is my behavior unforgivable?

[married_1997]

A little background first.

I've been married for over ten years now. As with most relationships, ours has included both extremes of good and rough times. We have a son in middle school, who is wonderful. My wife has struggled with her psychological health for much of her life, and the symptoms she's dealt with have gotten worse over the years. She experienced some repeated trauma during her early childhood, and has dealt with periodic depression and difficulty managing/expressing her anger ever since. More recently, her depression has yielded some additional symptoms of psychotic/delusional episodes that have resulted in some dangerous situations for her. Several times in recent years she has spent some time in institutions as a result of her actions based on these delusional beliefs, has found herself in an emergency room, and has once landed herself in the local jail. Her delusions were sometimes erotomatic (believing that a powerful person was in love with her) and often paranoid. She would feel compelled to do something, believing that it would create a safer situation for herself or for our son and myself.

In a strange way, these bumps in the road have brought us closer (since her medications have been properly balanced, and she is no longer delusional). I think that going through trauma together almost always strengthens intimacy for couples, but maybe we're just lucky. Lately, however, a new doctor that she's been seeing has started reducing her anti-psychotic medications. He believes that her medication levels are too high, and feels that she can do without most of them. Her anti-psychotic dosages are now at about 10% of what they were the last time she was discharged from in-patient care. She has been struggling increasingly with her grasp on reality, as a result. She doesn't see this, however, as is often the case with delusional persons. And, of course, I'm not allowed to breech doctor/patient confidentiality and discuss with her doctor what I'm seeing at home.

A few nights ago my wife had a particularly difficult time while settling down for bed. She was extremely anxious, angry, and distracted when she came to the bedroom. She wouldn't share with me many of the details of what she believes, as she thinks (rightly) that I won't believe her. She came to bed furious with somebody, but wouldn't tell me more. I tried to talk her through her anger, but she got progressively worse. After an hour or so of discussion she was so upset and angry that she made herself sick. After some time she was able to calm herself a little, and got back into bed. Shortly after that, she started to feel like she had "restless leg" syndrome, which quickly spread throughout her body. It took some time to calm her enough that she could fall asleep, and it was nearly 4am when she (and I) drifted off.

The following morning she woke at 7:30 or so and turned over to address me. She said that she was having some of the same emotions as the night before (the anger/fury feeling) and asked for help. Wiped out, I suggested that she try meditation - something that often helps her to calm her mind. I drifted back to sleep immediately, and after a few seconds she said, "is that all you're going to say? You're not going to get up and help me? Fine!" and left the room.

A few hours later I got out of bed and went to find her, remembering the exchange we'd had earlier. She was furious with me for going back to sleep, and immediately started yelling. I felt defensive. Although it may have been a less than totally selfless act for me to allow myself to drift off again, I didn't feel that it warranted the level of anger she was expressing. I felt justified in my decision to sleep, as I had been up so late trying to help her the night before. As she has had some history of misdirecting her anger, I responded by saying, "Hey, I'm not the parent who didn't protect you when you were a kid." This caused her to switch from anger to hysterical distress immediately. Exasperated, I exclaimed, "Great, now you're going to make yourself sick again!" and stormed out.

Okay, I'm not proud of the way I handled myself in the face of her pain. I wish that I had got out of bed to help her at 7:30, and I certainly wish I hadn't lost my temper and said those things when she was angry at me after I woke. However, she won't talk to me anymore. She swears that she'll never come to me for help again, that she'll never confide in me, and that I can't touch her without permission. That was three days ago, and she remains true to this conviction. I've grovelled, apologized, pleaded, reasoned and begged for her forgiveness. She hasn't changed her position at all.

I found my way to this forum because I desperately need some perspective from somebody outside of the situation. I don't feel like it's fair (to her) to go to a friend or family with the problem. The situation is so complex, and I want to protect her privacy. However, it is sometimes difficult for me to differentiate a legitimate level of anger from the kind of raging anger that's associated with her periods of delusional thought and history of post-traumatic response to her childhood pain. Does her response sound reasonable? Do I deserve to be cut-off permanently? Was my behavior as evil as she feels that it was, or is this the kind of thing that happens when lovers fight? Does it seem like a forgivable offense? Any thoughts or advice would be much appreciated.

[misombra]

I don't think it violates doctor/ patient confidentiality if you call her doctor. She needs to not be off her meds. Her doctor needs to know what a mess she is without them. Especially since you have a child in the most vulnerable times of their lives. Your son needs an emotionally stable mother.

[married_1997]

Thanks for your input. That's a very good point. I have called and left descriptions with the new doctor's office, but he maintains his treatment trajectory. My wife is quite able to maintain a level head for periods of time, and I'm certain that she's not talking about these things with him. I'm guessing that I just come across as the crazy husband who's trying to drug his wife into submission.

[Bella82]

I do not think at all that your response warranted her reactions. I do think you acted a little insensitive in that particular situation, but on the other hand, I have no idea of what the two of you have been through together with her psychological troubles.

She sounds like she needs medical help. There is only so much you can do (ie comfort and listen to her) and then the doctors will have to decide what the next steps are to getting her better. Her doctor needs to know about her adverse reactions to the decrease he prescribed in medications, and if you are the only one who can tell him, it might be best to have a talk with him... for both herself and the sake of your family and relationship.

Don't beat yourself up about the way you acted. We're not all perfect and we can only give what we're capable of giving. Even the most understanding person can have a breaking point. Comfort and be there for her, but beyond that, she needs the help of professionals.

[justcheckin]

I agree. If she is "loosing her grip on reality" without the meds.... I think your doctor needs to know, perhaps she needs more then he sees (from only seeing her for a few hours at a time)

what happens if you just basically approach her and apologize and say you where wrong? even if you don't think you were, have you tried just saying sorry? Usually if she is upset (from other reasons) that is enough to break down her defenses. have you tried this approach?

I really do believe that her doctor should know about your observations.

[MerryH]

Hey, bringing up her childhood issues during a fight was a really, really low blow. She got pissed off for a stupid reason initially and made way too big of a deal, but you brought it down to a really dark place. If you want to continue a relationship with a person with these psychological health issues, then learn how to deal with disagreements in a healthy way. You should probably go with her to some of her appointments, or try a different counselor you can see together. If you're really serious about staying with her, sorry, but you can't just rely on yourself to know the best way to deal with a "crazy" person. You need help with that.

Also, when you call and "leave descriptions" with her doctor, then say "but he maintains his treatment trajectory," it sounds like you're calling him up and suggesting he should be doing something different. Don't interfere with her treatment. You're not a doctor.

[vashti]

i agree with misombra that it does NOT violate patient confidentiality for you to speak to her doctor about what is going on at home. If necessary, make an appointment to see him.

[married_1997]

He won't see me, or talk to me. I'm allowed to leave messages, but we can't have a discussion. I realize I'm not a doctor, but the doctor doesn't see how she behaves when she's not acting. This doctor also doesn't know her psychological history, and she won't move to transfer records to his office (may or may not be intentionally blocking him from her past, which would reveal why she had such high dosages of the anti-psychotics she was released from the hospital with).

We have been seeing a marriage/relationship counselor for over a year, and it's gone generally well. She also sees a personal therapist in addition to her psychiatrist.

Thanks for your thoughts, everyone.

[RdHrshyKss]

get a new doctor...ASAP. this psychiatrist is horrible. my personal opinion is that people who have had traumatic experiences in the past are only really able to successfully work through their problems withOUT medication. but even i can say that this doctor is more interested in doing things HIS way than in being sensitive/understanding to what you guys are going through at home. dropping her medication by 90% is HUGE. if this drop in meds is making her behaviors destructive and more severe, and her doctor doesn't give a rats ass about what's going on at home (especially with a young child!), then he's a shitty ass doctor and you should find someone else.

[married_1997]

I can't make her change her doctor, unfortunately. She doesn't think she needs to change, she thinks that reducing her medication is a good thing. She doesn't believe that delusions are among her symptoms. She only goes to the psychiatrist because she does recognize her need for anti-depressants and anti-anxiety medications.

Don't get me wrong, I'd love to see her with less medication in her bloodstream, but not if it means that she's scared and angry most of the time. And certainly not if it means that she believes there's a secret government organization who have been tasked to kill her and her family, compelling her to flee in the middle of the night, ending up crashed in a farmer's field and hypothermic in the emergency room. As much as I'd love to agree with the many, many people who have told us that medication is bad, the reality is that some psychological disorders are beyond the reach our currently available non-medical techniques. A chemical imbalance, in many cases, can be corrected by introducing a replacement for the missing chemical(s). Until a new technique/therapy that's been shown to be effective is developed, I'm afraid it's going to have to be drugs for many sufferers of delusions and psychosis.

[Applesauce]

Does your wife hold a job? If so, how does she manage at work without getting fired? If not, honestly I would divorce her. There is no reason to be with someone who just drains you emotionally, physically, and financially

[misombra]

I can't make her change her doctor, unfortunately. She doesn't think she needs to change, she thinks that reducing her medication is a good thing. She doesn't believe that delusions are among her symptoms. She only goes to the psychiatrist because she does recognize her need for anti-depressants and anti-anxiety medications.

Don't get me wrong, I'd love to see her with less medication in her bloodstream, but not if it means that she's scared and angry most of the time. And certainly not if it means that she believes there's a secret government organization who have been tasked to kill her and her family, compelling her to flee in the middle of the night, ending up crashed in a farmer's field and hypothermic in the emergency room. As much as I'd love to agree with the many, many people who have told us that medication is bad, the reality is that some psychological disorders are beyond the reach our currently available non-medical techniques. A chemical imbalance, in many cases, can be corrected by introducing a replacement for the missing chemical(s). Until a new technique/therapy that's been shown to be effective is developed, I'm afraid it's going to have to be drugs for many sufferers of delusions and psychosis.

wow. she has psychosis going on. sadly for a lot of people in your situation things don't get better until the patient winds up in inpatient care and needs to be stabilized. her doctor sounds horrible if they're not willing to consider your input. is she diagnosed with schizophrenia?

i don't understand some doctors. is he new to her? some get new patients and decide to change everything because they think they're right and whoever had her last was wrong. you should talk to the director of the hospital this person works for.