Wife not getting medications- need to unload-kinda long

[TPaul]

Hey everyone,
Wife again has not been getting her medication refills, , and am wondering if anyone has some suggestions on how to better encourage her to do so. I have tried to remind her, she says she has called several times but that they have not did anything about it. I know that this is not true. It can take a few days some times or even a week before they can get her into the doctor at the clinic where she goes. This is going on for almost all of December and now a week into Jan. They would not make her go this long.

I am getting kinda desperate at this point. She is yelling at everyone about absolutely everything. It is not quiet or peaceful for more than a few minutes when she is home with the kids and I. If I ask her a question about something, she gets mad and turns the question into a negative and yells. If I ask her what her schedule is for the day, she gets angry and rants and raves. If I talk to her, she gets mad. If I don't talk to her she gets mad. She has a bad day at work, or is upset with someone at work, she unloads all that anger towards me. I know that this is a safe way, (in her mind) to deal with the inner turmoil and aggression that the Bipolar causes her within. She dumps all of this inner baggage on me. What is left over then she tends to spill on the children. I would so much rather that all of it would be directed at me than the children, ( but there is only so much that one can take before overload weighs you down to much yourself.

Added to this, I have been doing most everything to keep the house running. She is working a lot, and I mean a lot of hours at the two jobs right now. In some ways that is a blessing, if she is not here things are much more peaceful at times. Up a 6am to get the kids up for school and out the door from between 6:50am and 7:20 am. Then getting myself ready to head to my decorating job with my long term client, out the door for the 40 minute drive by 8:30am. At the clients house from 9am - 2:30pm. Drive to the antique shop in the town where we live and be there by 3pm. Work there till about 6pm. Come home a 6pm and see if the kids have done their homework, get supper going or run and pick something up. Put laundry in when I get homeat 6pm and try to get 2 - 3 loads washed,dried and put up before bedtime. Get the kids clothes out for the next day for school and then iron them the next morning before they go to school. Add to the top of that, still working on getting our house put together since the move. (Which by the way, I have done absolutely everything, and I mean everything from the actually moving of the furniture and all other things from the old house to the new. Placed every item in the house and put every room somewhat together.)
She has did hardly anything, beside day before yesterday when she went through 4 of the kids closets and cleaned out what she said was too small or was messed up, and threw things away.

Then yesterday she had X amount of dollars for the week to pay get her tag for the van she got(remember that, LOL) and yes she should have already gotten it, but had not. She had the money for that and a couple of tires for that van, and then some for a couple of other minor bills and spending money till next pay check. She went out and got the two tires and then spent all the rest of it, ( and mean every last dime and nickel) on clothes for the boys and her. She has no money left and did not get the other things paid that she was supposed to. Ok, they might have needing some things, but a few things now, a few things throughout the month, yeah. I see that, but to use all the money??. I know that she has trouble with spending money to make herself feel better when she is in a bipolar funk. That is why I put absolutely no money from my income into the bank. If I do then there is a good chance that it might be gone with nothing paid. That means I can have a good amount of money in my wallet at times. I then have to hide my wallet at night in a different place each night to make sure she does not know where it is. And yes I do have to do that, because she has been known to take money out of it when she has spent all of the money she had for a week. I hate doing this, but it is a neccessity to assure that we can survive from month to month. This is the reason we have no Credit cards. She would spent every last one of them up to the limit and then leave me to find a way to pay all of them. She does not even have a debit card for our checking account. She thankfully recognized after a spending binge a few month ago, when she got off medications and then back on, how she had damaged our finances and could not have the card or she would spend till there was nothing in the bank, and had me destroy her card. Hope she does not go around me and try to get another one from the bank.

Ok, sorry everyone, not been posting much and then come and mini rant, but it does help sometimes to just type it out and let a little of the steam out that can build up. Ya'll know how that can be, ,

Hope everyones weeked goes well,
Tpaul

 

[mstang67chic]

Wow....I think I've said this before. I get fed up enough RAISING a difficult child and can't imagine living with an adult difficult child. You've got your hands full.


One thing though....you keep your money in your wallet...I wouldn't do that....it's way too risky. You should be able to open a seperate bank account in your name only that wife won't have access to. Even if it's only a savings account, you could still get an ATM/Debit card for it so you're not carrying around hundreds of dollars at a time. And if nothing else, I would suggest a good lock box either very well hidden in your home or in the home of someone you trust explicitely. I would say put it in your car but cars can get stolen or wrecked. If you were to have a wreck and something happened to you....who would know to look for your paycheck in the car?

As for her appointments....has she ever signed anything giving you the ability to ask about appointments or make them? You may want to look into that if at all possible. Otherwise, all that comes to mind to me is to sit her down and tell her enough is enough. Either she do this and comply or other arrangments for the family will be made. It's not fair to any of you (her included) to live like this when all she has to do is take her medications. I know there is the "I don't NEED this medicine" thing...I hear it from my son and also she is an adult and can choose to not take them. But....you have to decide at what point do you draw the line, Know what I mean?? And I don't want to sound like if she takes her medications, all is well either or that I'm patronizing her and saying "be a good girl and take your pills". I realize it's more involved than that....I'm just not completely awake I think.

I just think that knowing how she is and how life is in your house when she goes off her medications.....you need to decide how much you are willing to do or put up with and act accordingly. Know what I mean??

 

[Mattsmom277]

Wow, what a situation for all of you.
I wish I knew some advice on how to get her medications going. I would suggest that when she finally does get in to see someone about a script, that x amount of auto refills are placed on it. Simply then fill it and give it to her on the days they become refillable?

it can be overwhelming to be floating a ship all on ones own while a spouse is functioning subpar. Throw in negativity and being the persons "safe" zone for expressing pent up emotions, and it breeds a environment for so many things, none positive.

I hope someone else has some insight for you. I wish I could offer more than to validate perhaps that anybody in that situation is bound to be having the same feelings that you are. I will cross my fingers that something gives, and there are improvements.

I would also perhaps open a account at a new bank, don't disclose the pin for your debit card, a solo account with you the only user. That would save you having to hide cash in your wallet in your own home. That itself is an awful way to end each and every evening, having to feel like scrooge, stashing your dollars in new places before bed. What a bad juju feeling when settling in for a night.

 

[GoingNorth]

TPaul, sounds like a nightmare. I did notice one thing that jumped out at me from your signature: your wife is on TWO SSRI antidepressants. They alone can cause mania, even in people who are not bipolar.

It takes very careful medication mgmt to handle SSRI dosing in BiPolar (BP) people. In fact, many psychiatrists simply won't prescribe that class of medications to BiPolar (BP) patients. I'm almost wondering if she's avoiding picking up her medications because she knows on some subconcscious level that they are making her feel worse.

Also, Lamictal, while an excellent mood stabilizer for many people, is known to be fairly activating. That is why it is usually given at bed time. That's another thing to consider.

Certainly, you are going to have to lay down the law as regards medication compliance. There is no question that she is manic, but I don't see medications in use for straight up treatment of mania. APs are often used for this.

You and your kids shouldn't have to live like this, and frankly, neither should wife.

Does wife realize that suddenly stopping her medications can cause all sorts of things like the mania, withdrawal syndrome from the SSRIs, and even seizures from stopping the mood stabilizer suddenly (they are actually anti-epilepsy medications)?

I would start now to seperate your business and finances from wife's. I'd also suggest talking to an attorney specializing in family law (they usually don't charge for the first phone consultation) so you can find out what your options are in case push does come to shove.

Sorry to hear you are dealing with this.

 

[GoingNorth]

CORRECTION: Lamictal is usually dosed in the MORNING, not at night. Sorry about that. I guess I'm a bit scattered this AM, LoLf

 

[ML]

You've gotten some great suggestions. I don't have anything to add except support. I'm sorry things are bad right now and hope they get stable soon.

 

[gcvmom]

Ugh. I feel your pain having lived through years of a difficult child-husband who desperately needed medications (and finally has them now).

I wonder if you can ask her doctor's office for a HIPPA release form that would allow them to speak to you about her issues and possibly put you in a better position to help her stay on top of things like prescription refills? Our insurance company had me sign one so that I could discuss any of husband's medical claims, which was very important since I am the one who manages the finances, insurance, taxes and just about everything else that's involved in running our household.

I'll be praying she gets those rx's refilled ASAP so the stress level you're all under gets a little better!

 

[KTMom91]

No advice, just hugs and support.

 

[DammitJanet]

Ok....

Just as an aside..I take my lamictal at night with no problem. That being said.

Onto more pressing problems.

You say she goes to a clinic to get her medications right? Does she have to go every month or can she go every three months? If she can at least get her scripts written with refills, then what you should do is get them set at a pharmacy with an auto-refill service such as CVS. Im sure others do it too. You can also keep an eye on this yourself on a calendar to call the pharmacy to make sure they are being filled. If you have to, go pick them up yourself.

Get her a weekly pill dispenser. If she takes them at various times during the day, get one that has the morning, noon, dinner and bedtime slots. Since she is out of the house during the day, they make one that you can take that day's worth of medication with you and then pop it back in the dispenser when you get home.

Can you tell I have been around the block with dispensers? LOL.

I can understand your frustration with money. I am somewhat the same way with money. I was REALLY that way with money before I worked for my own money. Then I understood how hard it was and how horrible it was to blow it. Now I am much better. Still, I have my own account for my own money. Rarely do we mix my money with Tony's money unless we are putting money in my account to cover certain bills. He used to have to hide money too but now he doesnt. I know better now. Of course, Im stable. If I wanted money from him, I would ask him. If we could afford it, he would say yes.

 

[susiestar]

The auto refill is the way to go. You simply MUST call the clinic and make an appointment if she needs one for refills. Then insist on going to the doctor with her. Be open with the doctor about what is going on. Ask the doctor for either 1 month rx's with refills or 3 month rx's if you have mail order pharmacy benefits. Also ask the doctor why she is on so many SSRI medications when she is bipolar and they are known to cause cycling and other problems for people with bipolar. You NEED this info.

YOU need to take the scrips from the doctor. Get them filled and set up a pill box. Make sure the medications are where YOU can see them to make sure she is taking them. If she doesn't want to take them, cheeks them, or hides them, ask her why. Let the doctor know what she is doing and why she is doing it.

Set up auto refills and also keep track in your planner, phone, or whatever so you can make sure to get the medications on time.

You will need to let her know you are doing this because you love her and want her to be healthy and happy. Let her know you are also doing it because she is hard to be around when she is off her medications and the kids do not deserve to have to live with that.

Figuring out your bottom, that limit where you will have to separate is also important. I know you love her but you also have to love your kids and yourself. If she is this hard to live with unmedicated, and she is going to refuse medications or not bother to fill them for days or weeks on end, well, it is not healthy for the kids. It is also not safe as when you stop some of these medications you can hallucinate and/or have psychotic breaks. Just because she hasn't yet doesn't mean she might not. It is also hard on her health to go on and off of them the way she is. It is bad role modelling for the kids.

FYI: The accepted medication protocol set down by the Board that certifies psychiatrists is first to use mood stabilizers until she is stable. It may take 2 mood stabilizers to do this. SSRIs are NOT mood stabilizers. Next you add anti-psychotics to help with anger and sleep and other problems. After she is stable, if she is still having some problems with depression then antidepressants of any kind can be added. Slowly and carefully. If problems with ADHD symptoms are still there, stimulants or strattera can be carefully added, but only AFTER the mood stabilizers and antipsychotics.

I realize that you are already overloaded with responsibility, but taking this on may result in a more productive spouse. Just be SURE to google SSRI withdrawal and each of her medications and withdrawal. You will be shocked. Docs often downplay or tell you that withdrawal does not exist. They are wrong. Many of us here have gone through it or seen our kids go through it. Effexor is one of the worst for withdrawal. You can have serious symptoms if you are 20 MINUTES late with a dose. That is what I dealt with. I behaved much like your wife is while withdrawing from several different SSRI/SNRI medications. Cymbalta has some wicked withdrawal also, but if she has any prozac left a dose of that can really help with withdrawal. Prozac has the longest half-life of any of the SSRIs, so one dose a week can help with the withdrawal. If she has any left have her take one until you can get her into the doctor.

The doctor needs to talk to her about staying on her medications. If the Trazadone is for sleep you may want to ask about seroquel. Many here have a dose of it at bedtime and it seems to work well. Ambien and Lunesta may also be options.

Hope this isn't too much info. It may help you to do a Parent Report on your wife. You can find it in the FAQ section. It will help you get all the info on your wife in one place.

Hugs.

 

[GoingNorth]

Trazadone is also an antidepressant. It's an older type called a 'tricyclic'. Some BiPolar (BP) people can't tolerate that, either.

A LOt of people have gotten good results with a small dose of Seroquel for sleep. At those low doses, side effects are rarely an issue

 

[crazymama30]

I second the medication minder (or pill box). My husband would never be able to keep his medications straight without it. I fill the medication box, I refill the medications, I go to psychiatrist appts with him (he allows this, but not sure after the last appointment). With that being said, your wife sounds much more functional than my husband---she is able to work and work a lot. I am lucky if husband even does laundry! If she will not accept your help or you don't want to offer it (and that is ok) then I am at a loss.

I would be leary of the SSRI's--husband's psychiatrist will not allow him to be put on Savella or Cymbalta for his pain.

I can sympathize. I went to work for 8hrs, went to the grocery store, came home, made dinner and have started the laundry. husband did fold a bunch of laundry (miracle) but I had to point out that he can watch football while folding. I take difficult child to all his appts, deal with all his prescriptions, husband's, mine and my grandfather's. It sounds like we have similiar lives and wow does it ever get overwhelming.

Fwiw, difficult child takes his Lamictal at night and sleeps fine.

Feel free to vent, and if you feel better you can pm and vent. I vent a lot to certain people in my life, and could not function without it.

 

[witzend]

Wow, I hope that she will get back on track! Last week when I filled my weekly pill distributor, I forgot my Wellbutrin. I'm not sure why, I just didn't put it in the container for some reason. By the fourth day, I had such a headache, I'd had night terrors for two nights, and I felt like I was going to jump out of my skin! I'm glad I figured it out as quickly as I did!

Do you think that she might need to see the doctor again just to be sure that she gets started back up in a way that won't be detrimental to her health? Hopefully she will be able to see that she can feel better with them than without, without your family going through too much further turmoil.

 

[GoingNorth]

That's a valid point. if she's been off her medications for this long, it is very likely that she might have start over and titrate up again.

 

[BusynMember]

I read somewhere that 60% of all bipolars are non-compliant on their medications. I think the reasons range from with being too confused to fill their own medication to not liking the side effects (I have quit medications myself for this reason...at times I felt worse on certain medications) to them thinking they just don't need them. Do you think she forgets or just doesn't want to take them? If she doesn't want to take them, are you open to hearing her explain why? If it's side effects, medications can be adjusted or changed. I'll tell you right now, I HATE MOOD STABILIZERS. They dull me into zombieness and I can't stand the feeling. However, I don't seem to need a mood stabilizer and I take the other medications that do help me without making me feel out of it.

If she doesn't want to comply, I really don't know how to make her do it. She doesn't have to take them. She's an adult...a pain, I know, but she can choose to be non-compliant. If she simply forgets, and you need her to be more stable, then, as big a pain as it seems, maybe you should get them for her.

I'm sorry you are going through this. I have a few diagnoses myself and without medications I can't really control my anger, which is why I take them religiously. For me, therapy doesn't work if I'm not on my medication.

I hope you can make your wife see that she does need something and that if medication A doesn't work or makes her feel worse, there are other options. Take care and hang in there.

 

[BusynMember]

Wow. I just noticed those medications. She's on two antidepressants and a stimulant????

I'd have a word with her doctor. That would make me bonkers. Too many stimulating medications would make me positively non-stop manic. I understand why she may not want to take those medications. The only appropriate one for bipolar is Lamictal and it can't work against all the other drugs. The wrong medications can make things even worse.

Whew! I'd get a second opinion on those medications!

 

[TPaul]

Hey Everyone,
Thanks for all the thoughts, ideas, and concern that each and everyone of you took the time to share with me. Sorry that I have not been able to post a reply before now.

Yesterday I had to go to my neurologist appointment about an hour and a half away. That went well except for the blow out of one of my tires on my pickup, , however that ended up with a happy ending. Right before the move I had to have one of the tires on the truck replaced and the spare was no good. With all that was going on, I decided to wait to pick up a good used spare. Well, I should have because I did not have one with me on my trip to the doctor. However as I began a short walk to the exit from where the truck was sitting, a gentleman pulled over. He ended up having a body shop and offered to let me see if he had a spare tire that might work for me, and told me only 20.00 for the tire and rim. That was an amazing price.
Ran back to his shop and found one that we thought would work. He took me back to the truck, and gave me his card and said if I had any trouble to call him back. Well, dumb me did not remember that the tire was a 6 hole and not a five. Call him back feeling dumb and tell him it was a 6 hole. He brought me another tire on the rim, and guess what happened when we moved, someone took my tire iron out of the truck, , I asked him if he had one with him in his car. He said his would not work on mine, but he called someone from his shop to bring one. That person got there and ended up changing the tire for me. I jacked it up, and he did the rest. Offered him some money but he would not take any. Made me feel good that there are still nice people out there, .

Well said that about my trip to the doctor, that before I left wife said that she would go and check about her medications. She did go, she told me, but that it would be the 25th of this month before she could get in. She told my oldest daughter that she needed to get her medications because if she didn't get them she was going to end up hurting me physically because all she wants to do is slap me or hit me with something. At least she maybe saw again that when she is off her medications, her feeling for me are all negative and that she unloads everything, both double barrels, on me. Keep your fingers crossed, that she follows through, and that we survive till the 25th.

Thanks again
Tpaul

 

[susiestar]

If these are her normal medications then YOU need to call her doctor. Tell the doctor that she is threatening to hurt you and needs her medications to help stop this. Ask the doctor for samples of anything that she is on (if he has them) and for one month prescriptions to be called in to the pharmacy or ready to be picked up. Assure him that seh WILL be there for her appointment if you have to drag her there.

Most docs will call in a month worth of medications for a patient on daily medications. Being off of her medications cold turkey can cause seizures and many other awful problems. (google the name of the medication and withdrawal to find LOTS of interesting info).

Or the pharmacy can call and get refills for you. This is very common. I know you want to let wife take care of this but YOU will be the person who gets hurt. wife's behavior is also VERY damaging to your kids. Document this in your dayplanner or journal, that wife ran out of medications and waited to call the doctor until she was ready to hurt you. You may need to be able to show that this happened (with specific dates) if your marriage ever breaks up or wife ever hurts you. This info will allow you to PROTECT YOUR KIDS in case wife ever gets a lot worse. NOT saying that will happen, just that you should prepare for everything.

Go call her doctor now. It is important -even if she gets mad. Chances are the scheduling person did not understand that she needs her medications ASAP.