I am 40, have 4 children and have had recurrent depressive episodes.
I have been diagnosed as Bipolar, despite the fact I have had no true
manic episodes. I may have had some hypomanic episodes. I have had a
history of excess spending of money, inability to control spending,
compulsive eating, mood swings, irritability, and lack of interest in
sex. My husband and I have been married almost 20 years, and he has
been very patient. I was tried on lithium for 6 months, but didn't care
for the side effects.. mainly extreme fatigue. I stopped the lithium
almost 3 months ago, but am still taking xanax and prozac. I want to
save my marriage and am also concerned about the effect my moods are
having on my kids.
I am a registered nurse and have just realized
the adverse effect my variances in energy and mood have had on my
career. My family doctor sent me to a psychiatrist, who now won't
see me because I owe her money and currently am unable to pay, even
though I have insurance. I need alternatives in therapy, and direction.
I am not now nor have I ever been suicidal. I have had one partial
hospitalization, but was not diagnosed with Bipolar at that time.
Help, I want to turn my marriage around.
ANSWER: It is not your moods alone that cause disturbances
in your relationships and achieving your goals. It is the behavior
you engage in that damages your relationships and thwarts your personal
goals. We all must learn how to nurture ourselves, and regulate our
self-esteem. We learn patterns of behavior in childhood, including
how to respond to our moods. Though medication may help adjust neurochemical
imbalances, it will not help you learn new behavioral patterns or
build deeper internal stability!
You are gaining insight and objectivity into the
effect of your actions on others. And you are confronting the self
sabotaging patterns of your behavior on your career. This newfound
awareness means that you are ready to develop a psychotherapeutic
relationship that can help you learn the internal soothing needed
to allow you to change the ways you behave towards others that are
self-destructive. You should not be on medication alone, without psychotherapy.
The medication can help stabilize chemical imbalances, but you need
a concurrent therapeutic relationship with a professional therapist
with whom you can develop trust to further reflect and amplify your
recent and valuable insights. You are on the edge of new growth. But
you cannot do it alone!
Find a professional counselor you can trust. A licensed
social worker, psychologist or other professionally licensed counselor
(such as marriage and family in the state of California) who is trained
in early childhood development and family systems would be a good
choice. Interview them regarding their experience with depression,
including bipolar disorder. Choose an experienced counselor who can
address family and individual issues as they emerge. And one you feel
to be a good "fit" for your personality. Couples' counseling will
also be needed to help reinforce therapeutic goals at some point.
Find a counselor who can refer you to a psychiatrist who is willing
to consult regarding medication. To a large degree, psychiatrists
are trained in pharmacology, but may lack the in-depth psychological
training to reprogram behavior in a proactive and thorough manner
necessary to turn around family patterns and relationships. Relatively
few psychiatrists are trained in family systems theory, but may be
quite knowledgeable about useful psychopharmacological interventions.
Be sure the psychiatrist you choose supports psychotherapy. With the
use of medication which can stabilize your neurochemical influences
on moods, you may be in a position to quiet the noise inside, so that
you can focus upon the behavioral changes you want to make in your
Through concerted effort, your situation can change.
One example of such turnaround took place in my practice with a wife
and her husband of 12 years. The husband expressed hopelessness over
a long-standing but emotionally excruciating couples' pattern. He
experienced deep pain when his wife used name calling to influence
him during arguments. He had come from a family where no such words
were ever exchanged, no matter how angry family members became with
each other. She came from a family that commonly swore and used name
calling whenever anger flared. She came to realize that his need for
rules around conflict needed to include abstaining from calling names,
as the effect on him was deeply damaging. But she could not simply
change her behavior! Through individual psychotherapy she had been
able to change this destructive behavior towards her children but
had been unable to suppress this programming in the heat of discussions
with her spouse.
It was ingrained in her neurological "wiring" that
whenever anger coursed through her veins, expletives were released
from her mouth! It was OK with Mom and Dad, so why not in her own
marriage? Though she intellectually knew that she did not want to
continue this behavior with her husband, she found it impossible to
control when she was in a desperately angry and depressed mood.
Several attempts were made towards allowing her to
reach out to her husband when she felt this desperation, rather than
push away and isolate. With consistent effort, she was able to build
strategies, such as taking a walk when she felt explosive, in order
to clam down, reach out for help when she became calm, and notes on
the refrigerator to remind her of the steps she could take to curtail
destructive behavior and build in constructive discussion. She gradually
learned to tolerate differences without exploding. And was able to
clarify and express her needs much more effectively in the couples'
Relearning deeply ingrained behavior takes time and
love. You need support to explore and then work through mood induced
behavior that is destructive and self-sabotaging. Use the loving relationships
you have to help you turn this dragon around. It is bigger than you,
and you will need help to do so. But do not despair, you can make
progress with the valuable insights you have already found. Our behavior
is conditioned through our emotions. The only way to recondition ourselves
is through this same emotional sphere. Healing relationships can help
you turn this energy around. But like learning to ride a bicycle,
you will have to fall down before you gradually achieve the automatic
and unconscious control you desire.
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