Wife has serious delusions after mania and refuses medication

[Little]

My wife came out of a manic phase about a week ago. This was only the second manic phase she has had in our marriage of over twenty years. The previous one was over 15 years ago and for the last 15 years, we've led a relatively normal life, with her free from medication.

This time, she was involuntarily hospitalized, which traumatized her and made her incredibly angry. She blames me indirectly for this. Her previous manic phase came after 7 years of psychiatric treatment for depression. She suffered from strong side-effects during this time and from the medication they gave her for mania and this made her become strongly against western medication of all kinds. She doesn't even take Panadol.

So, this time around, she reluctantly took medication while in hospital but has not taken any since leaving. There is zero chance of me convincing her to do so or convince  her that she is ill. In her mind, she is channelling and is on line.

She now does not have mania, but retains very strong delusions that there is an evil organisation out to get her. She believes they are monitoring her flat and around half the city are employed to watch her and trick her, including cleaners and members of the public.

She has zero tendency to self-harm, but she is impossible to live with (we now live apart but see each other daily). Also, it's becoming a problem when she confronts someone sitting next to us in a restaurant in the belief they are a spy sent to watch her. Having said that, she normally leaves when she feels threatened and she isn't a physical threat to anyone. She did leave her flat at 4am this morning to walk the streets because she believed the flat was haunted. She also keeps on throwing her phone away because she thinks she is being tracked.

Forced hospitalization is not an option because that would push her towards self-harm and giving up the will to live. This is one thing she has voiced very clearly. I see our only option at this stage as being me monitoring her while she "rides it out." In her previous manic phase, the delusions eventually disappeared without medication over time, but that was.very tough going

I crash read, 'I am not sick. I don't need help" over the past week, which details how to use LEAP. I've tried this, but am well away from being able to coax her to take medication as a "partner."

Any ideas would be appreciated.

[Little]

Thankyou therising,

I keep telling myself to trust in the universe and so far, I believe that things are slowly getting better on the whole. My wife is much safer than 2.5 weeks ago. I also feel like I am getting more clarity on where I am in terms of what I can do to help her, my boundaries, etc... For example, I was super-stressed when she insisted I make complaints on her behalf and I sent her a message saying that I wouldn't. I was really worried at what her response would be and it just seemed to fizzle out to nothing. So, this is some progress - I enforced a boundary. 

She also isn't happy that I am returning to Melbourne tomorrow night for three days (four nights). In the last, I would have agreed to cut the trip short, but this time around, I didn't change. I know that she can't go out for day trips from the centre without me, but I need a break, have a gig and a band practice in Melbourne and have to met the lawyer, etc...

I guess it's going to be hard not to be worried about her for quite some time, but it will help when I can relinquish the reins a bit to the professionals. I didn't do this enough a month ago which could have resulted in a better outcome earlier. For example, I could have called the professionals earlier to tell them that she wasn't taking her prescribed medication. 

Actually, the knowledge that we are no longer married in the real sense, is slowly making it easier to detach and be more objective. 

[Croix]

Dear Little~

I'm glad you recognize your limitations, that there is no way you can be a carer for somone who is delusional and that keeping your life in Melbourne and the music is something it's not possible to give up. Also that you refusing to make a complaint went well.

I did want to mention one thing that became apparent in my family. While the member was in the hospital they had taken charge of the patient, talked with next of kin and made plans for the discharge.

When the discharge came they seemed to relinquish any further responsibility, handing over to the person's GP for everything. There were no talks with the Hospital psychiatrist about the patient and they had switched their attention to other patients. I don't know if outpatient care was available, in some hospitals it may be, provided there is not an excessive wait.

This made a big difference to the family, who no longer realy had a point of contact with clinicians, It also made a big difference to hte patient , who was now in a different environment and had to behave in a successful manner looking after themselves as well as interacting with the family.

When discharge comes for your ex there may still be delusions or unrealistic expectations (perhaps you have been given an unofficial opinion on this). What I'm saying is I'd suggest you be prepared for this and may not be able to anticipate what will happen. It is even conceivable she might turn up in Melbourne at some stage despite her plans to stay in Adelaide. Even the divorce may not be straightforward .

It is a very heart-breaking, stressful and worrying time for you and judging fro the other members of my family there was a great deal of worry over how much responsibility for ongoing care they should take. Fortunately for all concerned the family member was rational and capable when discharged and things went reasonable smoothly.

The person you married is not the person in the ward now calling you her ex, and is not the person with the delusions they had before being hospitalized. If you remained together I guess you would alway be waiting for things to degenerate, not an ideal basis for a relationship.

Please don't think I'm trying to give advice or make suggestions as to your plans, I'm simply trying to relate the experiences of my family in case that helps.

I have to say you have coped with all of this and handled it in a really marvelous manner.

Croix

[therising]

Hi Little

Completely understandable how it's going to take some time for you to get used to not being your wife's carer. Definitely makes some difference when there are other people caring for her. As Croix touches on, having plans in place for ongoing professional care outside of the facility could help put you mind at ease even further. 

Strange to think that most of us are never given skills when it comes to how to constructively care less or care less intensely or in different ways. We can be left flying blind (with no vision) when it comes to how to master this. A learn as you go kind of thing. I smile as I say that sometimes I ask my kids (20yo son and 23yo daughter) 'Am I not caring enough, in this case? Am I being a little too emotionally detached?'. They're good for constructive feedback. On occasion they may advise along the lines of 'You're all good. Emotional detachment is important in this case if you want to save your sanity' or 'You could try caring a little more. Your lack of care is having a significant impact'. Care and the emotions that come with it involves a volume dial. At 55 I'm still learning how to manage the dial, when and how to dial things up and down. Being conditioned to always care at full volume can definitely become exhausting. Learning how to put the people pleaser in us on mute can also be a part of the challenge. Sometimes channeling our inner sage is what makes the difference. 'How do I need to take better care of myself at this time?' can be a good question for our inner sage. While we can be facing some breathtaking challenges, which can literally change our breathing patterns, the best advice may sound like 'For a start, you need to breathe'.😊