asked my husband if the VA ever told him about a treatment plan or went over coping methods.  "Never" is his answer.


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## David Baxter PhD (Mar 20, 2020)

Wow.

That's quite sad if true.


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## Daniel (Mar 25, 2020)

So far, so good with the VA.  My husband's relatively new psychiatrist called on Monday after we cancelled his appointment on Friday because of car trouble.   She changed his antipsychotic for a different one since he is having more mania than depression.  So he will be starting Zyprexa and has come off Latuda.   (And if he gets unwanted side effects from Zyprexa, her next plan concerns Geodon.)

When this coronavirus thing is over, she will be seeing the both of us in person.  I like her already since she expressed a lot of concern about his yelling. (She even recommended I try cashew milk since it may taste better than other non-dairy milks.)


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## Daniel (Apr 12, 2020)

The Bipolar Conversation: A Communication Tip to Change Your Life | bpHope.com

What Do I Do When My Husband With Bipolar Yells At Me? | bpHope.com


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## Daniel (Apr 30, 2020)

Happy update:

1)  Zyprexa is working well for him.   (It is like he is back on the lithium as far as I can tell, which he had to stop taking due to being older with kidney issues in his bloodwork.)   

2)  He has started painting as a new hobby and has signed up to take digital photography courses online.


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## Daniel (May 8, 2020)

Today was a bad day.    So much to deal with -- his chronic pain, his other bipolar family members, his bipolar disorder as usual, and my OCD/anxiety and depression.   I have been triggered all day long it seems and have been going for walks but they haven't helped much because I come home to him.    And I feel stuck because I live too far from Phoenix to do anything but work from home in the future.

He can tolerate a lot more drama/friction/arguing than I can.   I scheduled an appointment to see my therapist, but I told my husband our future doesn't look good since I can't take much more of this.  He thinks I should just buck up and am over-reacting as usual.

If there was some miracle chill pill that would increase my tolerance level, I could deal with things better.  But I feel like I am living in a group home of two mentally-disordered individuals who trigger each other, and this was happening since our marriage began -- way before the quarantine.   When I was working full time, we did not get along any better, either.

We get along and then we don't -- and then we cycle again.


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## David Baxter PhD (May 8, 2020)

Eventually, it comes down to a personal decision about how much tension, strife, conflict, stress, and abuse you want to tolerate, and perhaps more importantly whether you are living a life you want to live indefinitely.

It's never an easy decision to make.

But ultimately you have to trust yourself to make the decision that is best for you and to leave everyone and everything else out of the equation.


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## Daniel (May 9, 2020)

Partner Coping Strategies 



Lowing expectations:

• “It’s hard not to have too many expectations from the person that is closest to you, but you better not have expectations, because when there are expectations you get disappointed quickly.”

• “Sometimes I forget that he is ill and that I might have high expectations—expectations that he will pay attention to everything and make all the efforts, but this is not always possible.”

Focusing on the positive:

• “In moments of crisis you sit with yourself, and you say: “Why did I get into this [relationship]?” But then if you think about what is good, on the positive things, you get new strength. Because we can look on the positive and optimistic things.”

• “You need to find a source of energy to feed you. Because we don’t have a supportive environment, and there isn’t something that will motivate us. So you sit with yourself, and you build positive thoughts.”

Hope:

• “This illness is with her all the time. It’s an illness that is one of the most difficult ones to have. I hope that the scientists and the professors will develop a new medicine that will postpone the illness for a long period, for several years really.”
• “I don’t believe there will be another episode. Not with him on the pills.”

Love:

• “If you love your wife then you won’t leave her no matter what is going on with her, if you love her you won’t leave her. I’m with her until the end … I don’t care anymore if the symptoms will come back.”

• “With all the hardships I realized that I’m really connected to her. With all the lack of logic and the difficulty. You have to be connected spiritually or emotionally, because otherwise it’s very difficult for this marriage to last.”

Patience:

• “You need to be patient. Patience, a smile, these are the tools for coping.”
• “You need a lot of patience, this is the most important thing. It’s hard. You just need to take under consideration that the person is ill and you have be patient. Patience and to accept it.”

Nonreactivity:

• “In temperamental moments, you need to understand that it will pass. You need to restrain yourself and think this is a storm right now, and it will pass.”

• “I need to remind myself once in a while that I don’t have anything to be upset about, because it will pass. When I had moments of crisis, I would say to myself: It will be over, and it will come back to normal, it’s just a little bit more.”

Taking it day by day:

• “I live from day to day.”

• “[When she’s in a manic episode,] it’s basically just getting through the week, week and a half, or whatever it takes till she calms down and recovers and I just get through it the best I can.”

Avoidance:

 • “When coping with her illness, I take no time for myself, I had no time to stop and think. It’s is the way I choose to help her.”
• “I don’t deal with the difficulty. I am very busy, on the everyday I forget about it. If I sit alone, it’s
always in my head. At home we don’t talk about the illness at all. I never received any guidance, but I
don’t want any, because there’s no need, I don’t want to get into it again. We are well, he’s taking his
pills, there’s a routine. You don’t need to bring up that issue again.”

Source:  Granek et al., "Hold on Tight: Coping Strategies of Persons With Bipolar Disorder and Their Partners" (2018)


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## Daniel (May 20, 2020)

Decreased empathy response to other people's pain in bipolar disorder: evidence from an event-related potential study

Bipolar disorder (BD) patients often demonstrate poor socialization that may stem from a lower capacity for empathy. We examined the associated neurophysiological abnormalities by comparing event-related potentials (ERP) between 30 BD patients in different states and 23 healthy controls (HCs, matched for age, sex, and education) during a pain empathy task...

Compared to healthy controls (HCs), BD patients have fewer social interactions. Patients with BD also showed impairments in emotion identification regardless of current disease severity, a deficit also present in first-degree relatives, indicating a potential endophenotype for BD. In addition, BD patients with varied disease severity demonstrated deficits in mentalizing. These observations illustrate that BD patients are unable to comprehend and ascribe mental states of others, which could underlie deficits in empathy...

Our study provides preliminary but compelling evidence for a pain empathy deficit in BD patients at the neurophysiological level using ERP recordings during a well validated empathy paradigm. The results showed that late (conscious) and potentially also early (automatic) neural processing stages of pain empathy were impaired and that ACC activity while judging pain in others was reduced in BD patients. In addition, self-reported empathy scores were lower in BD patients than HCs [healthy controls]. Taken together, the present results demonstrate impaired empathy at the neurophysiological level in patients with BD. YMRS scores were negatively correlated with difference waves, providing the first indication that altered pain empathy in BD may be state-dependent. This deficit in empathy may explain the poor interpersonal interactions observed in many BD patients and suggests that BD patients may benefit from psychotherapy targeting empathy.


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## Daniel (May 20, 2020)

The Mentalizing Approach to Psychopathology: State of the Art and Future Directions
May 2020

Summary Points:

1. Mentalizing (or reflective functioning) refers to the highly developed, evolutionarily prewired human capacity to understand the self and others in terms of intentional mental states, such as feelings, desires, wishes, attitudes, and goals.

2. Mentalizing impairments are transdiagnostic and transtheoretical vulnerability factors for psychopathology; temporary or chronic impairments in mentalizing are implicated in a wide range of psychological problems and disorders.

3. Recent formulations have shifted from an emphasis on the role of dyadic attachment in the development of mentalizing in earlier formulations to a broader, socio-communicative approach that emphasizes the role of family, peers, and broader sociocultural factors in the development of mentalizing and the capacity for epistemic trust, the evolutionarily prewired capacity to trust others as sources of social information.

4. A growing body of research supports the (cost-)effectiveness of mentalization-based treatment (MBT)—that is, treatments that focus on the recovery of the capacity for mentalizing and epistemic trust.

5. Although the evidence base for MBT is growing, there is a need for large-scale trials to further investigate the (cost-)effectiveness of MBT, its purported mechanisms of change, and its potential to be implemented in routine clinical care.

6. Similarly, there is a need for more research on the assessment of the various dimensions of mentalizing, which will also enable research concerning the neurobiological bases of mentalizing and associated psychological processes.


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## Daniel (May 20, 2020)

"In development and in psychotherapy, mentalizing begets mentalizing, as exemplified by a mentalizing stance that fosters inquisitiveness and curiosity about mental states in oneself and others."  ~ Jon G. Allen, _Mentalizing in Clinical Practice_

What is Mentalizing  Why Do It with Jon G. Allen, PhD - YouTube


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## Daniel (Jun 6, 2020)

If my husband decides to ride an ATV (all-terrain vehicle) despite my reservations, am I ethically/morally entitled to divorce him if he becomes severely injured and needs round-the-clock care the rest of his life?   Doesn't sound like I love him at all that way, but he has a history of having made unilateral decisions with no concern for the effect on me, and it is wearing me out again mentally.    He has agreed (for now) not to ride an ATV because of my reservations, including the fact that a volunteer firefighter died in our small town last year from riding one.   

It seems telling myself that I can bail out of this marriage at any time is the only way I can cope lately since there is always a new risk he takes on every year or so that I think is just asking for trouble.   It seems like a tightrope between me seeming over-controlling and him seeming like someone who favors short term benefits over long term consequences.   

The other thing this month is he wants to trim trees again, with him on a 8-foot ladder holding a chainsaw. The last time he did that was six years ago, when he fell and needed rotator cuff surgery.   I told him it was a stupid idea back then before he did it.  Now he thinks he is invulnerable again since he thinks he will be more careful.

Just having to think about this stuff seems like another reason to bail, though things eventually work themselves out.    But it is like a surprise party every so often.  Before he always agreed that ATVs were too dangerous.  Now he is tempted again because the brother-in-law has one.

I just wish it was more black and white, since there are spouses without bipolar who do even riskier things like race motorcyles.   Everything seems so subjective sometimes, with both of us seeming irrational to the other.   We just seem too different some of the time.


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## David Baxter PhD (Jun 6, 2020)

I don't know what to say, Daniel.

Your husband's behavior is classic bipolar - the anger outbursts (aka bipolar rage), the impulsive behaviors, the risk taking behaviors, the lack of insight (anosognosia)...

The right medication certainly helps a lot of people with bipolar disorder but not all and it can take a lot of trial and error to find the right medication for an individual. And even then, compliance can be an issue since the individual often doesn't believes s/he needs or that the medication makes any difference.

That often makes living with bipolar disorder more difficult for family members than the individual himself.

If you stay, it's something you will probably have to struggle with as long as he lives, unfortunately.


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## Daniel (Jun 15, 2020)

I am going to try to make sure my husband never goes back to the VA for psychiatry, even if I have to pay cash.    The pscyh doctor of some sort he talked to today -- a different one than before -- didn't even know about Depakaote being worse than Abilify for black box warnings concerning most individuals.    In any case, she wanted to give him Depakote instead of his regular Abilify, and I was raising hell about potential liver concerns since my brother had bad liver labs from Depakote.  She was even dismissing his own conerns about his previous experience with Depakote years ago of swelling feet.   She did not even tell him about any potential side effects before prescribing Depakote.


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## David Baxter PhD (Jun 15, 2020)

That's appalling.


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## Daniel (Jun 15, 2020)

On the positive side, I got to personally experience my own manic rage   I already left a negative review for the VA on Google.


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## Daniel (Jun 17, 2020)

BTW, found out today the VA provider who was prescribing was a PharmD (doctor of pharmacy), not a psychiatric provider.    Husband complained to psychiatrist, who was very understanding.   Apparently, at the VA, the PharmD is the gatekeeper for getting approval for certain (non-formulary) medications.


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## Daniel (Jun 18, 2020)

More good news from the VA.    His psychiatrist was on the phone with him today to make sure he is doing well, and she is calling him again tomorrow.   

Incidentally, I went to pickup his Zyprexa refill today at the VA (since he is switching again from Abilify to Zyprexa), and it feels like a military base over there.  I had to go through two security checkpoints since they are still on semi-lockdown.  The first checkpoint was to make sure you are supposed to be there, and the second one was to make sure you have a mask on.


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## David Baxter PhD (Jun 18, 2020)

Hospitals up here are like that. You are funneled through only manned entrances where you need to be wearing a mask, use sterilizer on your hands, and answer a series of questions before you are cleared to enter.

Then you are double checked when you get to your destination in the hospital to check again that you were screened at the front, still wearing a mask, and again use the hand sterilizer (since you came up an elevator or through some additional doors).

At the pharmacy, I wear a mask anyway but I'm pretty sure if I wasn't I'd be given one or asked to leave until I got one.


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## Daniel (Jun 28, 2020)

Happy update:

Husband has not yelled since switching back to Zyprexa.       

Even if he is just at a good point in a cycle, I am happy for the break  

But if he does get acutely manic, he can take a higher dose again for a few days.  The psychiatrist has him at 20 mg twice a day for acute episodes, and 20 mg a day otherwise.


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## Daniel (Sep 24, 2020)

Another post of venting and processing:

The problem now is that some other symptoms have come back or worsened.  He is more restless (wanting another dog, complaining of boredom all the time), smoking marijuana more (almost twice as much as before -- he is reaching his legal limit every week), and has gone back to sneaking in cigarettes.  

I think another reason he is smoking more marijuana is we have more disposable income now and/or the cost of the marijuana has gone down to some degree.

After he refused again to call his psychiatrist (due to his almost-zero insight), I told him I am done, but we are already smoothing things over.   But I also told him: Would you want to live with you?  Someone who complains about being bored all the time, who spends a lot of our money on marijuana, and smokes cigarettes even though his sister is dying from lung disease?

I called his sister to let her know that is more bipolar than usual. 

I told him I think he needs to see a psychiatrist outside the VA.  His answer of course: "I have nothing to say to a psychiatrist," and of course I replied "I have plenty to say about you  ."


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## Daniel (Oct 14, 2020)

The VA psychiatrist told my husband that his restlessness could have been a side effect of the Zyprexa.  So she lowered his dose a week ago.   So far, so good.


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## Daniel (Oct 22, 2020)

OMG.   Looking forward to Phoenix traffic after spending a few hours with his sister and her husband, who also seem to have bipolar disorder.  He and them are so loud together today since they are arguing over the past.  I would go insane if here much longer. 

Update:  The traffic was about the same level of dissatisfaction


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## gooblax (Oct 22, 2020)

I guess noise cancelling headphones would be an inappropriate response to others arguing.


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## Daniel (Oct 22, 2020)

Today was also his birthday.  He later said I ruined the day for him and it was the worst birthday of his life because of me.   It's like being an unappreciated employee where I have to understand my boss's challenges, but he doesn't understand mine.   

When these bad days happen, I feel stupid for staying with him, and I wish I was dead.    Even if he has no choice but to act this way, I don't have the resources to deal with this on my own.

Hopefully, I can use this as an impetutus to get a local job since my fear of COVID-19 has vanished after the way I was treated today -- since life seems quite unhappy now.


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## David Baxter PhD (Oct 22, 2020)

I’m sorry to hear that, Daniel. 

Relationships are not easy. Relationships which include bipolar disorder can be especially difficult since you are often put in the position of being a caretaker and a peacemaker as well as a spouse. 

I don’t want to over generalize my comments. Some bipolar relationships do certainly work but they work when the bipolar partner is consistently compliant with medication, doesn’t mix it with other substances, and remains in regularly scheduled therapy. From what I understand, when that happens, if it happens at all, it’s because you insist on it and monitor it, putting you essentially in the role of parent as well as caretaker and spouse. 

It’s not an enviable position for anyone to be in. 


Sent from my iPhone using Tapatalk


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## Daniel (Oct 22, 2020)

Since I am losing hope, I think I am done trying to be his caregiver for mental issues anyway.  The resentment just continues to build, especially since I often feel just as lonely as I did before I got married (if not more so).   

The marijuana or his own self-focus also makes it hard for him to remember things, causing arguments.    He angrily told me earlier this week to return a $20 foam roller (that my doctor recommended) to Amazon since I have never used it, even though I have used it in front of him before (and when he was sleeping).   And I told him, even if I never used it, I bring in way more money than you do anyway, and I don't spend $100 a week on marijuana.  He later apologized, but he doesn't understand what I have to go through with my own mental health issues.  (Who tells someone with a history of suicide attempts to stop wasting money on seeing a therapist?  At least now, there are no-copays on mental health for the rest of the year, and next year the co-pays will only be $20.)

In any case, I "see" my new psychiatrist on Monday, and I will be asking him to refer me to a therapist.   My biggest problem now may be a general sense of hopelessness -- being tired of dealing with OCD and depression along with "problems of living."


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## gooblax (Oct 23, 2020)

Sorry to hear that Daniel, it sounds like a really difficult situation. Putting yourself first is definitely for the best. Him being unwell doesn't mean that you have to put up with being treated poorly or being blamed for things that are his responsibility.


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## Daniel (Oct 23, 2020)

Next time there is a blowup, I think I am going to try to reframe his symptoms as anxiety or OCD so I can relate to him better.   He does have a laser focus like I do for things that are not ideal.


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## Daniel (Dec 2, 2020)

I am angry at myself for staying -- again.  He yells at me on the way to the vet (what he calls talking loud), angry at me for me insisting we take the 11-year-old cat the vet (because the cat is having problems breathing and won't eat as of last night).  Then, after an x-ray, we find out the cat is dying of advanced lung cancer and may die within a day or a week, which can be a painful death of being unable to breathe.   So we had to put the cat down this afternoon.    

Then, after we get home, he yells at me that I don't have the heater ready in the bathroom for his shower -- like he requested (which I have no memory of).   

Even as the vet was putting the cat down, he even complained to the vet about something she forgot to do years ago concerning another pet we had (getting paw prints done before putting our dog down).  And that is not just from grief since that is his bipolar disorder (and being abused as a child, etc).

Now he is all calmed down.  Like nothing happened.

So I guess I will just stay with him like always, but the resentments are there and I don't know what to do with them.

The crazy thing is he says I am acting like a child for yelling FU after he continues to yell at me.

I guess I just will put it all down as stress making his bipolar worse.  He didn't want to take the cat to the vet because of the cost of diagnostics.     Before we saw the vet, he blames my OCD for worrying about the cat.  I told him he was just living in denial since cats hide their illness very well, and by the time they have symptoms, it will only get worse without treatment.

And our senior dog who is living with chronic bronchitis/COPD probably got that too from my husband smoking cigarettes in his house forever before I met him.   But he still smokes marijuana in the house even though he has mild COPD himself, which is why I got two air purifiers and now keep the COPD dog and myself away from him when he is smoking dope.   

Back to taking one day at a time... But with my existential anxiety, nothing makes sense (or feels "just right") much of the time anyway.


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## Mari (Dec 2, 2020)

So sorry you are going through this Daniel. I am having a bad day also and it is like 'what the hell?' Good that you can talk about it and hope you can figure something out. I do not have any expertise on illness so can not do much except offer support because everything I hear from you makes me think you are a great person and your posts have often cheered me when I am down.


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## Daniel (Dec 2, 2020)

Mari said:


> your posts have often cheered me when I am down.



ditto


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## Daniel (Dec 2, 2020)

The Burden of Sympathy: How Families Cope With Mental Illness

Quite simply, what do we owe each other? In this vivid and thoughtful study, David Karp chronicles the experiences of the family members of the mentally ill, and how they draw "boundaries of sympathy" to avoid being engulfed by the day-to-day suffering of a loved one...

Powerful cultural messages spell out two contradictory imperatives: pursue personal fulfillment at any cost and care for the family at any cost.


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## David Baxter PhD (Dec 2, 2020)

@Daniel

Do you know why you still stay?

Is it because you think you have nowhere rise to go?

Is it because you still see things worth staying for?

Or is it something else?


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## gooblax (Dec 3, 2020)

Sorry for the loss of your cat @Daniel, and for the super crappy treatment from your husband.


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## Daniel (Dec 3, 2020)

David Baxter said:


> @Daniel
> 
> Do you know why you still stay?



Yes and no.  Part of it is I still like him for the most part, and I am very attached to our pets and to him.  And I keep telling myself, if I have enough money for his dope, everything will be fine -- which is basically true.

Things feel mostly good 95 percent of the time, though there is always an undercurrent of my resentment building.  And the resentment builds and builds.    And it is almost 100% predictable every December we will have fights because of money due to the holidays.  With his bipolar, "more is never enough," so he will be angry either that I didn't spend enough on his gift, or a gift for someone else, or that he wants more money for dope.     Every Christmas, it is my fault for being a grinch of some sort.  Even though, without me, he would barely have enough money to pay his bills.  

So I just try to make sure there is enough money.  More money, less tension.  But even then, it's not enough because the money is still a limited resource.   It's expensive to have pets (all of whom he "had to have" except for the younger cat I got), his dope addiction where the tolerance builds and builds, and he doesn't want to seem anything less than generous with Christmas gifts at the same time.  

I can literally eat beans and rice if I have to, but, before he bought dope last time, he had a craving for an expensive menu item costing $20.  So in one day, he spends $120 and I spend basically nothing.   And I'm just supposed to nod and smile.  And then later I will be accused of being the one spending too much money because somehow it's my fault for not wanting to watch a pet have problems breathing.



> Is it because you think you have nowhere rise to go?



No.  I just feel I won't be any better on my own.  Just a different set of problems.  I hope to eventually make a lot more money in the next year or so, so we should hopefully have fewer arguments about money. 

When I do feel suicidal, part of what keeps me going is my attachment to the pets -- not necessarily my attachment to him since he's often part of the reason I feel down.  

But this month, he has no choice now but to smoke less marijuana because, even though he has money saved for Christmas gifts, we had to use some of that for the pets' vet bills.  We have had $1,000 in vet bills now in the last two months, and, in the last four or five months, we have been spending at least $400 a month on his dope.   And then my parents look down on me for not saving money for the future, because somehow my mom now thinks it is her business to ask me how much I have in savings.

I think going forward, I will just not give a **** about his dope problem.  And if he needs money for dope, too bad, so sad. Eat beans and rice if you need the money that bad. I need the money for future vet bills and my own future expenses like retirement and maybe one day having to pay for a caregiver for him so I don't have to deal with him all day if he gets dementia in 15-20 years (he is 61 now and I am now 43).  If I can't tolerate his temper tantrum, I will just go and take one of the dogs with me.


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## forgetmenot (Dec 3, 2020)

. With his bipolar, "more is never enough, Hi Daniel this line here hit home it does not matter how much you give them how much you do for them how much you support them it is never enough never. i understand that one fully. So it wont matter how much money you make how  much you give it will never be enough you are staying because perhaps it is all you know right now to do.  Sorry just thinking. YOU  first need is you and if you could take the animals with you and leave your would  maybe be best his only love it seems is the drug or he would not destroy you like he is doing. Don't stay in a relationship like that my thoughts but then i understand it is hard to leave.  Take care of YOU OK PLEASE.


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## Daniel (Dec 3, 2020)

> . So it wont matter how much money you make how much you give it will never be enough



That does give me the idea to hide how much money I make in the future.  Or to outright lie about it.



> but then i understand it is hard to leave.



Yes, it is very hard to leave him, even when things were much worse than they are now.   I got as far as the next state over (New Mexico) last October or so and thought I was done with him for life, and then drove all six hours or so back home the next day.  So by comparison, things are still great compared to this time last year when he was not as well medicated.

I think part of the reason he smokes dope is his death anxiety or anxiety in general.  And that is exactly what I have, though in a different form: existential OCD/anxiety.   And, even after 20 years of having anxiety, I still don't cope with it all that well.  So why would I expect him to cope better than me?   Because he is happier than I am as far I can tell, it seems, though there is a significant financial cost to his relative happiness as well as possibly a cost to his physical health.

So it seems I constantly fine tune my feelings about his substance use/abuse to cope with it.  And then when he complains about money, I go back to the narrative that he is a selfish drug user.

What is most memorable about his behavior yesterday is what he said to the vet.  It reminds me of when he once basically growled at a waiter because the toast was not toasted enough.   Like he has no spirituality to help him cope.   (My brother has bipolar as well and apparently thinks it is okay to steal now and then as a way to get a high, I guess.  Every decade he has at least a couple of run-ins with the police.  So it is a very strange disorder to me still, and yet, we are all wanting more, in some respect, even if it is just to want to live longer than a normal lifespan or to be in a relationship than none at all -- or just something with more good and less bad.)


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## Daniel (Dec 4, 2020)

Positive update:  During his appointment yesterday, he asked his psychiatrist to refer him to a therapist at the VA, mostly because of his grief from his mother's death 13 years ago.  And the psychiatrist also added Latuda (to his Zyprexa) for depression.


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## Daniel (Dec 4, 2020)

Also, both of us are now in a great mood since we adopted/rescued a 5-week-old kitten this morning who was living outside in the cold with her mother.



I am bottle feeding her kitten formula, and she goes to the vet in a week for vaccines.


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## David Baxter PhD (Dec 4, 2020)

What happened to her mother?


Sent from my iPhone using Tapatalk


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## Daniel (Dec 4, 2020)

The kitten's mom is owned by these people who do not know how to take care of young pets.  They lost a puppy a few years ago from neglect.   But the mother is doing well as far as outdoor cats go. She is well-fed and has an outdoor shelter that is fenced to help protect her from coyotes.


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## Daniel (Dec 4, 2020)

BTW, we weighed the kitten with a small postal scale (to see how much to feed her) and s/he weighs about 1 pound and 5 ounces, which is good for 5 weeks old.  But we won't know its gender for sure until next week when the vet sees him/her.   

The last time I had a kitten was as a child, so I am very excited.  The dogs love the kitten but, as expected, my adult cat is still getting used to it.

But it seems to be a boy since we just got a semi-expert opinion.


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## gooblax (Dec 4, 2020)

Have you given him/her a name yet?


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## Daniel (Dec 4, 2020)

Yes, since we now think it is a boy, we are going with Vester.   So it is a way of naming him after Sylvester, our cat who died this week.

But if the kitten turns out to be a girl, we are going to name her Glenda.

And the kitten is eating the wet kitten food now too, in addition to the kitten formula.

The other good thing is that the vet hospital in the next town over charges less than $70 to neuter the kitten later on, so I am going to take him there for life probably since they are cheaper on other things too like a free follow-up exam if your pet is sick.


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## Daniel (Dec 5, 2020)

A better picture from this morning, with her no longer nervous like yesterday:



She is off the bottle and now prefers a bowl of formula mixed with wet food.  Will try a little kitty kibble later today.

(I think she's a girl, until the vet says otherwise  )


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## David Baxter PhD (Dec 5, 2020)

Needs more toys.


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## forgetmenot (Dec 5, 2020)

what a beautiful kitten i think also it is a girl the eyes so adorable


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## GaryQ (Dec 6, 2020)

@Daniel

I'm sorry for not being around for some sort of moral support. (I actually thought my account was closed... long story... and an email said I got a PM earlier. It's been a very rough week physically and I'm not out of the woods yet and not going to discuss it)

Glad the kitten brings joy but at the same time I see more financial burden with vet bills.
I hope things stabilize at home but fear this pattern is a stereotypical trap.

Your mom and FMN are both right and i have suggested more than a year ago that you stop finding excuses for not putting money aside for if you need to bail. The more you bring in the more he will want (need). If you can't save it without spending it, Maybe your mom can open a savings account for you and you send her money on a regular basis and. Then if and when you need it she can get it to you. If all goes better you'll have some cash saved for later. Can't lose there!

Regarding leaving; seems like leaving a toxic relationship is harder than one that just doesn't work. 
Sure if you leave you will still have issues,,, BUT you won't have his to carry on your back.

This part may seem cold but the reality is Why would he change as long as he has you enabling him? 
He has s cook, a maid, someone to take his sh-t, a money machine. And like a spoiled child if he doesn't get what he wants he knows you'll give in with the right temper tantrum. That's abuse even if not physical. As long as you find excuses to justify his actions nothing will change. 

Wish you all the best.
Take care of yourself


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## David Baxter PhD (Dec 6, 2020)

> Glad the kitten brings joy but at the same time I see more financial burden with vet bills.



Yes but speaking from personal experience I can say that what pets give back far outweighs the additional costs.

And of course Daniel knows this from their other pets.

And with a kitten the initial costs are more predictable - spaying, vaccinations - which is different and less expensive usually than unexpected bills and CT scans and medications for illnesses in older pets.


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## Daniel (Dec 6, 2020)

GaryQ said:


> I hope things stabilize at home but fear this pattern is a stereotypical trap.



Well, I am more hopeful than that -- until I mentally "split" (not unlike people with BPD):



> What is Splitting in Borderline Personality Disorder?
> 
> Splitting means having difficulty holding opposing thoughts. A person who experiences splitting is unable to weigh positive and negative attributes of a person or event or recognize that good and bad attributes can be true at the same time.



Part of the reason I haven't been good about savings is there has not been a day in my life I have had to truly worry about money because my parents are "comfortable" and will always bail me out if need be.  Of course, I try not to take advantage of that anymore and I know they won't be around forever, and I think my parents were secretly glad I got married (even though they are anti-gay with their religion) since I haven't needed as much from them emotionally or financially since getting married.  

But my husband's marijuana use has been an ongoing issue for me -- mostly legally in the beginning as medical marijuana was not legal in Florida at the time.  That's also part of the reason we moved to Arizona since it's a more liberal state, as evidenced by the fact that even recreational marijuana is being allowed (unlike in Florida).  And part of the reason I worry about money is that it relates to my OCD worries like going to prison for a crime I didn't commit.  (How these relate is a long story.) 

My husband and most people have a firmer grasp of reality than I do for some things, which is why OCD is not unlike schizophrenia in some aspects:



> International OCD Foundation | Schizophrenia and OCD: A Consideration of Schizo-Obsessive Disorder
> 
> Unfortunately, while these definitions sound very different, in clinical practice they can be difficult to distinguish. Additionally, many patients have both ego-syntonic and ego-dystonic thoughts.



I had a distant relative with schizophrenia who believed the police were really following him and trying to catch him.  With OCD, it is more subtle than that, since the paranoia is more intellectual and about hypothetical possibilities rather than psychosis per se.


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## David Baxter PhD (Dec 6, 2020)

I hate the term "splitting" personally. It's a throwback to when borderline personality disorder was thought to be pretty much borderline schizophrenia.

It's really an extreme form of black and white, all or nothing thinking, something anyone familiar with CBT or DBT is very familiar with.


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## Daniel (Dec 6, 2020)

And such all-or-nothing thinking relates partly to ROCD (relationship OCD):



> Relationship obsessive–compulsive disorder - Wikipedia
> 
> *Partner-focused symptoms*
> 
> Another form of ROCD includes preoccupation, checking, and reassurance-seeking behaviors relating to the partner's perceived flaws. Instead of finding good in their partner, they are constantly focused on their shortcomings. They often exaggerate these flaws and use them to prove the relationship is fundamentally bad. The fact that they are unable to concentrate on anything but their partner's flaws causes the sufferer great anxiety, and often leads to a strained relationship. Recent investigations suggest partner-focused ROCD symptoms may also occur in the parent-child context. In such cases, parents may be overwhelmed by preoccupations that their child is not socially competent, good looking, moral or emotionally balanced enough. Such obsession are associated with increased parental stress and low mood.


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## Daniel (Dec 6, 2020)

When I was still in the honeymoon phase of the relationship, the ROCD was also about me not being good enough (to the point he may be better off with someone else), but I overcame that by focusing on his flaws almost exclusively  

I think part of the reason I haven't mentioned ROCD before is that my therapists never mentioned it, so I had to get to that conclusion through the slow, slow process of building insight.  

ROCD reminds me of existential OCD since both very much feel to me like a mixed bag of legitimate concerns and constantly evaluating things (even though the ruminating is more distressing than the objects of concern and the ruminating never leads to the desired outcome of certainty).


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## Daniel (Dec 6, 2020)

Similarly:



> The Many Faces of OCD
> 
> Couples may be unaware of the underlying causes – obsessive thoughts and beliefs; the anxiety associated with them; the controlling, complaining behavior that follows – and partners react emotionally out of frustration. On the surface, it looks like tension and arguments about the kids, money, chores, or even an affair in the past. And those can be troubling issues to be sure. However, the OCD process takes over at times, and becomes a primary source of relationship distress.


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## Daniel (Dec 6, 2020)

David Baxter said:


> what pets give back far outweighs the additional costs.



Exactly.  When the kitten wakes up, it is like another ketamine dose    My only regret is not getting a kitten sooner since it's been like 30 years since I have had one.

And I don't mind giving money to veterinarians compared to Walmart, which still gets most of our spending money.  We have been good lately though about spending less there, such as buying less processed foods.


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## Daniel (Dec 6, 2020)

Finding The Positives of Bipolar - YouTube


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## Daniel (Dec 22, 2020)

If my marriage is an opportunity for growth,  it is a post-traumatic growth as well 

I feel like I am married to a narcissistic Trump sometimes, esp. now with my husband having more agitation while not smoking as much marijuana.  Most days are good but twice in the last week, including now, I have had to leave our small 1200 sq ft house to gather my sanity.

Today, my husband criticized me for not being as in control over my OCD as he is of his bipolar.  Which to me just shows his lack of insight.  It would be funny if he were not scolding me about it and how I drive.  

 He needs me to take him everywhere like his various medical appointments since his foot is healing still after yet another foot surgery three months ago.   And my only reward is being told I am a terrible driver who needs to change lanes, speed up, slow down, etc.

In the same drive, he will criticize me for being too cautious and not cautious enough.  It is maddening and tiring.  Of course,  I tell him I hate his back seat driving (as I have told him for the last 8 years), but he never stops.

Then on the car speakerphone, he tells my mom in passing that I am not doing my share of the dishes.  Which is what he told his sister last week when she was visiting. My retort is there are a lot of dishes when you feed specially prepared meals to 7 pets, three times a day.  So he continues to be ungrateful since I do 95 percent of the pet care, which is more now with a COPD senior dog and a new dog.  And I do all of the chicken care and cat care.  He doesn't even know where the cat food is or what medicine the senior dog takes.  In other words, he plays martyr, forgetting I spend entire days making sure he gets to his appointments in Phoenix and soon Flagstaff as well (also 2 hours each way). 

So when we get the stimulus money next week or so ($600 each), I will probably beg him to buy pot, assuming he refuses to take more Zyprexa as prescribed for when he is more agitated than usual.  It is hard to care about his COPD getting worse when he does not care about triggering me.

At the risk of being melodramatic, I sometimes wish I liked women instead of men since women seem generally more introspective/thoughtful/insightful than men.  Most men seem like ass****** even without a mental disorder or a need to feel macho (as in toxic masculinity).

He will never work while I am trying to finish school to work fulltime so that he can have even more reason to complain I don't do enough around the house.


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## David Baxter PhD (Dec 22, 2020)

Anosognosia - Treatment Advocacy Center



> Anosognosia, also called "*lack of insight*,"  is a symptom of severe mental illness experienced by some that impairs a  person's ability to understand and perceive his or her illness. It is  the single largest reason why people with schizophrenia or bipolar  disorder refuse medications or do not seek treatment.
> 
> Approximately 50% of individuals with schizophrenia and 40% with bipolar  disorder have symptoms of anosognosia. Long recognized in stroke,  Alzheimer’s disease and other neurological conditions, studies of  anosognosia in psychiatric disorders is producing a growing body of  evidence of anatomical damage in the part of the brain involved with  self-reflection. When taking medications, insight improves in some  patients.


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## Daniel (Dec 25, 2020)

Another positive update:  

Later the same night, he agreed to take the PRN/additional morning dose of Zyprexa when I brought up the subject.   (After he agreed, I joked with him if he didn't, I would have gone off my Prozac  )

Also, I had underlying stress from him not going to the doctor/dentist for his mouth sore for a week.  (So he agreed to do that the next morning by going to the ER, as I had started to worry it may be mouth cancer given it was only getting worse -- after buying everything at the store for him -- and given his lifetime of smoking and it was so big it looked like a growth to me.  The ER doctor said it was the biggest canker sore she had ever seen.   She said it was probably stress related and in no way was it cancerous.   She prescribed a steroid mouth paste, triamcinolone, as well as lidocaine, and it is almost completely healed now.)

And I discussed with him today why does he complain almost every year that it never feels like Christmas when we are alone together on Christmas.   He then admitted it was because of him missing/grieving his mother, as opposed to not liking his gifts enough (his usual excuse).


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## Daniel (Dec 31, 2020)

"It's hard for most of us to go through a typical day outside the home without some humiliating incident, however trivial, without some frustrating reminder of how limited our power is, how unimportant we are. The relationships we want to spend our lives in should be a refuge from this. If they are just a source of more humiliation, they're not healthy places to stay in...There's no way you can win by staying. In that sense it's not different from physical abuse. But the sense of release and relief that comes from getting out of a relationship like this is enormous."

― Mira Kirshenbaum, _Too Good to Leave, Too Bad to Stay_


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## Daniel (Feb 27, 2021)

*"*In my experience, it seems that those of us living with bipolar and other mental health conditions are drawn to one another. I’ve always had an intuitive sense of unity with others who share a certain mental turmoil. I can _tell_—and I’ve almost always been proven right—that someone has this quality within them. And some of the most profound connections I’ve felt with others have been based to some extent around the particular outlook and understanding that coincides with having a mental health condition."

~ Brianne LaPelusa


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## Daniel (Aug 12, 2021)

“Moods are by nature compelling, contagious, and profoundly interpersonal, and disorders of mood alter the perceptions and behaviors not only of those who have them but also of those who are related or closely associated. Manic-depressive illness—marked as it is by extraordinary and confusing fluctuations in mood, personality, thinking, and behavior—inevitably has powerful and often painful effects on relationships.”  

― Kay Redfield Jamison, _ Touched with Fire _


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## Daniel (Oct 7, 2021)

https://www.healthcentral.com/slideshow/the-bipolar-marriage-ways-make-it-through-the-tough-times
		


Marriage vows don’t signify that two people merge into one blob. Doing so would be especially detrimental for the bipolar marriage. In her classic _Gift by the Sea_, Anne Morrow Lindberg likens a loving relationship to a double-sunrise shell, comprised of two symmetrical shells joined at the center. Each person in a bipolar marriage needs the space to maintain their own identity and grow emotionally. This separateness leads to deeper intimacy and appreciation.


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## Daniel (Oct 7, 2021)

Burden and marital and sexual satisfaction in the partners of bipolar patients
					


Objectives:  Bipolar disorder can be traumatic for both patients and patients’ partners. Hence, partners’ stress, burden, marital and sexual satisfactions are important areas to investigate. However,...





					onlinelibrary.wiley.com
				




Partners who attribute control for the illness to the patient may use strategies to influence behaviour that disrupt marital harmony.


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## Daniel (Oct 7, 2021)

The Disordered Couple
					


Experienced researchers and clinicians from a wide variety of theoretical background have come together to give a comprehensive analysis of couples diagnosed with major psychopathology, personality disorders, and social challenges. Bipolar disorder, panic disorder, psychosis, sexual disfunction...




					www.google.com


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## Daniel (Oct 13, 2021)

A Guide for Spouses of Partners with Serious Mental Illness - BC Schizophrenia Society
					


Do you care for someone with a mental illness? Find a support group to join. BC Partners for Mental Health and Addictions Information and BC Schizophrenia Society gratefully acknowledges the […]





					www.bcss.org
				




If you are feeling “trapped” in the relationship, it may be helpful to consider why you are staying. Identify what your reasons are for staying.

If you think your only options are to stay or leave, remember that there is always a third option – *staying in a different way.* How might you do that?

Here are some tough questions to ask yourself:

Have I mourned my unrealistic expectations for the marriage? Am I still trying to bring back what was or what I hoped would be, even though it is highly unlikely?
Do I make decisions that affect my spouse without involving them?
Am I doing more for my spouse than I really have to?
Do I expect my spouse to know what I need without telling them? How well do I communicate?
How often do I make time to try to emotionally connect with my spouse?
How well do I balance my needs with my spouse’s needs?
Are my arguments constructive?
Are my spouse’s criticisms of me valid? Maybe they are.
Are my spouse’s requests of me realistic and reasonable? Maybe they are.
Do I come across as a partner or a parent when I try to set limits with my spouse?
Do I see my spouse as a whole human being with strengths, talents, limitations, etc. who happens to have a mental illness, or do I see them only in terms of the mental illness?
Is there anything I still love about my spouse?
Of the things I dislike about my spouse, which are due to the mental illness and which could be the result of other factors?
Could some be caused by:

Unresolved issues with my own family
My spouse’s unresolved issues with their family
Medication side effects
Our relationship dynamics
Outside stresses
Learning more about the mental illness and finding support from others can help you cope with challenges that arise in your relationship. You might find it helpful to:

Read books, magazines or websites to get more information
Attend educational programs to learn more
Attend support group meetings to connect with others with similar experiences
See a counsellor/therapist for professional help
B.C. Schizophrenia Society offers educational programs and support groups for family members and friends who have loved one with a mental illness. Find out more at www.bcss.org.

Online support groups for family and friends who care about someone with a mental illness are also available through the Reaching Families Project at www.reachingfamiliesproject.org.


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## Daniel (Oct 13, 2021)

Impact of living with bipolar patients: Making sense of caregivers’ burden
					


Impact of living with bipolar patients: Making sense of caregivers’ burden




					www.wjgnet.com
				




Dore et al[8] showed the impact of illness on the caregivers relationship with the patient when he is unwell. Most caregivers (90%) found the patient distant and difficult to get close to during acute episodes of illness. The patient felt irritable when unwell (80%) and this frequently led to arguments that had never occurred before. Impulsivity and aggression may be common during episodes of mania or hypomania. Most caregivers (81%) were distressed by the relationship with the patient when the patient was acutely ill; 64% described the level of personal distress as ‘‘severe’’[8]. When patients became well again, their relationship with caregivers usually improved significantly, with 80% of the group feeling that the relationship remained close during times of remission. Almost half of the group (49%) felt the illness had brought them closer. A closer relationship was more common if the patient was male and the caregiver female.


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## Daniel (Oct 14, 2021)

The Importance of Relationship in Understanding the Experiences of Spouse Mental Health Carers | Semantic Scholar
					


The findings indicate that caring for a spouse with severe mental illness is a unique role compared with other caring roles and has implications for how mental health service providers work with and support spouse carers. The burden of caring for family members with mental illness has been...





					www.semanticscholar.org
				




*The Importance of Relationship in Understanding the Experiences of Spouse Mental Health Carers*

The burden of caring for family members with mental illness has been researched extensively; however, knowledge of spouse carers’ experiences is limited. In this article, we explore this from a carers’ perspective, with 28 spouse carers, using qualitative open-ended semistructured interviews and a grounded theory approach informed by the social interactionism tradition to collect and analyze the data. We present six interrelated themes around the central theme of this being “a real and genuine relationship.” 

The findings indicate that caring for a spouse with severe mental illness is a unique role compared with other caring roles. First and foremost, spouse carers strive for the relationship with their partner and accommodate mental illness into their lives to protect the relationship. Because of this, they often lead surreal lives marked by significant emotional pressure and isolation. This has implications for how mental health service providers work with and support spouse carers...

Men participants expressed coping styles that reflected the intensity of their emotional isolation. Compared with the women’s narratives, the sense gained from hearing the men’s narratives was that they were struggling, arguably more so than many women participants. They did not seem to have the networks of support from family or friends that many of the women had to draw on. They were very much alone with no-one to talk to about their experience, and did not seek others to talk to about their needs. Many men kept their experiences hidden from their peers and, in doing so, were even more isolated...

Women, however, strived to find meaning and positive ways to get on with their lives; to self-nurture. They appeared to be more able to seek refuge within domestic tasks and routines and in their community; accommodating to their circumstances and not letting them subsume their individual identity or personal autonomy...


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## Daniel (May 3, 2022)

Real-Life Tips from Four Long-Term Couples | bpHope.com
					


Will love really keep you together? Yes, plus these secrets to a successful, long-term relationship from four couples living with bipolar disorder.





					www.bphope.com
				




“Regular use of a mood tracker builds up a rich amount of information about the patterns of a person’s bipolar illness. Then the couple can discuss potential triggers—such as overwork or disputes with colleagues—before an episode happens,” says McInerney, an assistant professor of psychiatry at the University of Toronto and a staff psychiatrist at St. Michael’s Hospital....

POINTERS FOR PARTNERS​Some key advice culled from mental health experts and couples themselves:

#1 Avoid Blaming​It’s important to acknowledge that bipolar disorder is a legitimate brain-based condition that requires treatment and self-management. It’s no one’s fault. Hurtful or upsetting actions during mood episodes spring from the illness, not the person’s usual character.

#2 Acknowledge the Loss​It’s normal for both partners to feel grief, anger, sadness, or guilt over how bipolar will affect the family and plans for the future. You’ll need to accept that the life you originally imagined now looks different, but also that it can still be wonderful.

#3 Get Informed​It’s equally important for both partners to learn about bipolar symptoms, typical triggers, and coping responses. Self-education should make it easier to not take mood symptoms like irritability personally, but rather to recognize them as early warning signs of an episode.

#4 Take Responsibility​Having bipolar is not a free pass to act out. The individual with bipolar must commit to doing the work required to reach stability (to whatever degree that’s possible).

#5 Set Boundaries​Sometimes there’s a fine line between encouraging and enabling. And being supportive and patient doesn’t mean blindly putting up with symptomatic behaviors that feel threatening, like abusive language, or can be damaging to the family, like overspending. Agree together on what crosses the line and what consequences will click in—and what preventive measures make sense.


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## Daniel (Aug 16, 2022)

"Most marriages are more like Maseratis than Mazdas. They can be thrilling, but they need quite a lot of tinkering, and nobody is sure if they’re going to work on any given day."

~ Belinda Luscombe, author of _Marriageology_


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## David Baxter PhD (Aug 16, 2022)

Now THAT ^^^ is comedy!


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