Bipolar Disorder: Navigating a Spouse's Crisis

My wife has bipolar disorder?

Hello Doctor, I have been in a relationship with my wife for seven years and we have been married for nine months.
She started taking the antidepressant Paroxetine (Paroxin F.C.
Tablets 20mg) since the beginning of the year.
Initially, she took one tablet, then reduced it to half a tablet, but due to increased work and life stress, she went back to taking two tablets (for about two years).
A week before her manic episode, she increased her dosage to 2.5 tablets.
At the end of August this year, she suddenly experienced an increase in sexual desire, obsessively swiping on dating apps, to the point of hardly sleeping.
Her mood also became elevated and irritable (she would get angry over trivial matters), and she started expressing some outlandish goals (she was originally a very conservative person, but now she talks about wanting to be a rental girlfriend, selling used underwear, and trying to have relationships with different men).
After noticing these symptoms, I took her back to her original psychiatric clinic for a follow-up on September 13, where the doctor diagnosed her with a manic episode of bipolar disorder and prescribed four medications (Dipachro S.R.F.C.
Tablet 500mg once daily, APO-DIVALPROEX 250mg once daily, Bromazine 3mg twice daily, and Aripiprazole once daily).
I understand that psychiatric medications take about two weeks to show therapeutic effects, and the doctor mentioned that they would adjust the medications weekly based on her condition.
However, on September 19, my wife insisted on getting a divorce and said she planned to go to a hotel with a guy she met on September 21.
After discussing with my mother-in-law, we decided to take her to the emergency room, where the doctor assessed her and decided she needed to be hospitalized for treatment.
After being admitted on September 21, I am not entirely sure what medications she is taking, but I trust the doctor's expertise.
However, she still calls me every day saying she wants a divorce, wants to be a rental girlfriend, wants to have relationships with different men, and wants to be financially supported.
She has even started experiencing hallucinations and auditory delusions, has very little sleep, and has conflicts with the nursing staff.
She has also begun to criticize me as a "toxic partner," claiming that I do not give her freedom.
Honestly, I really don’t know how to face her...
Are those things she says truly what she thinks? Thank you, Doctor.

Mr. Huang, 20~29 year old female. Ask Date: 2022/09/29

Dr. Qiu Junda reply Psychiatry

Hello.
It appears that your wife is experiencing an acute manic episode, and hospitalization for treatment is indeed necessary.
It may take more than a month for her condition to gradually improve.
Her symptoms include inappropriate thoughts and behaviors regarding relationships, which are part of her illness.
These will improve once her condition stabilizes.
Please try not to take it personally and be more understanding, even though it may be difficult for you.
Especially after she is stabilized and discharged, avoid being harsh about the disordered behaviors she exhibited during her illness (she does not wish to behave this way but is unable to control it).
The best support you can provide is to help her continue with follow-up appointments.

Reply Date: 2022/09/29

More Info

Bipolar disorder, commonly known as manic-depressive illness, is a mental health condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). Understanding how to navigate a spouse's crisis during a manic episode can be challenging and requires both empathy and knowledge of the disorder.

In your wife's case, it appears that she is experiencing a manic episode, which is often marked by increased energy, reduced need for sleep, and impulsive behavior. The behaviors you've described—such as heightened sexual desire, engaging with dating apps, and expressing grandiose ideas—are typical manifestations of mania. During this phase, individuals may feel invincible, leading them to make decisions that can have serious consequences, such as pursuing risky relationships or engaging in behaviors that are out of character.

It's important to recognize that these behaviors are not a reflection of her true self but rather symptoms of her condition. The manic phase can distort a person's perception and judgment, leading them to act in ways that are inconsistent with their usual values and beliefs. This can create significant strain on relationships, as you are experiencing.

Your concern about her statements regarding divorce and her desire to engage with other men is understandable. During a manic episode, individuals may express thoughts and feelings that seem genuine but are often influenced by their altered state of mind. It’s crucial to approach these conversations with compassion, understanding that her current mindset is a result of her illness rather than a definitive statement about her feelings towards you or your marriage.

The treatment plan that her psychiatrist has initiated, including mood stabilizers and antipsychotic medications, is essential for managing her symptoms. It typically takes time for these medications to take effect, and adjustments may be necessary based on her response. Regular follow-up with her healthcare provider is critical during this period, especially if she is exhibiting severe symptoms such as hallucinations or significant agitation.

As her spouse, it’s vital to maintain open lines of communication with her treatment team. You can advocate for her needs and ensure that her care is coordinated effectively. Additionally, consider seeking support for yourself. Caring for someone with bipolar disorder can be emotionally taxing, and support groups or counseling can provide you with coping strategies and a safe space to express your feelings.

In the meantime, try to create a stable and supportive environment for her. Encourage her to engage in healthy routines, such as regular sleep patterns and balanced meals, which can help mitigate some symptoms. However, it’s also important to set boundaries to protect your own mental health. If her behavior becomes threatening or abusive, it may be necessary to involve professionals to ensure safety for both of you.

Lastly, remember that recovery from a manic episode is possible, and with the right treatment and support, many individuals with bipolar disorder can lead fulfilling lives. Your patience and understanding during this difficult time can make a significant difference in her recovery journey. Encourage her to stay committed to her treatment plan, and remind her that you are there to support her through this challenging period.

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