I feel like I'm loosing my mind

[colouringinagain]

I don't know what to do now. My head is exploding with trying to work out what to do. OH finally diagnosed with Bipolar 2 after 10 years. Last few awful. Manic, delusional frightening crisis last December. He decided marriage over. He's staying with family. Kids have more fun with him. Ds wants to go live with him.

Hi, I support my DH who suffers episodes of psychosis so I understand some of the issues supporting someone with serious mental illness and also the difficulty in getting a diagnisis and support. DH and I seperated for a while a few years ago when he ended things due to things he believed about me when he was unwell. I am also recovering from PTSD from DHs last crisis which was incredibly frightening for both of us.

How stable is he now? What support are you both getting from the professionals?

I would imagine that when hypomanic he will appear quite exciting/fun to the kids, where as full blown mania and depression would be pretty scary and not much fun at all. I'm also thinking that with it being a recent diagnosis he's not had a chance to get stable and learn to manage the bipolar and stay well long term. Whist I'm sure he is a fab Dad these things would concern me with regards to your DS going to live with him right now. I have a friend with bipolar who is a fab single Mum, but it's taken years and a lot of support to get to this place now.

Does your DHs MH team provide family support? DHs team did a lot of work with us arround rebuilding our relationship during and after our seperation. And have done a lot more joint work with us following this crisis including refering us for family therapy with a psychologist.

As for what to do right now I think you need to prioritise some time out for you. Look after yourself and give yourself a little space to think. That and providing as much stability for DCs as you can. Yes stability might be boring and less fun than some of the stuff they are doing with Dad but that is what they really need right now, they just don't appriciate it yet.

Feel free to PM me if you don't want to reveal details here, after what DH and I have been through I doubt I'm shockable

Thank you so much nolongeranxious I really appreciate this.

There has been no help for us as a couple or family, despite my requesting it. OH also decided our 20 yr marriage was over when v ill beginning of the year. I couldn't have him back home on discharge as was (and am) traumatised by psychotic episode, mania, delusional. Horrendous 12 hours at home with him before police could remove him.

Stable now tho on fairly low medication protocol.

I can't stop my head from trying to find a solution to all this and I really feel now it's making me ill.

Ds won't be going to live with him, but I can't cope with how much the kids miss him. I can't cope with a relationship of 25 years being over. But friends tell me I'm happier since we've been separated.

My advice right now is to focus on you and what you need to recover, everything else will fall into place once you have had a chance to recover yourself. Have you been to see your GP for you? To be honest it was one of the CPNs from DHs team who initially picked up on my PTSD, and then my councellor, I'm not convinced my GP would have done. I'm not saying that definately what you are feeling is PTSD, just that it's possible as police detentions and the surroundind events generally are incrdibly traumatic for all concerned.

PTSD often caused by a situation where you think that you or a loved one might die. It's caused by the fight or flight part of your brain going into overdrive which stops you from being able to process the traumatic memories properly and results in them resurfacing as nightmares or flashbacks. DHs last psychotic episode scared my to the point that I thought that there was a chance he would kill me. He's never been threatening towards me before, so it was a complete shock. For me the PTSD presented as anxiety and pannic attacks, flashbacks (but not that visual ones which I'd imagined PTSD to be, more that I would suddenly be hit by the emotions again without warning), inability to think about the event in any detail, (I could give a detatched factual bullet pointed account of the main events, but later realised that I had huge gaps in my memory), problems with concentration and memory (I went into work one morning and couldn't remember how to use a computer sysytem I've used for years, I even got stuck in our kitchen because I couldn't work out how to get out, and I couldn't work out how to do simple tasks like make a cup of tea. Another element is emotional numbing, where in order to protect you from the difficult emotions your brain turns down the intensity of all emotions. This is often misdiagnosed as depression. PTSD doesn't respond well to antidepressants though (though they are worth a try and did help take the edge off my anxiety) and talking therapy can make it worse (as I discivered to my detriment when I saw the psychologist at work) as talking about the events can retraumatise you. If if is PTSD that you think is affecting you then push to see a trauma specialist as it is completely treatable.

Did your DH suffer with psychosis when he was manic? It sounds like he may have done from your description of delusions and is not uncommon in bipolar. I'm not familiar with the NICE guidelines for bipolar, but the NICE guidelines for psychosis and schizophrenia definately reccomend support for the whole family, not just the person who is unwell (though I'm aware this support tends to vary by area and I've been incredibly lucky in this respect) Another thing is the Care Act which is a relatively new piece of legislation, which I have a feeling requires the mental health team by law to put in place an action plan for how they will support your husband with maintaing his "meaningful relationships" which I would take to mean his relationships with his parents, you and the kids. Because this is a new piece of legislation it is still filtering down to the front line professionals and it might need you to wave it under their noses and demand that they take notice. There should be a written care plan of how they will help your husband address this need. Ask if he has had a full Care Act assessment. I've got an article on it somewhere I will have a look for it after work.

If it's any comfort seperating when we did was probably the best thing that could have happened to our relationship. DH has been ill to some extent for years and I had gradually without realising also been absorbed by the illness. Having some time appart allowed my to build my own resiliance again and also for us both to figure out what we wanted from our relationship and come at it with fresh heads and also with my husband being in a better place than he'd been in for years. I had certain criteria that I needed to be met before we got back together too.

Just realised that what I posted above is copyrighted have asked for it to be removed and will PM it to you. Have also found some relevant stuff on the Care Act 2014 that refers to there being a legal obligation to suport your husband with his family relationships, will PM that to you too.

Hi thanks so much, very, very interesting to hear about obligations to support husbands relationships. I think part of the problem has been that when he was psychotic and manic (over many weeks) he did convince medics that our marriage was already over. I was too traumatised to have him home after discharge. He's told me that both his therapist and care co-ordinator think our marriage is over. It may be but it's impossible to know now.

I think the constant uncertainty and implications financially (no idea how we could afford to live apart) are contributing to my low mood. I don't think I have ptsd, but the degree of trauma I experienced this time(fear of being seriously harmed) following on from his v determined suicide attempt two years ago, also v traumatic has never been acknowledged or supported.

Husband has no written care plan at all so would put money on this Care Act not having registered with anyone. All his locum consultant psychiatrist could say was "oh bipolar isn't too bad" to OH and I which I am still furious about as it has been a total nightmare for the last four years.

Yes DH has a tendancy when I'm unwell to immediately tell the mental health proffesionals that our relationship is over and that I am claiming that I am saying that he is unwell to get back at him for leaving me. He can be very convincing and it has worked in the past. His CPN now knows us and our relationship well and has none of it, but I've had problems with crisis team cutting me out in the past because of what he's told them. The first time when he kicked me out, it was only when he later said to his CPN that he wanted me to be involved that they got me involved if I think about it. We weren't married back then though and don't have DC. I would think that a 20 year marriage and DC together would mean some family therapy would be appropriate.

Does your DH want to rebuild a relationship with you? Even if its a meaningful relationship as the mother of his children at first. I would imagine that if he told his mental health team that it was important to him they would need to look at ways to support you both with this. Is this something you would want? I know what you mean about it feeling impossible to know if your relationship is over right now. I remember that limbo well.

Have you been to your GP to ask for referals for you with regards to councelling?

Just ploughed through the NICE guidance and yes family intervention is recommended for Bipolar sufferers and their family.

I've asked for this twice and people look back blankly

Hmm interesting questions. I did suggest to him we have some relationship counselling (we had started prior to suicide attempt) and he says he spoke to his therapist and care co-ordinator who agreed that whatever happens with our marriage, a better working relationship is better for anyone. But OH has said he feels he's too fragile to start that at the moment (he may he right) but it means we're back in limbo....

For me to receive counselling my GP would have to refer me to the adult mental health team. She did this after his suicide attempt as it was the only way to get NHS support for me, but it meant that I was classed as suffering mental I'll health and my OH used the fact that I'd been under the adult team against me in various group meetings while he was sectioned.

So unless I go down that route there is no NHS support. I did see a v good private therapist after his suicide attempt, but unfortunately she's no longer practising. I did try another this year but it didn't work out.

It's being in that state of limbo and uncertainty around so many areas which is hugely stressful and there seems to be no imminent change in that.

Mn is messing me about so struggling to PM that stuff to you tonight, will try again tomorrow. Have found that in the NICE guidelines for psychosis it states that for those who have had a psychotic episode there should be a minimum of 10 family interventions.

I think the difficulty with MH services when they are overstretched is they will try to do the minimum. Thats the problem with the NICE guidelines, they are only guidelines. The Care Act 2014 is legislation so has more teeth.

Let's hope that now he has a diagnosis and is getting support the end of the period of limbo is in sight. For us DH finally getting a diagnosis and support has made all the difference.

The Care Act 2014 has 9 domains that have to be covered including, domestic, family and personal domains.

It also has 10 outcomes including:
Developing and maintaining family and other personal relationships.
Carying out any caring responsibilities the adult has for a child.

He saw a new consultant psych today who has changed his diagnosis to bipolar 1.

No-one, no-one has taken the time to even spend 30 minutes with me as his wife, as the person who has taken all the shit over the last decade, who is trying to keep things together for our kids, who is bottling up stuff I need to say to OH but can't as he's too fragile. It is disgusting. And for me, it's not sustainable without making me ill.

How do I work out how much of his personality and behaviour over the last 10 years has been him, and how much his illness?

Sorry, I'm ranting now. A colleague's partner has had a major breakdown over the summer as a result of two years caring for a severely mentally ill relative with no support, and this partner is now not receiving support. Fed up of partners and carers being ignored and at worse, becoming ill as a result.

Thanks v much re Care Act. Like you say a bit more clout with it being legislation

Looking back at what you were saying about accessing councelling and your husband trying to use the fact that you have been under the mental health team yourself against you makes me very sad. Having mental health problems such as reactive depression, anxiety and PTSD, is a very normal response to the hugely challenging situation of supporting someone with a serious mental illness. It is not in any way a weakness or a flaw in character and shouldn't be seen as such by anyone least of all the mental health professionals involved with your husband. It's sad that this is now preventing you from seeking the help that you now need to recover from the effects his illness has had on you. I always thing that when DH is unwell it affects me as much as it does him. I am hugely lucky with DHs MH team as I have an alocated family liason CPN who supports me. He has explained to me that most mental illness is a result of too much stress for too long and has helped me find coping strategies to relieve my stress to help me stay well. He is also very open about the fact that he suffers with periods of depression himself. Despite having this support from DHs team I have still had considerable support in my own right from my GP and through a councellor and psychologist through occupational health at work (is this an option for you?) And through a few sessions with a private therapist for the PTSD when nothing else was working. DHs CPN is also aware of my mental health problems because they impact on my ability to support him and when I've been unwell he has needed support to support me too. I've never felt that DHs team think less of me because of my mental health problems.

I do think it's shocking that you have had no support yourself even after requesting it twice. My family liason CPN has told me that there has been research that has shown that supporting a person's family is cost effective as well supporting relatives reduces the ammount of support needed by MH services over all and reduces hospital admissions, so they can't even use cost/resources as an excuse. I would complain through PALS to his mental health team quoting the NICE guidelines and Care Act. I did this about the shocking way I was treated when DH got poorly on holiday last year and had a really good response from the teams manager, who said he would use my experience in future training. Obviously as its not our area I won't see any changes, but I'm glad I pursued the complaint.

With regards to bottling up how you are feeling until your DH is well enough to talk to him about it. I found it helped to write DH letters about how I felt whilst he was unwell during his worst crisis (the one where we seperated for a while) I never actually gave him the letters, but it helped me a lot to get those feelings out.

As for how much of his personality has been him and how much his illness, thats a very difficult one. Looking back DH was not particularly well when I met him or for most of the first 6 years. A kind of low grade grumbling psychosis with the occasional mini crisis. Since his diagnosis and being on medication life has been a lot less stressful and I have all the best bits with less of the difficult bits. I think only time will tell.

Really glad to hear you have good support from cpn, doc and counsellor.

OH had apps with latest locum psych yesterday who actually had read his notes and put some thought into things! Changed diagnosis to Bipolar 1 reflecting extent of psychotic episodes and negative affect of ssris. OH seems OK with this. I'm still pondering.

Last night we talked about his psych appt and I asked questions etc and asked how he felt about it all and listened and empathise.

We had Dr foster on in the background on TV and at the end of the episode this woman's ex takes her son away from her. This scenario has played out in nightmares for me many times. So I said that this was the only nightmare I'd had that hadn't yet come true, and found the episode triggering. OH said no you've had other nightmares that haven't come true eg worrying about him taking the car off to the garage without my knowledge. A worry. Based on actual experiences living with him when manic on several occasions (in not unreasonable). I did manage to reiterate that my recurring actual nightmare re kids was a fact. He didn't really listen to me. After telling him my greatest fear he told me I was wrong. He didn't express any empathy or understanding whatsoever. But just implied I was over anxious. This is a common scenario and one I don't now think is fair or kind.

Thanks so much for the pms. For some reason I can't seem to reply to them (?!) Lots to look into here, really appreciate you taking the time to pm. I have to say I've found it hugely helpful to chat to someone who is married to and caring for a partner with a severe mental illness. It's a very different existence compared to most people, and while friends have been fab, they can't know what it's actually like...

No problem I'm glad it been helpful. Partners of people with serious mental illness seem to be a rare breed, both in ŕeal life support groups and online forums, the majority of carers tend to be parents. I suspect this is due in part to the common age of onset being late teens/early 20s but mainly due the extra challenges mental illness places on relationships! There is a very good book by Mark Lukash 'My Lovely Wife; a memoir of madness and hope' its an autobiography of his life with his wife who developed psychosis and was later diagnosed with bipolar. Not an easy read as so many parts resonated emotionally with me. Theres also a very good autobiography by a lady called Elyn Saks, who gives a first hand account of her experience of psychosis. She has schizophrenia rather than bipolar, but reading her account has really helped my to understand what DH goes through better than anything. (She's also got a very good TED talk on utube thats well worth a watch)

I'm no expert on bipolar, DHs psychosis seems to fit more with schizophrenia although his diagnosis is unspecified psychosis. My understanding is that bipolar 1 has more extreme variations in mood than bipolar 2. I think it's positive that you were able to have that conversation with your DH. I do understand to a certain extent that nightmare about your sons. DH and I were TTC prior to his last crisis and I went from desperately wanting to be pregnant to being terrified that I would be, it's strange how a kind of primal maternal instinct can take over even before you have kids. We are TTC again now things are more stable again but I've had that nightmare myself. I am 100% sure that DH would never hurt a DC, but it scares me that he will become paranoid about me hurting them and try to take them away to protect them one day.

It took a long time for my DH to accept my PTSD, to start with he would tell me that I was being silly and had nothing to be stressed about. He would tell me that it was him who was ill and that it was wrong for me to be going on about how much I was struggling, when he was going through such a tough time. I think a part of it is that he often doesn't fully remember the times he has been unwell, but personally I think that a bigger part is denial about what he has put me through and not wanting to accept it. I don't think he took me seriously about how unwell I had become until firstly I told him how much I was struggling with urges to self harm, and secondly he witnessed me having a full on pannic attack unable to talk to tell him what was happening. Then he started to take me seriously. It's been a long journey for him to accept how tough his illness has been on me and then there was a huge ammount of guilt about what I have been through because of his illness. This process has been hugely facilitated by his mental health team, leading to the family therapy we are having.