Posted by fxckfeelings on December 13, 2012
Given how little we control our own urges, it’s not surprising that we also have trouble controlling our reactions to them, but it is odd how often those reactions are totally wrong. Brains have a pretty good track record with instincts; get thirsty when hot, get sleep when tired, get away when near snakes, etc. When people get urges that are humiliating, however, even when they’re doing a good job of controlling them, they wrongly blame themselves, but when they get controlled by noble urges, even when they’re causing terrible harm, they give themselves a pass. So, however much you love or hate your urges, don’t give yourself a hard time about stigma or anti-stigma. Instead, remember your own moral priorities and ask yourself whether you’re doing the right thing with whatever urges, pretty or ugly, that you got, and to avoid snakes.
–Dr. Lastname
I have yo yo’d with my weight for ever—I was 8 years old when I remember going on my first diet, and I had binged by lunch time. I have seen a psychologist regularly in the past and a psychiatrist more recently, and been diagnosed with a binge eating disorder as well as melancholic depression. I also have a history of being sexually abused when I was a child and required hospitalization once for an attempted suicide (prior to diagnosis) and have been on various anti-depressants. Last year I decided to press charges against my abuser and the investigation is still taking place. This was very big for me as previously I couldn’t speak about or put into words to anybody what had happened to me, but with the professional help over years, could make a police statement. I have managed to get into a healthy weight range many times in the past, but only when on a program like Jenny Craig or weight watchers, and I resent having to do these programs and can’t commit to them after I have done them once, but I can’t seem to stay in this healthy way of life on my own. I am either losing weight or putting weight on– my thought are always around food, what when and where I can eat next. I hide most of my eating from everyone including my husband. I feel like a drug addict and don’t know how to take control of my eating. I do really well in my career and other areas of my life, I just can’t flip this switch that turns me into a zombie when I want to eat. I read everything I can about these disorders, I talk about strategies with my mental health professional, but when the urge to eat takes over I go into a zone that I can’t switch myself out of. How can I stop this pattern?
Having an eating disorder is rough, but it’s even worse if you give yourself a disorder about your disorder, giving yourself a hard time for having a hard time. It’s especially unnecessary given the fact that it’s harder to find someone with complete control over unhealthy food impulses than it is to find a unicorn.
Almost everyone has trouble controlling eating habits, as evidenced, not just by the multi-billion dollar industry devoted to weight management (which, as you’ve discovered, is no silver bullet), but by the fact that very few people get permanent weight control without surgery. In reality, of course, as much as we try to control our weight, more often, it controls us. WAIT! There is more to read… read on »
Posted by fxckfeelings on November 8, 2012
Although stopping long-term intensive psychotherapy can leave you in a state of mourning and fear, particularly if it occurs during tough times or against your wishes, it’s unrealistic to expect that returning to therapy will make everything right again. Instead, give yourself time to adjust to change and reassess your ability to stay functional and positive. Then, if you think it’s necessary, find a therapist who’s a good, supportive coach and use him or her for a different kind of therapy that keeps your head straight without stirring up your deeper feelings. If you’re certain that you have to be “in therapy” to get helpful support and are helpless without it, then the therapy you’re in is helping you a lot less than you think.
–Dr. Lastname
In my early 20s I spent 4 years in therapy (which I think in and of itself says a whole lot about the not good place I was in my head). Therapy ended, not because I was ready, but because I moved. I am now 46, and in the years since I continued to work through a lot of things on my own, with my therapist’s voice in my head, if no longer in actual therapy sessions. In January my grandmother took a turn for the worse, with both health and cognition, and we had to place her in full nursing care. She has always been one of the most influential and positive forces in my life, so I had a hard time dealing with this. It sent me spiraling down into my 4th lifetime episode of depression. I’ve started back on Prozac, which I now realize I need to stay on for the rest of my life to try to prevent future recurrences, and I’ve spent the last 10 months in therapy with my former therapist via phone sessions as we now live 1,000 miles apart. I have finished working through a lot of stuff in that time, meaning I’ve changed my attitudes and perceptions and behaviors, which has changed my life, inner and outer. I wish I’d figured it out 25 years ago, during that first round of therapy, but better late than never. It’s been a hard year. My grandmother died 7 weeks ago. The grief hit me more than I ever imagined. I thought I’d prepared in those months when she was slowly dying, but I was wrong. What is the saying—Where there is no struggle, there is no strength? Good growth has come of the pain—I have returned to college, and I am training for my first full marathon in January. I am at a truly good place in my head and was ready to end therapy, so two weeks ago, with my therapist’s blessing, I had my last session. I knew, though, that ending therapy because I am truly ready is a celebration, but that it would also be a loss. It is currently hitting me harder than I imagined. How do I get through this and find a place of healthy acceptance of this transition?
While it’s unfortunate that stopping intensive psychotherapy after many years is hitting you hard, it’s not surprising. As you well know, loss is painful, be it the death of a loved one or the end of a source of support.
That said, your pain doesn’t mean your psychotherapy has been less complete than you thought or that you stopped it too soon, just that you can be a solid, resilient person and also be very sensitive to loss, both because of temperament and circumstances. WAIT! There is more to read… read on »
Posted by fxckfeelings on October 18, 2012
Assessing one’s self-esteem is like checking for Puxatony Phil’s shadow on Groundhog Day; while we have a long tradition of caring about its status, the results are fairly meaningless. After all, some people with strong characters don’t like themselves because they don’t measure up to high standards, and other people are madder at life’s unfairness than they are at themselves and underperform, not because they don’t like themselves, but because they care more about feeling good than getting strong. And of course, sometimes, it’s just cloudy. In general, it’s better to have a strong character, even if makes you kick yourself, than to see yourself as a deserving, entitled victim in order to break out of the rut of bad decisions and get out of Puxatony once and for all.
–Dr. Lastname
My 14-year-old son seems to care about his schoolwork but he’s unusually stubborn (the psychiatrist says he has Asperger’s syndrome) and he never does his schoolwork the way his teachers want him to. When they ask him to show his work in Math, he refuses, but he often gets the answers right anyway, just without any proof. When they ask him to do a draft of an essay, he just won’t do it, but then the final version he writes at the last minute is fairly reasonable. My son always feels guilty and angry, both for not being understood and not being able to do it correctly, and I’m worried that they’re not teaching him right, in a way that caters to his specific needs. My goal is to get them to give him better help.
You’ve been trying for many years to get your son to show his Math work and finish his preliminary drafts on time, and it just doesn’t happen. He’s had many teachers work with him and no one has found the answer. You’ve made an effort, and after showing your work, it’s fair to conclude “the answer” doesn’t exist.
In addition, telling teachers they need to improve is bound to make things worse since they already have the government telling them they’re responsible for their class’ performance, regardless of what those kids and their families are like. Holding them accountable for not getting results—the “show your work” of the teaching world—isn’t quite fair since you know it’s an impossible job.
Once you add your own personal “no child left behind” intervention, don’t be surprised if the teachers start to find fault with both you and your son in order to defray blame. Whatever happens next, it won’t involve praise or more positive results for anyone. WAIT! There is more to read… read on »
Posted by fxckfeelings on September 24, 2012
Coping with the mental illness of a family member can be agonizing, and when you can’t stop destructive behavior, it feels like defeat. Trying to defeat the symptoms of mental illness, however, is like trying to win a war on weight-gain or terror—difficult, endless, and resulting in gains that are easily lost. If you learn to accept setbacks as part of the process, rather than attack them as tests of your love and will, you’ll do more to sustain morale, including yours and your family’s. Take pride in your willingness to endure a difficult, painful, and sometimes frightening relationship; you won’t win or lose a war, but you’ll gain peace.
–Dr. Lastname
I’ve got an adult daughter whom I know is mentally ill—she thinks people are plotting against her, including her very nice husband—and, for the last few years, without my own husband’s help, I’ve desperately tried to persuade her to get treatment before her marriage fell apart and she got arrested for doing something violent and stupid. The harder I tried, however, the more she suspected I was part of the conspiracy. There was a ray of hope 6 months ago when she had a screaming fit one night and got locked up in a mental hospital, but the medication made no difference, and she came out more certain than ever that her husband was her worst enemy, so she left him. My husband says I’m part of the problem because I never take my daughter’s side, but my goal is to restore her to sanity, and I know my husband is in fantasyland if he thinks she’s sane and has a “side” based in reality. I’m getting nowhere, though, and my own marriage is under pressure. What do I do now?
Unfortunately, while there is no surefire cure for paranoia, pushing a paranoid person to get help is a reliable way to make it worse. After all, if somebody thinks the world is against them, disagreeing with that person only confirms their delusions. Call it the paranoia-dox.
If your daughter’s paranoia can’t be helped—and it seems you’ve tried very hard to help her—then I’m sorry, but your husband has the right idea, even if it’s for the wrong reason. By not challenging her feelings of being victimized, your husband avoids the paranoia-dox, which makes it an approach worth trying. WAIT! There is more to read… read on »
Posted by fxckfeelings on August 30, 2012
If you listen to (other) experts, psychiatric treatment should always begin with objective evidence, which then determines a diagnosis, which directs us to proven, effective treatments. This expert, on the other hand, thinks that “evidence-based psychiatry” would be very nice if we happened to know lots more than we do, but it is one of life’s great ironies that the organ we know the least about is the home of knowledge itself, the brain. Until we can fully wrap our heads around our minds and how they work, scientific thinking in psychiatry is often wishful thinking. It can actually get in the way of making good, practical decisions and accepting the necessity of living with the unknown, be it a mystery illness or the grey mush in our skulls.
–Dr. Lastname
I’ve been very confused lately because of what’s going on inside me. My father did some bad things to me while I was growing up—things that I just began remembering a year or so ago (sorry, I can’t label it). Since then, other memories surfaced as well, but not many at all. Most of my memories of my childhood are snapshots that are just little moments in time, separated by years in between that I just don’t remember. Anyway, the thing that distresses me is that sometimes, but not all the time, I’ll feel like I have another part of me who is talking in my head. This came to my awareness mostly after the memories started coming up, although I feel like maybe it happened occasionally before. For instance, recently someone asked me a question, and a child’s voice answered in my head. I have other instances of similar things like that happening. One time it seemed like there were two parts conversing with each other and I was just observing the conversation, per se. That being said, I am educated enough about what happened to me and the consequences of it to know that I think I’m describing DID, but from what I’ve read, I don’t think I have it. I don’t switch to other personalities, and I don’t really lose time or anything like that…but I do know I’m not qualified to make that kind of assessment (and I know you can’t just by reading this letter). But my question does relate to that: is it possible to have the kinds of experiences I’ve described and not have DID? Since I’m pretty sure I don’t have it, I feel like I’m just some crazy, messed up person for no reason. It terrifies me to share this with anyone, but I don’t know what to do anymore, and it’s getting harder and harder to keep going.
Diagnosis in psychiatry is never precise and, when given too much attention, can do more harm than good. Until the day a mental illness diagnosis can be determined by peeing on a stick, all we can currently do is lump symptoms together and try to observe what happens to people who fall within an arbitrary category.
In the short run, knowing you’re not alone might be comforting, but it would tell you very little about what to expect from future symptoms or treatments. Worse, it would get you thinking of yourself as a diagnosis instead of as a person who’s trying to live life in spite of some disturbing, hard-to-understand symptoms.
As such a person, ask yourself what you most want to accomplish in this life, despite whatever’s going on in your head. For most people with traumatic childhoods, it’s always meaningful to be decent to others, whether they’re your kids, relatives, or friends. You know how easily people slip into abusiveness when they’re angry and how much it hurts, so you never take a good, supportive relationship for granted.
Most symptoms that impair the way you function won’t prevent you from being the person you want to be or doing what you really want to do, they’ll just slow you down and force you to work harder to think up alternative methods. A good coach helps you to accept your impairment without getting discouraged or demoralized.
So instead of looking for the ultimate shrink diagnostician, find a therapist who can act as a good coach, who isn’t too upset by symptoms, and is eager to see what you’re capable of, even when you’re distracted by traumatic memories, internal conversations or the sensations of observing yourself.
Consult a psychiatrist at least once or twice to get an overview of possible treatments, including medication. Of course, non-medical treatments almost always pose a lower risk, but many medications are relatively safe and require no more than a few weeks to try out. If your symptoms are sufficiently painful and/or disabling, and non-medical treatment is insufficient, then you owe it to yourself to check out every possibility.
Whatever symptoms you have, you want to do your best to manage them without letting them define your life. Keep up your diagnostic questions until you’re confident you’ve heard what the experts have to say, regardless of how unsatisfying that might be, and then forget about what caused your problems or how they might be categorized.
Your next step is to manage your burden and respect yourself for carrying it, even if the nature of that burden remains a mystery.
STATEMENT:
“My psychological symptoms spook me and leave me feeling distracted and distanced from myself, but they can’t take the meaning out of a good day’s work or a solid friendship. I may never figure out why I feel the way I do, or stop myself from feeling that way, but I can certainly lead my life according to my values regardless of the tricks my head likes to play on me.”
No one was more surprised than I when I suddenly got depressed about a year ago, because it’s not something that ever happened to me before. I lost energy, felt like crying, and got anxiety attacks. There was lots of pressure at work, but my job was safe, and I’ve never been prone to buckling under pressure. Now I could barely get to work and I didn’t give a damn about the projects that I was responsible for. My wife finally forced me to see a psychiatrist, I started to feel better on an antidepressant, and then my internist really surprised me by telling me my testosterone was low and I should try a trial of replacement therapy, which I did. Within 2 weeks I was back to normal and a few weeks later I stopped the antidepressant. So now I wonder whether I was really depressed or not or whether I should have tried antidepressant in the first place. My goal is to figure out my diagnosis so I’ll know what to expect.
Even on that rare occasion when a specific psychiatric diagnosis really matters, it doesn’t matter as much as you think. Yes, it was critical to your recovery that you and your doctors checked out testosterone deficiency as a possible cause of depression; the sudden, unexpected onset of your symptoms raised the odds of your having an unusual and potentially curable cause, which deserved an extensive workup of your hormone levels, vitamin levels, evidence of inflammation, etc., so congrats for making a good decision.
You also discovered that depressive symptoms may have many causes, making depression less of a diagnosis than a cluster of symptoms. So, much like aspirin, antidepressants can improve symptoms, no matter what the cause, if they work at all. (Unfortunately, no matter what the cause, antidepressant trials often fail [35% for each trial] and require lots of time [three to four weeks] before there are noticeable results.)
In addition to lucking out with both the diagnosis and the response to antidepressants, you learned a valuable lesson, which is that anyone can get depression. It wasn’t caused by bad psychological or medical hygiene, just bad luck. Getting depression often doesn’t have a deeper meaning other than that we live in a tough, unfair world where people often get sick for no reason, and sometimes that sickness makes your brain miserable.
Your own observations are the best guide to your prognosis. If you responded rapidly to getting testosterone replacement therapy, then you may be relatively unlikely to get depressive symptoms again (as long as you continue taking the testosterone, which you may need indefinitely). At some point, if you want to experiment with reducing the testosterone treatment, ask your physician about the odds and choose a good time for experimenting, when not too much else is going on in your life.
From what you know, there’s no reason to think that your prognosis—your expected luck—is worse than anyone else’s. You made good choices, which is an essential survival skill when you happen to live in a bad luck world.
STATEMENT:
“I’d love to take my mental health for granted the way I used to, and maybe I will, after enough time of not feeling depressed has passed, but there’s no escaping knowing how easy it is to get sick. I’m proud of having made good decisions and happy to have gotten lucky enough to almost balance the bad luck I had to get sick in the first place.”
Posted by fxckfeelings on August 6, 2012
Like all symptoms of mental illness, anxiety and suicidal feelings seem controllable since they’re related to thoughts and how we look at things, especially since they have the potential to be so destructive. In reality, their primary causes are powerful, mysterious and, whether rooted in past events or biology, are not curable or easily reversible by the best treatments, most loving families, and strongest willpower. What good treatment and a loving family can do, however, is give meaning to the courage it takes to ignore pain and dangerous impulses, giving one comfort, if not control.
–Dr. Lastname
How do you get rid of the pain from your child’s suicide? My son died four years ago, and our entire family is still devastated. We are all now living with depression, anger, and our own thoughts of suicide at times. We are all in therapy but it’s moving so slowly, it doesn’t feel like life is moving forward. After a tragedy like this, how do you get your purpose back?
While I can’t imagine anything much worse than having your child suicide, the key to surviving it is to understand how similar it is to having your child die of any other cause. No parents should have to bury their child, no matter how that child’s life ended.
Intuitively, suicide feels like a preventable cause of death, so it seems justified to review the many would-haves and could-haves leading up to it.
Mental health professionals sometimes make things worse by focusing on such possible “causes” as unacknowledged trauma, unshared feelings, or unrecognized calls for help, all of which mean blame. Blame then feeds the depression and anger you talk about, poisoning normal grief with feelings of guilt, regret, and failure. WAIT! There is more to read… read on »
Posted by fxckfeelings on July 16, 2012
While plenty of crazy people make their mental state known with a tell-tale twitch or tinfoil hat, a severely manic person can look relatively sane and still be completely bonkers when it comes to making decisions about life, love, and money. Our laws allow them to fly under the commitment radar until their behavior gets so erratic that they’re about to fly off a mental cliff, whereupon the police (with your help) can take them off to treatment. So if you wish to help someone who is mildly manic, don’t hesitate to offer good advice. If someone is very manic, however, your helpful words may cause nothing but fear, aggravation, and mental jet fuel, so you will need to be quiet, patient, and knowledgeable about commitment law to be helpful when things get out of hand and the tinfoil hats come on.
–Dr. Lastname
I was diagnosed bipolar as an adult and usually take some lithium to deal with it, but, for a few weeks last month, I started to get manic. I rode it out by spending all my time in church and buying a lot of philosophy books. It wasn’t too bad—I just wasted a little money and a lot of time, but otherwise, I felt kinda great, and I haven’t felt depressed, at least not yet. Now I’m back to my old self, but I’m not sure where the mania came from, or when/if it’s going to come back. My goal is to figure out what it happened.
What happened when you got manic is that you got manic, forgetting who you are and what you wanted to do with your mania. That’s what mania tends to do.
It gives you strong feelings that need immediate expression because you feel more real and “in the moment.” It tells you what to do, whether it’s cleaning the house all night, sleeping with as many strangers as possible, or spending your bankroll on religious literature.
What you want—you, as a person and manager of your own interests, rather than a manic diagnosis—is to figure out, during a sane moment, how much manic behavior is safe, where to draw the line, and what you want done about it by you, and if you’re out of commission, what you want done by others. You say nothing about that in your letter; unfortunately, you don’t seem to be present other than as a passive eyewitness to your symptomatic self. WAIT! There is more to read… read on »
Posted by fxckfeelings on July 12, 2012
When a bad habit gets between you and something you really want, it’s hard not to expect that good motivation, loads of therapy and deep insight into why you’re fucking up will give you the control you need. Unfortunately, bad habits don’t have easy solutions; they often have a life of their own and, short of administering a good ol’ lobotomy, the power of therapists often falls short. That’s when you need to accept that, for many of us, the best solution for bad habits isn’t a great therapist, but good management.
–Dr. Lastname
I don’t know why I’m always getting in my own way, but I’ve been a fuck-up since I was a kid in foster care (my parents were drug addicts who couldn’t take care of me). I’ve managed to hold the job that I really love, but I almost lost it after 5 happy, productive years because, for a 6 month period, I couldn’t get myself to show up on time. I’d get up on time, but then find some reason to arrive late, and I couldn’t stop myself until I was within an inch of being fired. I got it together to find a therapist, but I can’t get myself to take medication he prescribes, even though I think it could really help me. I also can’t get rid of my drug-addict girlfriend though I and all my friends think she’s a deadbeat user who does nothing for me. My therapist says I have a problem with self-esteem. My goal is to get control of my life.
It would be nice if the only thing standing between you and keeping your job safe, your home ex-girlfriend-free, and your sanity was depression, fatigue, or low self-esteem, but your problem is probably worse than that. It’s not a matter of what you have; it’s more who you are.
So if you think that a supportive therapist or a pick-me-up drug will do the job, you’re wasting your time and heading for more self-disappointment. You did a great job of diagnosing yourself from the get-go—you’re a fuck-up—and, while you’re not hopeless, you’re not going to get the help you need that easily. WAIT! There is more to read… read on »
Posted by fxckfeelings on May 31, 2012
The helplessness of trying to help troubled kids often brings out the fighting spirit in those who care the most. Unfortunately, without a clear enemy from which you can rescue your child, you often fight for goals that can’t happen, target other would-be helpers, and make a bad thing worse. Regardless of how helpless you feel, your goal isn’t to save troubled children from a monster or a mental illness; it’s to find out if there’s something you can do that will actually help while avoiding direct emotional conflict. Not fighting won’t relieve your helplessness, but it will let you work towards something better.
-http://www.fxckfeelings.com/ask-for-help/
My ex-wife, who is a therapist, is spooking me out about our son, whom she says she’s treating for a variety of serious problems. He’s now 10, and he’ll tell me one day, when I’ve got visitation, that he’s having suicidal thoughts, using grown-up phrases that make me think he’s just repeating something he got out of a book or from TV. Then she’ll keep him home from school and stop visitation for a couple weeks while she does “therapy” with him, at the end of which time she’ll declare that the problem is solved. A few weeks later, he won’t show up and she tells me she’s keeping him home for treatment because he’s having “panic attacks.” My kid needs help and I can’t believe her treatment is doing any good. Meanwhile, he’s not getting help from anyone else, especially not the staff of his school, who are eager to help but never see him enough (they’re already bending over backwards to keep him from repeating this year and are trying to avoid reporting him for truancy, given the number of school days he’s missed). My goal is to get my son the help he needs.
It’s hard not to unleash your wrath when your ex-wife’s insistence on playing doctor blocks the real doctor from getting through. Your own child is in trouble, your ex’s behavior is troubling, and you’re this close to tearing her a new one.
Remember, however, that nuclear wars between protective caregivers are costly and often harm the one you most want to rescue; by fighting against your ex-wife’s treatment, you’d just be increasing her blast range.
The first thing to do then is to consider the alternatives while taking comfort in the fact that there’s a great deal you can learn about your child’s problems, and a great deal you can do to help. But it’ll only work if you take things one at a time instead of taking your wife down. WAIT! There is more to read… read on »
Posted by fxckfeelings on May 7, 2012
Particularly when you’re expecting to raise kids, there are good reasons to commit yourself to caring for your partner through thick and thin, sickness and health. What you should recognize from the beginning, however, is that uncontrollable, bad things can happen that can make a partnership dangerous and destructive to one or more family members and then it’s your responsibility, as an individual, to do what’s necessary. Mental and neurologic illness can change personalities and create overwhelming burdens. Unrecognized character problems are equally uncontrollable and can have a similar impact. When you take your vows, keep this in mind and remember, many people who divorce are trying to choose the least of the evils that face them and haven’t forgotten the promises they made.
–Dr. Lastname (Doctor only today– the writer half is under the weather)
When I was manic and crazy, I really fucked up my marriage. For 6 months, I was talking fast, flinging money around, drinking hard, sleeping with anyone I could catch, and generally acting like an asshole. The third time I went into the hospital, the doctors found a medication that worked and, since then, I’m back to my old self but my wife has decided it’s all over. She goes out without me whenever she can and acts like she’s angry whenever we’re together. I can understand her feelings, but she won’t accept my apology. For the last 6 months, I’ve shown her my old, reliable self, but I can’t win back her trust. The problem is my bad; I should be able to make it right.
We all want marital vows to overcome whatever bad things life throws at us, and so we promise to care for our partners through thick and thin, unconditionally.
What’s stupid about such promises, however, is that some of those bad things are the size of an asteroid and can wipe out any marriage, regardless of how strong the love and commitment, and feeling obliged to stick with vows that have no escape clauses can drive you crazy.
Yes, your wife should forgive you for having a manic episode: you couldn’t help it and the part you can help—taking your medication—you’re doing well. It takes courage to resume your life and face the people you know after the humiliation and chaos of acting like a crazy jerk.
The sad thing that can’t be helped isn’t your illness; it’s your wife’s reaction to it. I assume you and others have done all you can to educate her about it and you’ve had a good opportunity to show her what your values are and regain her confidence, now that you’re well again. If it hasn’t worked, it’s not because there’s something wrong with your approach: it’s probably because there’s something wrong with your wife’s character. She just doesn’t have the strength.
Look at her closely, and you’ll probably find she’s never had the strength, meaning that she’s never been able to keep a relationship going if it hurt her too much. That’s why it’s important, when looking for a partner, to find someone who’s shown an ability to stick by her friends and family regardless of hurt. It’s a quality that’s even more important than the fact that you love one another. Without it, you’re fucked. Now you know.
So don’t make yourself responsible for her reaction, as sad as it is. You didn’t cause your illness or give her the character she has. Don’t apologize. Don’t beg. Let her know you understand your illness put her through a very hard time, but that you’re confident that you’ve recovered and that you can again be a good partner. Maybe surviving this hard time has made you stronger and wiser. In any case, if she still wants the partnership, it’s hers; if not, you both need to move on.
You need someone strong who can still love you after a manic episode, and she needs someone lucky who doesn’t get sick.
STATEMENT:
“I feel like I destroyed my marriage and it’s my job to get it back, but I know I didn’t cause my illness, and I’m proud of the way I manage it. I can’t help it if my wife can’t tolerate it, but I know I need a wife who can.”
After her last hospitalization a year ago, my wife didn’t recover all that much, and she’s gradually become very different from the woman I married. Her psychiatrists tell me there’s no new treatment to try (she didn’t tolerate clozapine, which is the Hail Mary treatment for crazy thinking) and she’s probably not going to recover much more than she has now. She’s able to keep herself clean, but she still hears voices, looks befuddled, and thinks I’m spying on her for the FBI. She can do simple chores, but she’s very distractible. Most nights, she sleeps at her mother’s house because that’s where she’s most comfortable. I’ve got used to taking care of the kids on my own, and I can’t trust her with them when she’s around. I miss her terribly and I promised to stand by her in sickness and health, but I don’t know that I can stand this much longer. I feel bad about deserting her when she really can’t help it, but taking care of her and the kids is more than I can manage.
You sound like you’ve done all you can to help your wife recover from severe mental illness and it isn’t going to happen. Instead of blaming yourself or anyone else for her failed recovery, you’re facing it as a sad fact of life. What troubles you most is dealing with your marital vows to stick together through sickness and health.
Marital vows ignore the fact that some illnesses can destroy a family and present you with impossible choices. Most times, sticking together is manageable, better than the alternative, good for the kids, and the right thing to do. It’s not hard to imagine situations, however, when sticking with someone does no good for them, destroys your life, and is bad for the kids. No one likes to think of those things at a wedding, or ever.
Put aside your guilt long enough to ask yourself what she would expect of you if she were her old self and what you would expect of her if your positions were reversed. Assume that you both believe in standing by the one you love, but not if it does no good, or overwhelms the resources of the healthy partner, or endangers the kids and their future. Assess the impact she has on them and they on her. Take into account that she probably qualifies for social security/disability and may also be eligible for state services for the chronically mentally ill.
Don’t assume that the path that hurts most is the one that’s right. This is not a conflict between duty and pleasure or between selfless vows and selfishness. It’s a conflict between your responsibility to care for your wife and your assessment of the value of your sacrifice, the good it can do, and the harm it can cause to your other responsibilities.
Either way, it breaks your heart, but you have an administrative responsibility as the sole leader of the family and you need to do what will do the most good/least harm. Whatever you choose, respect yourself for bearing the burden of this choice.
STATEMENT:
“I feel like I can’t leave my marriage without breaking my vows and deserting my wife when she needs me most. I can’t help the fact that she’s no longer the same person and doesn’t get much from being married to me. I’ll try to weigh the competing ethical responsibilities and do the right thing, knowing there’s no way to do right without also causing harm.”
