Question for those in the know.

My wife has a bipolar diagnosis (type 2 I reckon, but no distinction back in the day). She is currently hypomanic, but she always has had some idiosyncratic symptoms that has me wondering about comorbidities or possibly even a misdiagnosis.

She speaks of episodes in her life as "masks" she's worn along the way. Long ago, during an episode called by her professionals post-partum psychosis, she had very noticeable disassociative symptoms. Her current m.o. is that she "has to" shed her latest mask, and needs to be completely free from anything that "tries" to return her to her old one. This current one she acknowledges to be an escape, and she is aggressively fighting any attempt to tie the clearly unhealthy and/or irrational ideas she has to any diagnosis. Like she'll admit that she was suicidal, but not that she was bipolar, or needs psychological care. She'll acknowledge that what she is doing now is escapism, but won't allow any abstraction from that...that she's manic/hypomanic, needs professional help etc., but will admit that it's not good, but states there are no other options.

Throughout our lives she's been incredibly episodic, but not always in a clearly depressed to manic pattern. For instance, the last 10 years have been largely depressed, but there's been a lot of episodes where she's clearly a different person. There's continuity between these "people" she assumes, in fact she sells it in a very generic/normal context most times, but other times she'll acknowledge how disordered it really is.

In her mind, for her to become an attentive, functioning mother and wife, she needs to assume a certain identity, an identity that will make her so miserable that she'll kill herself most likely. She's used language like this a lot over the years, and she can't separate behaviors from the paradigms or masks, versus behaviors we simply integrate into ourselves. It's as though she doesn't understand how healthy/most people change and evolve over time.

So all that for, does that sound consistent with simple bipolar? I've often thought she had a more complicated mental health profile than that.

BTW I am well aware nobody can give a diagnosis here, nor would I expect anything definitive if one were to take a shot at it anyway. I'm just looking for feedback to see if I'm off base in my speculation about this being somewhat atypical for bipolar, or if it's 100% within the realm of experience for many people with bipolar.

Thanks

This sounds like more then bipolar to me. Is your wife open to to being evaluated by a psychiatrist?

Well...right now she's not. We've been having a lot of hard conversations lately, but has taken mental health off the table. It's weird, she says so many things that beg the question (are these the words of a mentally ill person?) but she's not going to entertain that right now. If/when she comes down, especially if it's not a soft landing, she'll be more amenable.

Here's some history.

She is the first person to recommend somebody else gets help.

Anytime she's been compliant, it's only been when it's easy and new.

She has been known to play with, and befriend her therapists. She's smart, and a couple of her therapists haven't been. Doesn't like most of them.

Can be really cynical about mental health treatment for herself, despite being eager to see others get care.

I'm not sure how honest she has always been with her professionals.

She was professionally tested years ago. I believe the MMPI was one of the tests, but I believe the clinician did additional testing. He felt she scored high for bipolar, and near threshold for borderline. I'm not sure of the methodology.

Yuck

My heart goes out to you. I'm bipolar and I've put my husband through hell. Mostly from being morbidly depressed and not wanting to do anything. I finally got help from a pdoc and meds, and my quality of life is much better, for myself and my husband too. Thank god there are no children in the picture to complicate things.

I don't know if your wife has another issue besides bipolar. My sister is bipolar and untreated, she's also alcoholic. I feel sorry for her but also her husband. She insists that she has a right to live her life as she she's fit. True to some extent, but she parties and drinks, has affairs and just in general lives a self destructive life in front of her children.

Her husband does everything to keep that family going. Works full time, cares for the children, grocery shops, cooks, handles the laundry, etc. Sister surfs the internet, smokes and drinks until the wee hours. Then when she's especially manic, she's starts destroying things, furniture, TVs, computers, potted plants.

He had her hospitalized against her will once, and she hates him for it. I see his point of view though. He has children to think of.

Your wife may take mental illness and treatment off the table. But you have every right to put it back ON the table. It's your life too. Perhaps you could try going to therapy together. She can share her point of view but you can and have a right to share your point of view and how her behavior is effecting your life and the life of your children.

I hope your family can get help. You all deserve it.

No, that does not sound like it's an aspect of bipolar disorder. She might very well have bipolar, but the 'mask' or identity thing sounds more like a personality issue.

Wow that sounds horrible. Fortunately, my experiences have never been that severe. She's gone off the reservation a couple of times, but I think she's got some inner voice that makes her play it safe when she gets going. She'll be really rebellious, but seems to want to check in and make sure I'm OK sometimes. She also sets things up where it's a little easier for me to tolerate. So for instance, this new episode involves her going out drinking fairly often. She makes it safe by playing wingman for our male gay friends, usually at gay-friendly venues. She'll get drunk, but not falling down, she'll stay away from the house, but does some things with the kids, and doesn't ignore the big things like birthdays etc.

So although she scares me by being erratic, she likes to push boundaries more than shattering them. I think under a lot of stress she could blow up those boundaries, but right now...she's staying on this side of them. It's a bit weird to describe, because it's not good by any stretch, but it's like she likes the trapeze, but wants the safety net deployed.

Not a doctor but almost sounds like BPD with a little bipolar thrown in there for good measure.

Yes to you and the other person who sees BPD. We had a psychologist who thought he saw BPD. I think she has both mood and personality disorder characteristics. The personality disorder is manageable but ever-present even during depressive states. However, it makes her UP periods particularly hard.

From my personal point of view, your description of your wife sounds like a well meaning but overly simplified version of her actual problems. I don't know why I get this feeling, but I do. I'd say there is certainly something going on but I'd never be reckless enough to make any determinations based on what seems to be a tiny part of a bigger issue. It could be so many things. How an illness manifests can be very personalized. Most people have issues they should work on, including those with Bipolar, so likely she's dealing with a combo of several unhealthy varieties.

There are often ways in which family members can nudge or shove a person in the direction of seeking help. How this is done can be very individualized and often needs to be tailored to the individual. Have you considered getting therapy yourself to get support and possible advise on ways to handle or cope with this?

Certainly simplified; I've posted more detail across a few other threads. In this case I wasn't trying to develop a full picture, I was sharing a few things that stand apart from what I can easily describe within bipolar.

Thanks, I've been seeing a therapist. In fact, I started with anxiety a few months ago, and I think it was really my early warning system coming online. I had started coming less often when things went off the rails. I've seen him three times in two weeks. I really trust this guy too, which is great.

I'm glad you're going to therapy and getting help