Question: Hi,
My close relative is 30 Year old married female.She has following smptoms.Highly impulsive;uncontrollable anger(physically abuses-slaps/hits/pushes her own mom,dad and husband infront of others too)for trivial matters,blackmails for self harm holding knife near her neck/wrists if parents/hubby do not obey her orders or comfront her/disagree with her;gets severe panic attack(breathing issues and rolls on ground) for half an hour if victims try to hit her back or shout back;always accuses others for her aggressive actions;hardly attends social functions/family functions;complete fearless when angry as runs out of home even at 2 AM alone to her another flat 18 km away threatening never to return back.does not have any friend of either sex;high punctuality issues;100% behaves like every family member staying with her should revolve around her without complaining;non-stop talker but least listener;,inteligent(software engineer);very generous/helping/childish/witty when normal;Very religious,donates to charity;sleeps minimum 12 hours daily mostly from 12 midnight till 12 noon(works from home);what could be her disorder.Her Mom and only Sister too have similar problem but around 50% less intensity;Her sister child has Autism;Her Mother supports her completely while fighting with others despite knowing others are not yet fault.Threaten their husband of police complaint if they try to run away from house to escape their beatings.pl help.

Hi Dr.
Thanks for your reply.
Actually I have done lot of google research and I was confused whether it is BPD-Hyperactive or ADHD. Since her mood swings are rapid i thought it is not bipolar.Her Maniac episodes lasts only for 2 hours which used to occur every 2-3 days and some time few times a day too specially when she used to work full time under stress.After she left job and become freelencer her episodes have reduced significantly.Her normal verbal abuses(not physical) with suicide threatenings/Police threat occur almost every day throughout year.
once when cool she told me that she has ADHD but she never takes any medicin other than restill which too only when she is very cranky(4 to 5 times a month).
I have found Torvate 200;Tremadin 5;Relicalm plus5 in her Mothers Bag.Dont know she takes it or gives it to my wife in food as she only cooks.
She is very inteligent;smart;sharp memory;caring-loving when she is in good mood.After every episode she says sorry and asks for forgiveness for her behaviour only to repeat the harassment again after few hours.Pl let me know what could be the exact disorder Bipolar/BPD or ADHD(as per her).When she used to work full time she used to threaten suicde alsmost every day now it has come down to once in 15 days or so.Pl confirm as I want her to understand so that I can help myself and Her to live peacefully under one roof whcih is not possible now.

Hi,
Thanks for theh reply.
I am still confused about Biploar vs Bordeline(BPD) and ADHD.Reason stated below.
1.she is either normal or irritative/abusive but never "High" extremely happy like.also how can she fight 365 days a year if we do not obey her as there must be "High' stage after every Low stage for bipolar.

2.If Bipolar each "UP" or "DOWN" stage should last continuously for few days altleast.In her case she get angry/irritated/resstless anytime whenever the victim does something differently than she expects him to do/gets defencive/justifies himself etc.(perfectionist).She is perfectionist in when she does some work too like when she writes a mail she ensures no spelling and grammatical mistakes by rechecking 2 times.(she never does house work as it is done by maids or her Mom).little unavoidable door opening sound makes her crazy if she is asleep and shouts screaming the victim for this.
3.Her mood swingns starts with accusation then "poor her image" then if victim says sorry she cools down after few minutes of scolding and becomes normal.If victive turns defecnsive then accusation turns it into verbal abuse then physical abuse then crying and lying on the bed.She sleeps for minimum 12 hours EVERYDAY which can go up 16 hours against normal person's 7 hours.
4.She was very depressed 4 years back when I met her after her enagagement broke due to her constant blackmails and fights with that boy.she used to cry always showing 'poor me" image and first year of marriage she used to get panick attackes in the process of crying and verbly physically abusing me.her mother was not with us that time.now

5.Important point is as per her she had taken 25 sleeping pills at one time 10 years back after fight with her mother.She got up after 18 hours but nothing happened to her as per her.could this be the issue that these pills damaged her brain cells and so she acts like this.can one survive aftertaking so many pills.
5.she has damaged XXXXXXX phone by throwing atleast 10 times since last 4 years.taken knife in her hand around 15 times,climbed on window ledge to jump down 4 times, but never harmed her.only blackmails.
Hi,
To be more specific her syptoms as follows.This may help you to diagnoise correctly.
• Sleeps minimum of 12 hours every day.Mostly 14 hours a day on an average.
• Shows all symptoms of a narcissist 365 days a year round the clock.(People at home must agree to her views,should not quetion her,Everythig must be done the way she say ACCURATELY,the very moment she says.must not question her wisdom/judgement
• Always assigns some or the other tasks to others at home and never does simple,her own tasks by herself.Eg: Mummy, close the windows,connect my XXXXXXX to charger,give me water,check maid has cleaned bathroom etc and then tries to find faults even if they do it best to their capacity. She never does anything by her own.even she needs to woke up everday by her Mom/husband despite having Alarm with her so that she can shout on them if they forget to woke her up at the precise time she told them to wake up.Constantly looks for/ creates opportunities where she can find faults and yell at her dad,mom,hubby.Screems,yells and even sometimes physically abuses victims even on a slightest mistake done in performing these her own tasks.She MUST Dominate else she gets angry and ruthless.no one else has any say in my house.
• If I question her why others have to do her own simple tasks and even then listen shouting from her,she gets angry,verbally abuses me,calls My parents and screams at them for not aksing their son to look after her etc,cries,throws things around etc.
• Her almost 99% of all fights,mania episodes like,physical abuse,crying,damaging things,Suicide threats,(panic attacks very rarely happened may be 7 times since 4 years) occurs when some one does not listen to het non stop talks,disobeys or questions her dominations ALWAYS. Normal accusation starts as ‘you do not love me,care me else you would have listened to me”.
• Since her temper rises from 0 to 100 in few seconds and leaves no stone unturned to put her offender in trauma by verbal abuse,cursing,holding collar,hitting at extreme cases, social shame etc.. I really doubtful that this disorder is Bipolar.
• If I treat her like queen by completely obeying her like a slave in everything she says she never gets angry even for a entire month(I tried this when she was pregnant) which otherwise a daily problem.Her blacmails of suicide threats,bad mouthing with my relatives etc are actually ways to get the things done as per my experience with her and not real threats even thoough she truesly losses her control fully on herself.

Hi Dr. XXXXXXX
Thanks a lot for your reply.Now I beleive that you really read through my points and your answer is not copy, paste or generic.I done payment and recharged again after realizing your sincere efforts in my case to help me.Thanks again.
I had kept one fact hidden from you.This is because I feared you may not diagnosis her properly.Fact is just like you said our neigbours indeed took her to a nearby private psychiatric hospital 11 months back,one midnight after she physically abused her DAD and then ran out of the building at 12 midnight bare foot,crying wearing home dress . Her screams and cries had mad neighbors of my society building who called police and later convinced her Mom to take her to a hospital for her palpitation problem and without telling them took to a psychiatric hospital which she and her Mom came to know only after admitting her(I was not staying with them for a month and her dad was at my house).Next day my neighour informed me and spoke the doctor and told him her acts and suicide attempts.He locked her up for 18 days inside hospital without outside access even we could not meet her.after 18 days he allowed me to meet her and seing other Lunatic people there I had pity on her and convinced and doctor to release her and took home.her mother(retired from a bank )paid the XXXXXXX and too the XXXXXXX despite my many tries.doctors too said since her mother admitted her,they will give bills to and not me.
Doctors are not telling ME what is her sickness and her mother always kept her issues a secret from me and her husband(he was abroad alone for 30 years,4 years back retired after this daughter got married).As per my wife doctors used to give her injections after which she used to loose conciouness every day and they used to give her medicines which were highly sedative and she was drowsy all the time.Shocks were not given.
Her mom was in custody of her medicines and was giving them to her time to time which she religiously took for 4 months .She was sleeping for average 18 hours during this time.No fights,no threatening,no abuses nothing.Only thing is she used to get restlessness whenever awake and could not focus more than 15 minutes on anything(she told this so).her medicines were changed 3 times by doctor due to this.she used to move involuntarily in side house as per her statement due to medicins.After changing medicin after two months this restlessness dispappered but sleeping 18 hours continued.After 4 months she completely discontinued medicine without informing doctor. Good thing is her all other issues were disappeared almost 90% till recently as fights became 2 times a month from daily earlier.Her sleep pattern to became 14 hours which was normal for her before hospitalization.recently again symptoms have reappeared and she does not want to take medicines.
I require you help on below areas.
a)As doctors don’t tell me what is her sickness,leagally can I force them to give treatment report as I am her husband.As per doctor my wife/her mother may take legal action on them if they disclose to me/give bills to me.
b)My wife is staying in Karnatak since 5 months with our 2 yr child and her parents ather parents place.I am in XXXXXXX How can I protect my chid from my wife’s constant fights/screamimgs.My child gets terrified and starts non stop crying during her loud verbal abuses on her dad/mom.How can I save her legally or otherwise.Will court give custody to me if hospital gives reports with BPAD or any mental illness diagnosis. or can court force hospital to give report.
c)She threatened to give me divorce and called up my parents/uncles /relatives and published that I am torturing her and so she is giving divorce.My family and I agreed for mutual consent.Now she says she does not wan divorce and wants to come back to me.Should I accept her knowing her condition or go ahead with divorce.
d) Can it really be treated permanently within a year or so.Pl confirm Which medications should I give as you are aware my case fully now.Pl help.Thanks.

Hi Dr.
Thanks for your reply.but sorry to highlight that out of 4 questions where I requested your help you only answered 4th question partially.
Pl help me to know the answers for those questions which I am listing below again as this is very critical for me to protect my daughter from her and also to protect myself if she files False cases in future as she always threatens t get her things done from me or stop me run away from home to escape her verbal/physical attacks .

a)As doctors don’t tell me what is her sickness,leagally can I force them to give treatment report as I am her husband.As per doctor my wife/her mother may take legal action on them if they disclose to me/give treatment reports to me.

b)My wife is staying in Karnatak(Mangalore) since 5 months with our 2 yr child and her parents at her parents place.I am in XXXXXXX How can I protect my chid from my wife’s constant fights/screamigs.My child gets terrified and starts non stop crying during her loud verbal abuses on her dad/mom.How can I save her legally or otherwise.Will court give custody to me if hospital gives reports with BPAD or any mental illness diagnosis. or can court force hospital to give report.

c)She threatened to give me divorce(at least 500 times she has done that) but this time called up my parents/uncles /relatives also and threatened that as am torturing her(she is highly manipulative) she is giving divorce.Her lawyer too called me to give peaceful divorce.My family and I agreed for mutual consent.Now she says she does not want divorce and wants to come back to me(Divorce was manipulative threat to give in to her demand as she thought my family being fearful for respect of society may not agree for divorce and then she can demand and enslave me).Should I accept her knowing her condition or go ahead with divorce.

d) Can it really be treated permanently within a year or so and afterwards no medicines are required and she still be normal for lifetime.

e)Can the medicins mentioned by you can be taken at medical store without doctor's prescription


Also pl note that the names of the medicines I mentioned earlier where found in her mother's bag BEFORE she was hospitalized.After discharge she used to take many pills(i dont know names,i think they were colored tablets without name printed on them though not sure)but were locked inside by her mom so that I can not get access.

She is very vengeful and takes vengeance by socially humiliating me and my family.Recently she went to my parents house in XXXXXXX and physically abused my parensts by pushing my mom twice and holding shirt color of my Dad because i did not go to her house as demanded by her.Then she asked for Divorce with my parents.They did not say a single world till she left even when she was physically abusing them infront of my brother's wife and children.

If she comes to know I have contacted you she will go to any extent to ensure I will not try to investigate/get more ifo on her sickness with anyone further.This is because she is very smart and manipulative and knows well that if I come to know about her sickness she can no more accuse me that I am tortuing her which she accuses every time just to put me in defensive.
So I may not ask her to talk to you for my and my parents safety.she knows Law is in favor of wife's and husband and his family are at her mercy.she told this many time to me.

Pl answer all of my above quetions as they are very improtant for me.

Thanks Dr XXXXXXX
I am very much thankful to you for your detailed and problem specific answer.
I have not hidden anything major from you except that ,first six years of her life, her mother & Father were not with her.This is because their building went for redevelopment and her mum was working in XXXXXXX for a bank,Dad abroad.So When she was 11 month baby she was kept in managalore along with her 6 year elder sister at her Chacha’s house.She was the most pampered kid there and she always got everything she wanted there as well as later from her dad & Mom as they too pampered her a lot as per her sister.when she was 7 yrs her Mom took her back but her sister continued in managlore .
Few other facts.
a)She is intelligent because she was employed with Organizations like Infosys,IBM full time for few years.Only thing is she has changed 10 organizations in last 7 years by her own even though all companies wanted her to stay as she was perfectionist and workaholic in software programming(She likes and enjoys programming ). She never loses focus or gets impatient while at her job. She even used to work after office hours and holidays. She was slow to complete a job compared to other colleagues but not even single mistakes in her JOB once completed.she says she never want to be in leadership role as she can not do people management. she always asked for and worked in 2 PM to 11PM shifts.even now being a freelancer she works in this time slot only even though she can work any time.She never lost her control in her office.Another fact is she never likes same sex collegue (jealous)where as she always praised male colleagues(may be they showed attention to her)Being a mother only thing she did was milking baby.she can not do time consuming tasks like puting baby to sleep or feeding baby from hand as she looses patience and screams at baby.
b)when she gets angry only thing happens Every time is “HER NONSTOP TALKS in the form of accusations with crying ” for Minimum 2 hours.(I MEAN it when I say 2 hours every time, else she will not cool down).She does not cool down in any other way.If she was not allowed for free talk her angry modd continues for next day too.Talk can be targeted at victim or victims relatives over phone if they are not present physically or her mom complaining about the victim.If no one else is reachable she will do self talk either blaming victim or blaming self.My parents stopped picking her phone after she cursed them once and my uncles fed up taking her calls as she calls at any time even at mid night and goes on talking for 2-3 hours and then cools down and returns to normal.Only 2-3 hours nonstop one sided Talk cools her down every time and nothing else.
c)Her mother has 3 sisters and 2 brothers all in XXXXXXX Her mother was not in talking relationship with none of them and never took her children to their homes and or went for any functions.Her sisters too where very high dominating females and alsway fought for silly things and never compromised their ego as per people who know this family(we came to know later).Brothers were normal but no relation even with other sisters.others sisters too not in talking terms with each other.
d)My Wife sister mixed well in society.My wife never attended any functions.Her sisters wedding was first wedding she attended and later 1 more she attended it seems.(I might have attended 100 weddings)Her Dad’s side family is very good but due to her mother’s constant fightings they too are not in good terms with this family.In her Dad’s family no one blames my wife infact praise her (she never fought with them and very very nice to them and very helping ,sweet talking and generous to them.Actually her problems are limited only to the people who live with her).Mother’s family never interacted with her as I said.
I request you help in clarifying my below doubt.
As told by her when she was 18 years of age she took 25 sleeping pills at once but woke up after 18 hours and perfectly ok without visit to doctor.(Reason ,angry with mother because she forced her to take engineering instead of Biology of her interest.)
a)Can this be true.If yes then is this incident to blame for her all mental problems.
b)Would not these much pills harm her brain cells.OR she is just manipulating so that I take her suicide threats seriously.
c)Also how can I make use of Metal health act 1985 without her consent as I do not have any reports which states about her problems.(last time they agreed only because neighbors told them they are taking her to a hospital for her breathing/palpitation problem and hospital was only 20 minutes from my house).After wards after realizing my wife was cursing the neigbours (not infront of them)for taking her to mental hospital. Now she will be double careful.How can I take her as she is very smart and may call police instead compling about me.
d)Even if somehow I managed to get the tablet & injections prescribed by you ,at the most I can give her the tablet mentioned by you. How can I give her injection without help of a doctor if she is unwilling to cooperate(she will never cooperate as she never agrees she has mental issue.ADHD is personality issue as per her and not mental issue.)
e)How to live rest of life of 30-40 years with her Tantrums /dominations/irritation unless she is cured of her disease.
f) Even if I am successful to admit her to hospital and give treatment will not be this a lifetime issue or
will these medicines cure her in one year and no need for medication later.

Thansk in advance.