Spouse with treatment resistant bipolar 2

Hi all,
I'm sorry if this is the wrong place to post. My spouse was diagnosed 20 years ago with bipolar 2. She's been through every medication and none of them work anymore or have life threatening side effects. She's very treatment compliant, has a great psychiatrist and therapist, and is doing her best, she really is. It's a devastating situation. The only thing left, according to her psychiatrist is ECT. So, she's looking into that.

The issue is she won't talk to me about it at all. I've tried to research ECT and discuss what to expect, but she won't talk. This isn't new. She is not a big talker. She is really kind of silent all the time, silent and really really grumpy. I know this is bipolar depression, but after 10 years together, there is simply no fun, no joy, no happiness at all ever. I've forgotten what it is like to have a partner that you can laugh and joke with. I have a therapist, but it doesn't seem like anyone understands that this really not only is devastating for her, but I feel like I have absolutely no life, no passion, no joy anymore. The energy has been sucked out of me with the constant depression (hypomania for her is dysphoric and rare). I don't know what to do about this especially since she refuses to talk. If anyone can give insight I'd appreciate it.

Welcome to MSF @monchi - I am sorry that you are facing a difficult situation. I can speak from my own experience with med resistant bipolar with my partner that they are always in a state of flux. Sometimes I feel I have two partners, one who is depressed and one who thiinks they can solve all the problems of the world, but they just cannot be the way they were when we met.

The meds keep them stable after ECT treatments but the meds alone do not. They have been hospitalized multiple times and had ECT dozens of times. Ask the doctor if they can try Single sided ECT first as that is reported to have less effect on memory, although in either case emory improves over a period of weeks. ANesthesia is required.

TMS or transmagnetic Stimulation is less of a problem with memory but it may not be covered by insurance and it requires daily visits for a number of weeks and not every facility does TMS.

I do not know what to suggest of dealing with your partner. I experience their procrastination and anxiety when I want to discuss things with my partner. They often "cannot think."

What I have done is reinvent my life in terms of not looking to my partner for y happiness although I am still supportive. I do 5 minute Tai Chi and Adrienne's complete beginner yoga on youtube and that heps my energy. I volunteer online and belong to anonymous communities and support groups that help me.

CANDC

[If you want me to see your reply to this post please tag me by including @CANDC in your message - not in requoting my message and not the first word of your message]

For treatment-resistant Bipolar I, Clozapine should be considered before ECT, and can be a transformative treatment. See Clozapine As Transformative Treatment In Bipolar Patients - PMC But I have not heard of Clozapine as the last resort psychopharmaceutical in Bipolar II. I wonder if your wife has tried it. It is not an easy medication to take and you need frequent blood draws in the beginning of treatment, but it changes the course of illness for many people, for the better.

I also wonder if the therapist has tried Just a moment..., an evidence-based therapy developed specifically for Bipolar patients. I think it will suit your wife well, from your description.

How do you do your own self-care in the face of this big challenge?