Monday 23 September 2019

Social Anxiety Tied to Prior Manic Phase Activities

My wife has been diagnosed as Bipolar since her induced menopause from 7-8 years ago. Her behavior has changes sporadically during that time, culminating in a serious manic phase earlier in the year where her Xanax use and alcohol abuse resulted in some very troubling actions. I had to file for divorce in order to protect myself it got so bad. Eventually we were able get her to agree to committing herself to a Mental Health program in southern FL that took about 2-3 months to complete followed by 6 weeks of group therapy locally. She is now back home, on the proper medications and actually doing well. My concern is I cannot get her to reach out to family and friends. I really believe this all stems from being ashamed of her manic behavior earlier, which really was out of control. She is fine with me but hardly ever leaves the house or talks to anyone. Her doctor says to give it time but I think she needs therapy to address this. Do you have any suggestions? She has come so far but cannot seem to move forward.

You mentioned that she had engaged in some “very troubling actions” so much so, that you needed to file for divorce in order to protect yourself. It would’ve been helpful to have included more details about her troubling actions for context. More information would have made it easier to understand why she is now reluctant to reach out to friends and family.

You are pushing her to do something that she is not comfortable doing. Again, without more information about her history, it’s difficult for me to know whether or not you are doing the right thing. The fact that her doctor does not endorse your idea leads me to believe that it may simply be too soon for her. Her doctor knows all of the facts of her case and is still advising you to “give it time.” People are ready when they are ready and no sooner. You might be prematurely pushing her to do things that she’s not ready to do.

She might feel a great deal of shame and embarrassment about what happened. That can be difficult to get over. You mentioned that she had been in treatment, but it’s not clear that she’s in treatment now. She obviously has a doctor but it’s not clear whether she also has a therapist and is in counseling. You might encourage her to undergo counseling to examine why she is reluctant to connect with friends and family. Counseling is the ideal place to deal with these types of issues.

One potential risk of pushing her to do things too soon might be her having another episode. You would never want to jeopardize her mental stability by pushing her to do something she’s not ready to do. It might be best to follow the doctor’s orders.

Talk to your wife. Voice your concerns but don’t push her too hard. Ask her why she’s reluctant to reach out to friends and family. You might already know or think you know but it wouldn’t hurt to ask her to expound upon her reasons and to share her feelings. She might need more time to overcome whatever it is that she’s feeling as a result of that difficult time in her life.

If you’re uncertain about how to proceed or are struggling with your relationship, you might consult a therapist, for individual counseling. There you might learn helpful strategies for supporting your wife. It can be difficult to love someone with mental health issues. That’s one of the primary reasons that advocacy groups such as the National Alliance on Mental Illness (NAMI) exists. It was started by family members who struggled with their lack of support for their loved ones with mental illnesses.

I hope this issue can quickly come to a resolution. It may simply be that she needs more time and you need more patience. A therapist could assist you in making a determination about how best to proceed. Thank you for your question. Good luck and please take care.

Dr. Kristina Randle



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