Bipolar rage - how to deal with husband’s melt-down

[Sapphira]

My husband was diagnosed with bipolar 2 a couple of years ago. It has been a journey. Getting meds right, keeping him going to a psych...there are many challenges but mostly things are vastly improved since before diagnosis and medication.
Last night our adult daughter was over and an argument got out of control. He totally lost it. He had been drinking (he doesn’t usually drink more than a couple of wines) and I’m wondering if that was the trigger, combined with his BP meds.
His violent shouting was so full-on and abusive that we are all upset and in shock today. He threw things and also shoved me when I challenged him. I’m angry at him but also know that it’s his brain and the condition. Does anyone have experience with bipolar rage, and how best to handle the aftermath? I think he needs a trip to the psychiatrist ASAP, but we all know how hard it can be to get an appointment. Also wondering if an inpatient stay would help. Does anyone know how I could make that happen? A normal person would ‘just leave’ but instead I would like to use this terrible event to push him to getting more intensive mental health support... I’d like to hear from bipolar carers or maybe people with BP2 on what approaches worked to persuade them to get help when things went bad...

[white knight]

Hi, welcome

I have bp2. I had a previous relationship 1997-2007 whereby she had the wrong approach. E.g. she didn't accept that a meltdown or blow up doesn't last very long and once calmed down there is no fragments left of the event...back to normal (normal for me). However she'd ring my psychiatrist and he'd change my meds and take her side in events that were not necessarily mine in error. E.g. she was an alcoholic and physically assaulted me when drunk- often.

There was also her threat that she wanted me to be admitted to in patient care. I felt trapped and left her!

In contrast my now wife since 2011 has more patience, she never considers in patient care, suggests things like going to bed early when tired and is more compassionate. As a result I haven't had a blow up since we first dated.

"Also wondering if an inpatient stay would help. Does anyone know how I could make that happen?"

Well a doctor has to assess there is a need e.g. was his blow up the result of bp2 alone? Or was it due to stresses brought about by other factors? Was his medication ok? Is stress a factor ? Is alcohol abuse present? etc.

As an example if alcohol is out of control it's a separate issue to address. Inpatient care might be the wrong course or not even appropriate.

The bulk of your post is about a domestic situation. Him "shoving you" is unacceptable. You "challenging" him could have made the situation worse. What I'm saying here is that two people without a mental illness arguing often split up but if one has a mental illness- how do I get him into inpatient hospital"?

I don't see that as a positive way to assist your husband.

He needs patience, an approach to lessen alcohol intake and maybe anger management?

Just my views, others might think otherwise.

TonyWK

[quirkywords]

Saphira welcome to the forum.

I am glad your husband’s health has vastly improved , so I am thinking maybe this outburst was a one off.

I have bipolar and have not heard of bipolar rage. I know when unmedicated and high I would get irritated easily and maybe get annoyed.

Is this a one off outburst , or something else.?

Did your husband say anything or apologise.?

Sometimes an outburst can be the result of tension and frustration.

Can you talk to your husband and explain how you feel ?

I used to be embarrassed after I said things I wished I had. These are just my thoughts. I understand how shocked and worried you are, would it be helpful for him to see his pysch doctor.

[Sapphira]

Thanks Tony for your thoughts. Things have calmed a bit. I went away for the day and came home to him to him cooking and cleaning. I still need my space. I am hurt because caregivers carry a lot and I am expected to forgive and forget. Soon I will be able to forgive, but I won’t forget because then we won’t move forward.
My question is - what do I do to make sure this doesn’t happen again? Of course I run through the options - inpatient, meds etc when someone is screaming the house down and frightening his kids. Am i forced to accept this is part of bipolar forever? It’s a horrible weight to bear - I won’t leave him because I do care but it is so very hard. Neither of us are substance dependent. He just drank a lot yesterday, unusual and I don’t know why he did unless it was part of the mania coming on. It it made him lose the plot.

[Sapphira]

Hi quirky words, thanks for replying. I appreciate hearing from folks who have BP, because you have unique insight. Maybe it was a one-off. Though it has happened in the past BEFORE diagnosis and meds. The meds usually work very well, but i am wondering if you can get a break through mania, even if on meds? He is partially in denial and doesn’t like to talk about it. Lots of masking and forgetting. I guess my real question is what do I do so this doesn’t happen again?

[quirkywords]

Sapphira ,

I can feel the pain, anguish , compassion and maybe bewilderment.
my outbursts and unacceptable behaviour happened before I was medicated but everyone is different so it is so hard to advise what do so it doesn’t happen again.

I feel that I had to be honest acknowledge my problems and have insights it to what triggers me, for me it was I give go too tired or too high then I became impatient and irritable.
if your husband can understand how upsetting his behaviour was , he maybe able to work out what happened.

I found keeping a notebook and writing down my behaviours and moods and what happened before helped me find a pattern. Yes it does happen that people get mania and or depression when on medication. Has the doctor been told.

If you google Black Dog institute has lots of information on bipolar.

I realise it is difficult and distressing for you and your family, and confusing for him.

I have guilt for what I put my family through but that was then and now. I can mange my bipolar but I always need to be vigilant.

[white knight]

Hi again
And thankyou to Quirky, she has BP2 also and on most BP topics we dont differ in opinion although male and female and environmental differences will always bring up some differences.
Sapphira, I have more time today and would like to mention several things that will help you and your family. I'm hoping your husband can read this also. They will include links to other threads that I encourage you to read after you've read my reply. There is a lot of ground to cover so it might take two posts. My one aim is to enable your marriage to survive happily as mine has.
My psychiatrist, upon my diagnosis 2009 said to my wife- "one of your biggest challenges is to determine if your husbands behaviour is a result of his personality or his illness. Or how large a portion of his behaviour is personality and made worse by his illness."
If for example alcohol was the main culprit of his anger outburst then it would be a gross injustice to blame the bipolar. Many people without a mental illness have outbursts of the same. But for him to be told its his illness, a condition thats lifelong with very limited capacity to resolve, AND to be told by yourself he could be a candidate for inpatient hospital stay is one way to enrage him further. I'm wanting to educate you about this without upsetting you and I appreciate your approach to us thus far about it. With only two years of diagnosis your knowledge of the illness and how to approach him is limited. For example- if you were in an accident and you'd had drank only one wine (well under the alcohol limit) and you were in the wrong...imagine how outraged you'd be if family members believed you were drunk and had an alcoholic issue? It is really important to hold back your judgements that have no evidence. eg it is only his bipolar to blame if his psychiatrist confirms that is what caused an event.

to be continued next page

TonyWK

[white knight]

continued

For that reason you can see clearer why my initial post was full of questions and in a way I challenges your assumptions that his anger was "bipolar rage", a term both Quirky and I doubt actually exists eg bipolar behaviour doesnt include "bipolar rage" as a distinct symptom. Hencemy belief that his rage on that day was more likely caused by other factors like family issues and/or alcohol. Now that isnt to say that his depression side of his moods contributed towards the extent of his anger but would not have been the cause. It is the cause that you need to determine.
Sensitivity can paly a large factor in Bipolar depending on the person. Men have different triggers than women in my observations and in your instance we are talking about your husband. This might help-
https://www.beyondblue.org.au/get-support/online-forums/relationship-and-family-issues/man's-disease-thinking-more-than-one-thing-at-a-time#qgkH9nHzvGGEbv8AAOnT_A
Some people bottle things up and explode. This might have been the case with your husband towards his daughter. Like many things if you could predict this is going to happen (if he indicates ongoing frstration with her over an issue) then its best, as his carer, to get it out of him in calm discussion over a cuppa (most of my issues are resolved over a cuppa with my wife). Effectively you are replacing a therapist which isnt a bad thing, its all relevant to your role...prevention of conflict.
https://www.beyondblue.org.au/get-support/online-forums/staying-well/who-cries-over-spilt-milk-#qt5QuHHzvGGEbv8AAOnT_A
THE PATIENTS RESPONSIBILITIES
As you eluded, a carers role is not easy. You have to be so many things other than the traditional spouse. Because of this a patients role (or sufferers role) is one that should ideally elevate upwards in effort purely for gratitude... extra thankyous and voices of appreciation. Unfortunately some sufferers do not have insight. There is a saying- "if you have insight with your mental illness then you are one of the lucky ones". That means lacking insight stops one from being aware of their behaviour adverse or otherwise. That downloads to whatever adverse effect on the carer is magnified.
https://www.beyondblue.org.au/get-support/online-forums/staying-well/embracing-the-embracer---calming-the-waters#qgoQHnHzvGGEbv8AAOnT_A
https://www.beyondblue.org.au/get-support/online-forums/staying-well/caring-for-your-'well'-partner#qf_8anHzvGGEbv8AAOnT_A

to be continued

TonyWK

[white knight]

continued

ABUSE
Any forms of abuse must cease- forever. What is abuse? It comes in many forms from yelling to physical assault and everything in between including manipulation and bullying. Hence my statement that pushing you is unacceptable as is "challenging him" depending upon what that actually is, but clearly not as clear cut as physical contact. Your ideal approach in this situation could be de-escalation and that approach is a far cry from how the situation developed. Overall I totally understand how you tackled the situation considering your lack of long term experience with bipolar. For this reason reading up on the disorder is paramount, seeking opinions as you have is commendable. It's a little like parenthood, some think parenting comes natural, wiser ones educate themselves to improve.
ACCEPTANCE OF MENTAL ILLNESS
Two years since diagnosis is not nearly long enough to accept the situation. It does take time to accept and live with it. In time it will for both of you - drop down to a less topical daily conversation.
MENTAL ILLNESS AND ALCOHOL
Simple- they dont mix. Your husband will not benefit from drinking in any way. Stop, simply stop.
I hope you have found this enlightening. We are here for you when ever you want to ask questions.
https://www.beyondblue.org.au/get-support/online-forums/supporting-family-and-friends-with-a-mental-health-condition-(carers)/tolerant-partners#qmPZo3HzvGGEbv8AAOnT_A

TonyWK

[Sapphira]

Thanks so much Quirky for your reply. My big challenge is that my husband doesn’t seem to have insight about his condition, in fact he is in denial. He does take his pills and he seems to think that is enough (and sometimes he forgets). I like your suggestion about keeping a diary, I wish I could suggest that. I will try when things get calmer. I wish there was some sort of counselling setting where we could discuss these things. He doesn’t want me to go to his psych with him, because he feels like the psych talks to me and excluded him. His psych suggested we come up with a signal word for me to use when I think he’s sounding a bit manic - but he hasn’t been able to do it yet. There just seems to be a lot of repressing and pretending they everything is fine - then this past week or so I noticed that he was talking more animatedly than usual and seemed more busy - but now I’m annoyed at myself that I didn’t notice those flags earlier. Now we’re all left bruised and upset. I feel like walking away, my daughter doesn’t want to see him and he wants to pretend like nothing happened. Of course I have compassion for the illness but it’s very hard to be treated like I don’t matter at all... I appreciate you taking the time to share your thoughts with me.