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Suggest Treatment For Sudden Onset Of Anger And Irritation Along With Depression In Spouse

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Posted on Fri, 7 Aug 2015
Question: Hi.
This is about my wife. She suffered a breakdown 6 weeks ago and entered a quite deep depression. She was behaving strangely a few weeks before and I feel so stupid I did not recognise her falling. I found out she had been in an emotional affair on line but found sexual comments from the other party on Twitter. I challenged her calmly and within hours she had collapsed and gone under the care of a crisis team for mental health. We have been together 24 years and married for 22. We have three children but all grown up now 17 to 22 with two living at home. I have discovered from my children that my wife has been complaining about me to them secretly over the years in their bedrooms since they were about 10! about me and saying cruel things. I think this depression has been coming a long time. She has severe sexual trauma from teen years rape, and a voilent second marriage where she was raped again. Our marriage was bumpy over the years, both of us had problems and she would shout and I would leave for days / weeks in the first 10 years. In 2003 I had an affair. We did reconcile through marriage counselling after 3 months apart. She has never got over it though even after forgiving me and it still dominates her trust issues to this day. She is receiving counselling through my corporate health plan but won't engage it at the moment until she moves out. She has demanded separation, separated bank accounts and is demanding I find her somewhere to live because she cannot manage the day to day finding a rented house to go to. I am doing this. We are separated but living under the same roof. She is not handling this well, keeps saying she wants to run run run, she blames me for everything but mostly harps back to the period from when we met 1991 to 2003 and my short affair (which I confessed) she is brutal and cruel in what she says to me. She remembers no happy times, she does not reflect on her own behaviour which has always been almost narrsistic through the marriage. Obsessed with her looks and wrinkles, getting older. She says she feels nothing inside, she feels dead. She. Says I am empty. I need to get away from you, the house the dog and responsibility at all. But when I pull away to try and find my strength to carry on ( two of my children are ASD) and need my support she gets a little upset and says it feels like I am moving on and she does not like the lack of control moving away. I have been pushing a little hard for her to stay and reconciliation and do get upset. This irritates her and makes her angry. I was on the phone to a male friend a few days ago and she came out to listen and said I was talking to a woman. Trust again. I have seen about annedonia and wondered what am I facing here. This woman my wife is not really recognisable. Sometimes a bit of normal then anger, apathy, don't care just want to run away attitude. She cannot move out for another 3 weeks and she is now away on a 5day break to give her space. She just just not want to be near me or the marriage or our home but in the last 2 weeks she has been amorous with me after a drink and wanting sex. Once done she gets angry and cold again. I am lost, how long could this last, is there any hope of any reconciliation or is this depression and anedonia here for a long time? Please advise
doctor
Answered by Dr. Vipul Prajapati (5 hours later)
Brief Answer:
need detail evaluation,it may be bipolar disorder.

Detailed Answer:
Hi dear,

Thank you for your query.

first of all i would like to tell you that she has definitely some psychiatric illness.
it may be some personality issues or it may be Bipolar disorder.
From history what you had described about her suggest that she might have bipolar disorder mixed type.

But for diagnosis we need to take detail history and mental status examination.

Also we need to ask particularly about her past relationship and also behavior with others like family members and friends.
Whether she is on any medication or not?

We need to start her a mood stabilizer like sodium valproate or oxcarbazepine with tranquilizer to make her calm.

Also she needs counselling and behavior therapy.

We also need to ask about psychotic symptoms like suspicious behavior or any other unusual behavior if any.

Thank you

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Vipul Prajapati (5 hours later)
We have been wondering about bi polar. Her history is very damaged. She was raped as a teenager when 15. Was very rebellious as a young teenager and was a runaway child a few times. She had an abortion in her first marriage when she was just 18 which I know she has always regretted. Her second marriage was to a much older man in his late forties or fifties. They were married two years. He was a violent drunk who beat her up a few times and I found out in the last two weeks he also raped her. My wife says there is more I do not even know about.
When we got together in 1991 she was divorcing her second marriage. I was only 20 she was 22. We had a lot of arguments she was always very angry and vocal and crude at times and I was immature and used to take off for days on end with friends. We broke up about 5 times over 8 or so years. Our kids were born in 1992, 1993 and in 1997. In 2003 I had my affair. This killed her inside I think since then all trust has been gone and she even accuses me of multiple affairs now even though there was only one. We have moved house too much, raised two and children which has been very hard, lost our house and had financial difficulties in the last 5 years. Her behaviour has always been slightly aggressive, sulky and she is constantly preoccupied with her looks and a seems to regret not having a glamour modelling career. She is accusing me of being an abusive partner at the moment which is not true but constantly refers back to events long ago. I think we have drifted in the last few years and I should have paid more attention to her, her hobbies and interests. No this full mental collapse. She is desperate to move away, can't see what she is doing to us all, including her children. She just wants to run away and be on her own. She won't tell me if it's over properly just a separation and whnen I push her to say whether there is hope she gets angry. I do not feel her diagnosis is accurate with depression and PTSD. She says she feels empty, no feelings of anything not for me or our children. She feels flat and nothing at all and is broken. She has CBT booked through a counsellor but won't go again until she moves out. She is now miles away in a hotel and I do not even know if she will come home or not. Please can you help me and advise I don't know what to do. Thank you
doctor
Answered by Dr. Vipul Prajapati (11 hours later)
Brief Answer:
she needs treatment both medicine and counselling

Detailed Answer:
Hi dear,

thank you for your query.

what ever you describe about her symptoms suggest she is having personality problems mostly borderline .

In her case she has emotional instability with depressive symptoms.
Also regrets about her misbehavior or odd behavior.

she has micro psychotic episodes in which she has suspicious over you.
She had very bad experience in childhood particularly rape which is very emotional disturbing.

also broken relationship with husband and mistrust form you because of affairs also make her very annoying which leads to depression.

You need to consult local psychiatrist for detail mental status examination.
she needs mood stabilizer with low dose anti psychotic treatment and if needed anti depressant.

In her case counselling has a very good role.

Thank you
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. Vipul Prajapati

Psychiatrist

Practicing since :2009

Answered : 849 Questions

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Suggest Treatment For Sudden Onset Of Anger And Irritation Along With Depression In Spouse

Brief Answer: need detail evaluation,it may be bipolar disorder. Detailed Answer: Hi dear, Thank you for your query. first of all i would like to tell you that she has definitely some psychiatric illness. it may be some personality issues or it may be Bipolar disorder. From history what you had described about her suggest that she might have bipolar disorder mixed type. But for diagnosis we need to take detail history and mental status examination. Also we need to ask particularly about her past relationship and also behavior with others like family members and friends. Whether she is on any medication or not? We need to start her a mood stabilizer like sodium valproate or oxcarbazepine with tranquilizer to make her calm. Also she needs counselling and behavior therapy. We also need to ask about psychotic symptoms like suspicious behavior or any other unusual behavior if any. Thank you