Can a Marriage with Mental Illness Survive a Symptom Cop Spouse?

A few weeks ago, the Weightless blog published an interview with Susan Schulherr, author of EATING DISORDERS FOR DUMMIES, in which she explains the distinction between a symptom cop—someone who tries to control your symptoms—and a truly supportive friend or family member. The interview, of course, focuses on eating disorders, but it got me thinking about how to best offer support to a spouse with any type mental illness.

Being in recovery for an eating disorder myself, and being married to a man with bipolar disorder, I have experience with this issue from both sides of the fence. Interestingly, when I was in the thick of my illness—bingeing and purging multiple times a day—I didn’t think I’d recover unless I was being monitored/controlled by a symptom cop.

I daydreamed about getting locked up on eating disorder ward, joining the army, even going to jail—all because I imagined that in those places, finally, with someone else dictating what and when and how much I ate, I would lose weight and be okay.

At one point, I tried to enlist my mother as a symptom cop. I told her that having sweet foods in the house was bad for me. She understood, and stopped buying them. Of course, that pissed me off, and in the end, it only served to reinforce my sneaky behavior around food.

In my experience, relying on someone else to fix you never works.

When it’s your spouse who suffers from a mental illness, however, it’s hard to remember this fact.

Mental Illness, Misdiagnosis, and Forgiveness

About a year ago, I had a terrible, two-week anxiety attack. My eyelids twitched constantly, I couldn’t sleep without serious pharmaceutical assistance, and—in lieu of a heartbeat—cold-winged butterflies beat around in my chest.

At first, I wasn’t sure what had triggered my anxiety. I’d experienced one similar episode about six months earlier, after starting a new job (I didn’t work for nine months after John’s hospitalization) and having a confrontation with a woman at one of my Twelve Step meetings. I chalked that experience up to nerves around the new job and a fear of conflict, and I didn’t think too much about it after the anxiety went away.

The second time it happened, though, I had to dig a little deeper to figure out what was really going on. And the truth was, I was still traumatized by the fact that my husband had been misdiagnosed after all my efforts to communicate what was happening with his psychiatrist.

The worst night of my life, in fact, occurred two days after said psychiatrist—Dr. Black—decreased John’s dose of Risperdal, and then proceeded to tell him that she “wasn’t that concerned” as his psychosis escalated and I pleaded with him to return to the hospital.

After my husband went back to the hospital, I was furious. I had trusted his psychiatrist. I had assumed that, because she had much more experience with mental illness than I did, she knew what she was doing when she ignored my calls and input.

I had, of course, assumed wrong.

Happy News (about the Baby) that Made Me Sad (about Bipolar)

I started thinking about babies when John and I moved to the West Coast three and a half years ago. John wasn’t quite on the same page; he wanted some time to establish himself at his new company. He wanted some time to settle into our new life.

About two and a half years ago, we had a bit of a scare that left me thinking—briefly—that I might be pregnant. When I learned that I wasn’t, I was disappointed. I said as much to John, but once again, he wanted to wait. He wanted to make sure his company was stable and his future there secure.

To be honest, his reluctance to start a family pissed me off. It made me feel as though what I wanted was less important than what he wanted for his career.

So I got passive-aggressive.

Being the Weak One

Last Sunday night at 11:00 pm, I woke up with a bad stomachache. I’d been having minor stomach pains at night for a few days prior to Sunday, but I wrote them off as some kind of normal, pregnancy-related thing.

Anyway, I got up that night and sat on the living room couch for an hour or so, to see if being upright would help the pain go away. It didn’t, so I woke up John around midnight and told him what was going on.

He phoned the on-call OB, who told us to go to the hospital to have everything checked out “just in case.” Before we left, I threw up.

On the labor and delivery floor, I got hooked up to two monitors: one to measure the baby’s heartbeat, and one to see if I was having contractions. Everything looked normal, and the nurse suggested it was probably just a case of food poisoning. Before she took us down the ER, I vomited again.

As soon as we got into the ER, they slapped a blood pressure cuff on my arm. My blood pressure was 70/35, and all of a sudden, there was a whirlwind of activity around us. People hoisting me onto a gurney, drawing blood, inserting an IV drip into the crook of my elbow. I threw up again, and then again.

Surviving Trauma in Your Marriage

Seeing your spouse suffer is a terrible thing. You want to make things better. You want to take away the hurt.

So much of the time, though, you can’t. Or at least not fast enough, and not to the degree you’d like.

A recent post on Marriage Gems references the book HEALING TOGETHER: A COUPLE’S GUIDE TO COPING WITH TRAUMA AND POST-TRAUMATIC STRESS. Marriage Gems quotes the authors of the book as saying, “Trauma puts up a wall that for a time locks a couple out of their familiar world and leaves them frozen in the traumatic event. Suddenly there is no past, and the future feels impossible.”

God, can I relate.

Love, Mental Illness, and Vulnerability

As a teenager, I told myself that I didn’t want marriage, I didn’t want kids, I didn’t want a family. In reality, I was afraid I’d never get them, so I tried to deny the desire, cut it off at the root before it blossomed into something I couldn’t control.

Fat, bulimic, and depressed, I didn’t think I was attractive enough to find a man. I didn’t think I was good enough to have a family. If people really knew me, I reasoned, they wouldn’t like me. Why should they? I sure as hell didn’t.

When I met John, I’d been in recovery for four years. I’d stopped doing things that made me hate myself, and I’d gone back and cleared up the wreckage from my past. I knew that I deserved good things, and I wasn’t afraid to admit I wanted them.

It sounds cheesy, but I was ready to fall in love.

When John and I married three years later, I spent the day in a blaze of happiness. I felt blessed, and I prayed only that, whether John and I experienced times of joy or heartache, our love and commitment to each other would remain strong and be used as a foundation to help others.

I never imagined that bipolar disorder would be God’s answer to my prayer.

Being the Strong One

A recent post by Therese Borchard contained a beautiful Biblical verse, a portion of which reads, “To everything there is a season… a time to break down, and a time to build up…” It reminded me of something my mother said to me when John was in and out of the psych ward: “You take turns being strong in a marriage. This is your turn.”

At the time, I was scared that John would never recover, and that I’d have to be the strong one for the rest of our lives. Fortunately, that hasn’t turned out to be the case.

But looking back, I can see that as my husband was breaking down, I was building him up. When he was sick, I advocated for his recovery. I took care of paying the medical bills, scheduling doctor’s appointments, and communicating with his employer about his eventual return to work.

It was sort of a yin/yang kind of thing: I took care of the details of everyday life so he had the space to get well.

Letting Go

When John got home from his latest business trip on Friday night, I was reminded of what a difference a year makes.

A year ago, John went on his first business trip since his diagnosis with bipolar disorder. (Prior to his manic episode, he’d been taking several business trips a month. It took about six months of being back on the job before his company sent him on another one.) I remember how nervous I was the whole time he was away: Did you bring your pills? Have you taken them yet? Did you sleep well? Are you feeling stressed out?

Poor John! I’m sure my anxiety did not help him stay relaxed.

When John travels now, it’s not a big deal. I trust that he has his pills with him, I trust that he knows when to take his PRNs (Ambien and Klonopin). I trust that one night of so-so sleep is not going to send him immediately back into the tailspin of the psychosis.

Letting Go of Trauma

Last year, I was still struggling to come to terms with the trauma of dealing with his delusions and paranoia. I worried that if I wasn’t constantly overseeing my husband’s recovery, he wasn’t going to get well. You see, that had certainly been our experience when he was in the thick of the mania—he felt great, nothing was wrong, why didn’t I believe that his colleagues had hypnotized him, or that there were security guards posted outside our apartment door? I’d been forced to advocate for his health at a time when he couldn’t do it for himself, and I was having trouble giving up the reins.

Time, experience, and joint therapy sessions helped alleviate this, but so did prayer. God used me to help my husband at a time when he could not help himself, but that time has passed, and I have to remember that God—not me—is in charge.

And right now, what better reminder do I have of that fact than the little baby that’s building itself inside me? I’m not directing this baby’s growth. I’m not deciding, “Okay, baby, today your kidneys are going to start working and you’re going to gain 0.05 ounces.” All I can do is take care of myself and trust that the baby’s development is progressing the way it’s meant to. Without that trust, I’m a constant ball of anxiety and stress.

One Marriage. Two Mental Illnesses.

When John and I got married in 2006, he was well aware of my history of binge eating and bulimia. He’d come to Twelve Step meetings with me and heard me talk about all the dirty details of my eating career. He knew that without the FA program, I’d be a heavy, depressed mess. He also knew that with it, I am a happy, healthy, and vibrant woman. With it, I am the woman he loves.

Moreover, John was aware of all the limitations my recovery from this eating disorder—this mental illness—entails:

• I don’t eat flour or sugar.
• Unless I’m eating at a restaurant, I weigh and measure my food.
• I go to three Twelve Step meetings every week.
• I call my sponsor (my mentor in the program) on a regular basis, and I get up early every morning to take calls from my sponsees (the people I mentor).
• I spend time in prayer and meditation every day.

John went into our marriage with his eyes open. The fact that I had actively pursued a solution to my problem (versus his mother, an alcoholic who died of her disease) was attractive to him. My limitations were no big deal.

I, on the other hand, was blindsided when mental illness struck John two years into our marriage. His breakdown was sudden and violent and scary. Overnight, psychosis changed his personality radically. I questioned whether the John I knew and loved would ever return.

The Last “Crazy Class”

Back in February, I had a really terrible bout of anxiety. For two weeks, my eyelids twitched so badly that I could see my veins jumping when I looked in the mirror. My stomach ran cold, my heart beat fast, and I was sleeping very poorly.

The anxiety was triggered by an interaction I had with someone at a Twelve Step meeting–I’ve been in recovery for food addiction for nearly 11 years–who pretty much told me that I acted like I “owned” the meeting and needed to back off. The woman in question is very direct, very confident, and–to be honest–a little controlling. Her words threw me into a tailspin of self-doubt: Was I too controlling? Was I trying to impose my will on the group? Did I need to back off?

For two weeks, I fixated on these questions, trying to figure out why this whole thing was affecting me so deeply. And then, on the fifteenth day, it became clear: My reaction wasn’t so much about this particular woman or the things she’d said to me; it was about the fact that she, like the doctor who misdiagnosed my husband after his first hospitalization, had made me feel like I was doing something wrong when I knew, I knew!, that I wasn’t.

Dr. Black thought John was anxious and depressed. When I tried to tell her about his psychotic symptoms, she dismissed them. She told John that he needed some space from me, that we were “making each other nervous,” and that the hospital doctors were the ones who’d gotten his diagnosis wrong. When she cut back his dose of the antipsychotic drug Risperdal and he became delusional again, she told him over the phone that she “wasn’t that concerned.” He ended up back in the hospital again the very next day.

I knew what was happening, I knew he wasn’t well, and yet the fact that she was a doctor had made me doubt my own instincts. As a result of listening to her, my life–and my husband’s life–skidded further off the rails.

Once I realized what was at the root of my anxiety–this intense ball of anger and self-doubt and fear–I decided that I needed to get some support from people who knew what it was like to suffer through a loved one’s mental illness. A couple of people had mentioned NAMI to me, but until I had that anxiety attack, I didn’t feel like I needed to go.

Now, having just completed the 12-week Family-to-Family class*, I’m sorry I didn’t go sooner. Not only did I meet people who understood the hell my husband and I had gone through, but I learned that the things that had happened to him–and the way I had responded to them–were very typical. And I now have an arsenal of knowledge to draw upon should we be forced to deal with a psychotic crisis ever again.

The biggest thing I got from the class, though, was an intense feeling of gratitude. Because, my God!, could things have been worse.

John has accepted the fact that he has a mental illness. He sees a psychiatrist and takes medication and has kept his highly responsible, high-paying job. From everything I heard from my classmates, John is the exception and not the rule.

My anxiety has lifted, and I’m pleased to report that the intense anger I felt toward Dr. Black for the last year and a half has disappeared.

*I stayed late at work and went directly to the class every Thursday evening. When a co-worker of mine asked why I was working late, I mentioned that I was taking a class. He asked me what it was about, and I vaguely told him it was a psychology class. Seeing that I was uncomfortable–and being a bit of a jerk–he asked me what specifically we were studying, so I told him it was a class on mental illness. Of course, he then started referring to it as “the crazy class”–and hence the title of this post.