Take It Or Leave Her

Posted by fxckfeelings on April 11, 2011

If you watch basic cable, you’ve seen enough shows about bizarre health problems to know there’s someone out there for everyone, willing to put up with anything; from morbid obesity to tree hands to a lack of sex organs, there’s no physical trait so daunting that there isn’t someone out there (usually someone with low expectations) who can’t accept it. It’s always surprising, then, when people with lesser problems, like illness or bad habits, have trouble getting the same level of unconditional support. Of course, acceptance, as hard as it is, doesn’t mean being a doormat. That’s why the payoff of acceptance is becoming stronger, prouder, and more realistic, even if it never airs on basic cable.
–Dr. Lastname

I like my wife, except when she doesn’t take her bipolar medications, which she hates, and then she becomes nasty, irritable, and overbearing. She makes my life miserable, and I worry about her impact on the kids. My goal is to protect the kids and get her to take her medication.

The best way to keep someone from taking their medication is to persistently ask them whether or not they’ve taken their medication.

That’s not to say that leaving the issue alone will insure she takes her meds, either. The point is, if she doesn’t want to take then, she won’t. The second part of the goal is a no-go.

The best you can do is tactfully encourage your wife to look for her own reasons to take medications. Having done that, you can predict whether it’s ever going to happen, and direct your life accordingly.

That’s the same rule you would use for a spouse with any ingrained bad habit. Begin with acceptance, make a realistic, nothing-but-positive-emotion pitch, then end with acceptance. It’s a helpful suggestion sandwich on acceptance bread.

Ask yourself why, from the point of view of her values and perspective on life, she would want to take medications, given the fact that she hates the idea of them, the smell, the appearance, the side effects, the fear of possible side effects, the cost, the implication that she’s ill, the memory of being told what to do, etc., etc. There’s no reason that she or anyone else would ever want to take medication for mental illness, except for desperation.

Then ask her whether, from her experience, she’s reached that state of desperation; if there’s reason to think she has lost jobs or relationships because of symptoms, or whether she’s been too emotional with the kids. Urge her to gather information from others, not just from you, even to tape herself, if necessary. You want her to do what she thinks is right and necessary. It’s her decision, and you want her to make one she believes in, using rational methods to make it.

If she’s willing to consider that method, give her time to do a survey and observe her own behavior over time. Give her your observations in a neutral way, without condemnation. If you think her symptoms have fucked her up, that’s your opinion, and you’re not implying fault.

Symptoms are a torture that’s beyond her control, so what counts is what she does with them. If she doesn’t have the capacity to observe them, there’s nothing much she or you can do to open her eyes or change her mind.

If all else fails, purchase a copy of my imaginary best-selling cookbook, “Cooking with Lithium” and its exciting sequel, “Baking with Depakote.” A dog will take pills with some peanut butter or cheese, but I don’t think your wife will fall for that; she’s mentally ill, not stupid.

After that, it’s your call whether you and the kids are better off living with Bipolar Mom or not and, in either case, what you can do to stay clear of her bad behavior. You can’t make her better; but, if you can accept that fact, you may be able to persuade and/or incentivize her to get real.

STATEMENT:
“If I can keep my emotions in check, there’s much I can do to encourage my wife to get back on her meds. If that doesn’t work, I will know that I’ve done my best, there’s no reason to fight with her, and my responsibility is now limited to finding the least destructive way forward. Happiness is not an option.”

Some days, I find it almost impossible to get up and take a shower, so I don’t. There are also weeks when I never even get out of the house. Fortunately, I have a wonderful wife, she’s a nurse, and she supports the family and takes good care of me, but I don’t know what will happen to me if she dies before I do. The only time I can get going is when my sister comes to town—she’s got a forceful personality—and she gets me up and out. Otherwise, nothing helps, including the medication I get from my psychiatrist. My goal is to find a medication that will get me going.

When medication goes up against bad habits, medication usually loses. That’s because medication is seldom very strong, and habits have a way of grooving themselves into your brain, attitude, assumptions, rationalizations, and relationships.

Your habit has got you bad; it’s been going on for years, prevented you from living a life, and shaped your most intimate relationship. If your spouse and your kids can’t get you to shake your routine, then medication by itself doesn’t stand a chance

That said, all is not lost. You do better when your strong-minded sister comes to visit, which means that social pressure can sometimes pry you out of your sedentary, sedimentary existence. That’s what behavioral therapy is all about.

Let’s be clear from the beginning, however, that there’s a big part of you that doesn’t want to leave your house, or do much of anything, unless your feelings change, and that isn’t going to happen. For example, a drunk will often moan about much s/he needs to stop drinking…before downing 10 shots night after night.

So no matter how strongly you tell me you want to get up and out, we know you don’t. The first step then, as they say in a 12 step program, is acknowledging your helplessness to control your addiction. Otherwise, you won’t get far.

If you’re still interested in changing—not finding a pill that will do it for you—there’s lots you can do. You can invite your wife to stop supporting your bad habits by telling her to do the things you like if you’re taking care of yourself, but leave you alone otherwise. Ask her to schedule good things for the two of you to do together and leave without you if you back out. Ask your friends if they’ll help you in the same way, and get a coach or therapist to help you stay on track.

As long as you accept your lack of control, you won’t get over-confident or count on any one trick—or medication—to give you a handle on your sloth-demon. In that context, medication may help.

Expect yourself to wiggle out of your agreements, but don’t give up. Remind yourself that time is short, and you have some living to do. Be prepared to hurt, because changing habits like these does hurt. If you slip back, do better next time. Just keep going, one day/shower/step outside the house at a time.

STATEMENT:
“I’ll never know why I can’t get myself going, and it’s hard to change my habits. If I let people know I need help, and use that help to push myself back into the land of the living, I’ll be doing what’s most important to me, and that’s what matters.”