Bi-polar DH going downhill. What do I do? How do I cope?

[BuzzingNoise]

I'm not sure really if this should go into relationships instead, but here goes:

DH is bipolar and was diagnosed about 5 years ago. He hasn't been on any medication for about 4.5 years, and for a long time claimed the diagnosis was wrong and that he wasn't bipolar. However, he has since accepted it, and can see his ups and downs (I know that's putting it simply) retrospectively when I point them out.

He had a 'down' period just before Christmas, and it was nearly the end of us because he stopped talking to me, got stressed about everything and was extremely hard to deal with.

That episode passed and he was fine for a couple of months (a bit manic over Xmas with resulted in a massive money problem, but we've dealt with that), but for a week now I have seen him go downhill again. I've triedto be supportive, being kind, listening on the rare occassions when he does talk, and I gently pointed out that I was concerned.

Today he emailed me from work to say he wasn't coping at all and needed to see a doctor ASAP to get help.

In a way I was pleased that he accepted that he needed help, but I am worried that this episode could get really bad. He's been hospitalised before as a result of this, I don't want it to get to that point again. I have mental health issues and would not be able to cope with DS on my own.

I'm also worried because he is notoriously bad at actually making an appointment at the docs and going when he needs to. If he doesn't make an appointment, how do I get him to see a doctor without him getting angry about it.

I don't know what I want really, as a result of posting this. Advice, support, that kind of thing, I guess.

I guess if he is realy bad then you could phone the Dr on his behalf who may come out and see him, not sure? sorry

if he has said he needs a doctor then you have to hope he will follow thru.

only he can take that step.

but you can call the doctor too. then doctor will call him - and it will be up to him to admit he needs help or not.

if he gets bad at home you can call the mental health crisis team ; if it gets really bad you can dial 999.

get support around you so you would be able to cope with your ds if needs be - do you have family, friends you can call on?

thing is you dont have control over your H's mental health - you can only control yours.

if he wont go to the doctor, in a way you forced to wait til it gets bad enough to call crisis team or 999. (i've been in that situation with my exP). give the crisis team a call though and explain your concerns from your point of view.

think practical - what sort of help would you need with your DS were your H to be hospitalised? (because if he needs to be, he needs to be - it is out of your control) .

is diferent for me now mine is exP (undiagnosed but has clear periods of ups and v. depressive downs)- but i do have to watch out as he has contact with the dcs. so when he was bad before xmas i had to make sure all visits were supervised - now he is "better" i can be more flexible...but if he goes downhill again i will have to watch out and impose supervision again.

it is a lot of responsbility. but I cant do anything about his mental health - only he can.

oh dear, do you have own cpn/sw you can turn to? maybe they can liaise with your husband's doctor on your behalf

it all sounds very familiar (reminds me of me)

why won't he take the medication? Lithium maintains bi-polar very well over the longer term.

As someone mentioned, there will be a mental health crisis team in your area. They come out to your home, so you wouldn't need to worry about getting DH "out" to the dr.

Have you got their number?

Thanks for all the advice.DH made a doctors appointment and I'm going with him this afternoon.
Sadly we live a long way away from both families.Hopefully not for long though as we're planning to move in the summer.
I haven't had use of a crisis team. What exactly is their role?

in periods of acute serious mental illness they will come out everyday to your home, inc. saturdays sundays, bank holidays etc.

They will monitor you, adjust your med, etc.

The idea is to keep you out of admission to hospital stage.

Didn't work in my case, but I did find it helpful to be visited at home, and know that I wasn't abandoned.

Mental health crisis team
Most areas have a mental health crisis team. These teams are made up of psychiatric nurses, social workers and support workers and:

are available 24 hours a day, seven days a week
respond to a crisis within four hours wherever possible
carry out assessments under the Mental Health Act (1983)
provide support and short-term help until another team is available or the help is no longer needed
Mental health crisis teams are part of social services and you will be able to find their contact details via your local council.

origin.direct.gov.uk/en/DisabledPeople/HealthAndSupport/MentalHealth/DG_10023332

tho when i used to call to say exP was freaking out they used to say "we cant help - call the police" - however - i think they can be useful for day to day stuff, maanging medicaiton and so on and are always on call. point is you can ask for their number and they are a point between GP and A&E/dialling 999 - ie more specialised help

there should also be an associated mental health crisis helpline number, staffed by the crisis team which you can call any time of the night or day.

I only called them once but think I was unlucky - having a major anxiety attack the lady on the other end of the phone suggested I have a nice hot bath and go to bed

Good understanding of mental health issues there.

Hi, Buzzing, found you .

Sorry to hear you and your DH are going through this.
I think cestlavie's first post is excellent and I am not sure what I can add.

A really important point is that you are NOT responsible for your DH's mental health - you can, and clearly want to, be there for him and support him, however ultimately it is up to him to seek and accept help.

If he goes up and down like that (and badly enough to cause fincancial pressures ) then it is well worthwhile considering mood stabilizers. Lithium is the most established one, but there are others if he has had a problem with Lithium in the past?

Also to have access to a CPN, you or him, would be a V Good Thing. That is certainly something your GP could organise for you, in your own right.
MH Crisis Team IME are usually v helpful: they will make at least telephone contact on the day and visit the person in question according to need the same day or very soon after. They can also arrange for urgent clinic appointment etc.

Look after youself, you are in this for the longhaul (I presume ). And you have a child to consider.
Having just seen my brother, whose situation is quite different from yours of course, what upsets me most is that he is really damaging in own MH by feeling it is up to him to make his DW 'happy', wheras she is making no effort to address her issues... Anyway, that's between them.

No dr can see your DH against his express wishes unless he is "sectionable" (hate that expression), however the suggested course of action that you phone the dr who then makes contact with your DH and arranged to see him at home or at the surgery is fine.

None of this will be an issue if you are both going to the GP's this afternoon anyway.

V best of luck.

Let us know how you got on.

Thanks so much for the info about the crisis team.I wish I knew about them before.

DH went to the doctor yesterday afternoon, and I went with him. He got Lustral, which is Setraline (sp?) I think.

Will post a bit more later when I get a break at work

Glad you made it to the dr's.

Are you ok?
{smile]

Well things seem to be going fine. DH has been a tad manic since Friday morning, which has hindered any housework being done this weekend, but as I am off for a few days tomorrow (to my mum's and MN party) I don't mind about that!
He's been taking the tablets, so fingers crossed that things settle down soon.

is he just taking the sertraline on its own or in conjunction with lithium or an anti-psychotic or anti-convulsant?

Just on its own. He has other tablets that he takes as a anti-histamine for an allergy, but they also help to clam him down.

am just worrying about the 'manic switch', presumably GP aware and keeping a close eye?

Buzzing, how are things going?

I am really just marking this thread for me as I am about to go to bed, but I'd share Miffy's concern.

Back tomorrow for more. If you are still watching this...

Please be aware that prescribing anti dpressants to someone in a depressed phase of bipolar can cause them to tip over into hypomania.

If you feel his mood is getting unaturally high,seek urgent advice. A lot of damage can be done in manic episode, as I am sure you know

i looked up "manic switch" and hypomania..interesting...wow, hypomania so describes my ex - he has been on citalopram nothing else as far as i know...

"They are often very jolly to be with but can become impatient if they cannot do what they want.

Hypomania can be difficult to diagnose because it may masquerade as mere happiness. It is important to diagnose hypomania because, as an expression of bipolar disorder, it can cycle into depression and carry an increased risk of suicide.

However, hypomania can rarely be maintained indefinitely, and is often followed by an escalation to mania or a crash to depression.
" www.depression-guide.com/hypomania.htm

he is very jolly and dc's enjoyng him but also getting v impatient demanding things his way and his way only....

he was v depressed sept to december - then in this new mood since jan.

prior to sept 2009 was in hyper moood incl reckless overspending etc from july thru august 2009.

sounds like bipolar? but if he wont admit to hypomania no one can do anything right? as i said to op - i cant do anything...

"Hypomania may feel good to the person who experiences it and may even be associated with good functioning and enhanced productivity. Thus even when family and friends learn to recognize the mood swings as possible bipolar disorder, the person may deny that anything is wrong."

just sitting waiting for the "switch" .

I shall have a good look at the links when I get a chance later on.

How are you doing, Buzzing?
Hope your DH is doing ok