Lost in Diagnosis.....

[kennysgirl]

I have been married to my husband for 8 years now, and have always seen the depression side of things for as long as i have known him. But about 5 years ago he started acting alittle different, starting with inappropreate flirtations and actions with women at work. He has always had a problem with seperation with me, i have only gone on one vacation with out him, and during that time he cheated on me with my sis in law. ever since then he freaks out if I mention I am going to go somewhere. His Anxiety is ruling his world, along with what seems to be mixed states of Bipoloar. He isnt working anymore, which means I am looking for a job now . But each time I mention a job interview or going to work he flips out. He feels like he is going to die from the anxiousness and pain inside. He usually sleeps the entire time i am gone, which is either induced by xanax (per the dr) or Pot...(per his dad!) He has had 5 suicidal attempts, once with a gun, twice with a razor and his arm, and twice just talking about how much he wanted to die. He has been hospitalized twice and diagnosed with  major depression, anxiety, PTSD, agoraphobia for a few months last year, schizoaffective disorder and now Bipolar, maybe along with BPD or ADHD. Each time they change his diagnosis something else comes up and they have to change it again. He has been on quite a few antidepressants as well as two antipsychotics. But so far not much has helped.Zoloft helps the most out of anything, but it kinda plateau's  at its highest strength of 200 mg, and he continues to struggle with the depression. recently the dr took him off invega (the diagnosis was the schizo one at the time) because it obviously wasnt doing anything good, and also took him down to a 50 mg of zoloft. She desided he was mainly Bipolar, with possible BPD and ADHD, so put him on Lamictal. SOOOOOO MY QUESTION IS....Since the Lamictal wont take action for a few weeks shouldnt she keep him on a higher dose of Zoloft until then? When she took him down he LEPT into the deep depression and nightly mixed state again!!! But she isnt avaliable to speak with until next week, and no one else can give us answers as to whether we need to up the dose of zoloft for a bit or not!! I am scared he will become suicidal again, and even if not, I cannot live with him in this mixed state ****! He is rude and selfish, and nasty to live with. he wont make eye contact or even answer my simple questions during these times. He argues the meds he knows he should take. and he is up all night pacing or walking around our yard. so any help here? I honestly dont know what to do. I think he is BPD for sure, I have studied it in great lengths and He fits the profile, but the dr argues saying that it cant be treated with meds so she will only look at the bipolar symtoms.  
I am, and of course my husband is as well, SICK of the ups and downs of the diagnosis ****! and I mean i understand switching meds to find the right mix, but they cant even figure out what is really going on with him!! and I am ready to bail. I have lived thru this for too long, and If we cant find the answers soon I cant handle it any longer! sorry, had to vent.  anyway, any words of wisdom? any insights of what may be really going on??

[FMXSMKR]

Hi there!  So sorry you and your husband are having such a rough time, to put it mildly.   Here's the first thought that came to my mind.  Since AD's, and anti-psychotics I assume, can take up to six weeks to be effective I wonder if starting and stopping so many meds over the years could be the reason for no improvement.  What if, under a doctors supervision of course, all meds were stopped in order to let his symtom "reboot" so to speak?  I would think a hospital stay would be in order to do this.  Then reintroduce one med at a time.  Many people feel worse before they feel better when they first start AD's and end up discontinuing the drug instead of having patience.....which is difficult to have when the meds seem to make you feel worse.  Then, stopping an AD can cause MONTHS of w/d,  SO.....maybe all the readjustment of meds is keeping him at this intolerable level and he is in a constant state of either adjusting to a new med or withdrawing from an old one.

Just a thought.....I may be way off base here.

Best of luck to you both.....

[kennysgirl]

Thanks FMXSMKR for your reply. I have also thought of doing that, a REBOOT. But when he gets like he is now he will NOT go to a hospital. The two he had to be in for the suicide holds were bad experiences, and they made him feel trapped and "locked up". SO now any time I speak about hospitals he gets really freaked out. And do be honest they scare me too, I know that alot of times people get the help they need and can come back out into live again, but I worry it would scar him. That even if the meds were evened out that the experience would cause more trouble emotionally. He has such a problem with authority and with people who would have control over him. that is part of why I think he has BPD.
anyway, the meds  he has been on are these.
Lexipro to start ( 5 years ago, made him try to commit suicide with a gun)stopped after two months
Seriquel (from the first hosp admit) which made him worse, seeing things, hearing things life inbetween sleep and awake, and fearful.stopped that after a month
Zoloft (3 years ago) helped the very most. but once he hit 200 mg's he still had depression, and rare mixed state situations when he would miss a dose or go off them for a week (he said he felt better so he'd quit...duh!) after 2 1/2 years anxiety and panic came stronger and more frequent. then mixed states happend more often.
xanax for the anxiety and panic, and agoraphobia
Paxil (last september) which sent him into a constant "mixed state" situation, which the dr didnt see.
Klonopin and Xanax for the anxiety and what we see now as Mixed states
weaned off the paxil when someone finallly realized he was Bipolar in December
Zoloft 200 mg again (started in dec) with invega 9 mg
did well for two weeks then spiraled down again. not as bad as on paxil but still very bad.
NOW on Lamictal starter pac, with only 50 mg of zoloft.  and Adderal for Adhd (another guess....what is wrong with people?)
anyway, i am just very scared what a hosptialization would do, has anyone lived thru this to talk to me about it? I just dont know if the end justifies the means! ya know? with my hubby anyway.
thanks again!!!

[FMXSMKR]

Ok, let's forget the SSRI's.  Has his doc ever put him on a "Tricyclic" AD?  Tricyclics are a completely different group of antidepressants and used long before SSRI's were created.  

My heart absolutely goes out to you and your husband.  He must be so miserable!   He's very luckly to have you.........

[FMXSMKR]

......and in response to the hospital dilemma, being in a....oh maybe a behavorial unit or just as a regular patient would be completely different than being in a psych ward under suicide watch......or is he just not open to ANY type of hospitalization?   I can understand the trauma for both of you under the first circumstance.  

You know, unless your husband gets to the point where he is sick and tired of his life being so out of control, there is only so much you can do and after 8yrs of this.....well, I can see where you might be at the end of your rope.....

[diemyn]

I've been on a lot of meds over the years. In my experience zoloft is one you have to wean off of. It kind of took me out of myself and all I can think to liken it to is jumping into a cold pool. The world is a harsh place and reality kinda bites. Zoloft tended to dull it for me, so the sudden jolt is a lot hard to take. I sure wouldn't go from 200 to 50 like that, since there's such a great difference to me.You'll notice that I make a point to state that this is solely from my own perspective, which is that of a diagnosed BPD.There's no one thing or combination of anti-s that work for everyone. If you've tried many medications and  have had no success, I'd suggest getting off of them. If you research them on your own you'll find that they also tend to worsen the mental almost more often than they help it. I'd also just like to add that mixing pot with any prescription generally increases anxiety in people with a history. It sounds like you have a hard journey and I wish you and your husband the best.

Love and light,
Diemyn

[xartificialxflowersx]

By describing your husband, you have completely described what my boyfriend used to be like. I only had to go through about 2 years of it, but that was quite enough. You're being very strong dealing with this.
First of all, are you safe at all times? I know I feared for my safety a few times when he got really upset, and also for his safety. (I think my undiagnosed, untreated mental illness kind of added to his difficulty as well). You're a blessing, and when they finally get his meds right, he'll thank you endlessly for sticking with him through the whole mess.
Also, do you trust the doctors who are prescribing these meds? Make sure they are fully qualified and experienced in the field, because both he and I had to go through hell with wrong diagnoses and inexperienced doctors.
From my experience, Lamictal + Abilify helped a little bit. Adderal made his irritability much worse in the long-run, even though it cheered him up when he started it. He's been on more antidepressants than I know of, and the only one that works for him is Effexor. That's the only one that works for me as well. I hate to be promoting this drug because if it doesn't work, it's a ***** to get off of, but after the first week or so you start feeling the effects (the first week can seem to make you more depressed, but you have to stick with it).  Talk to his doctor about Effexor. If he "feels better" and stops taking them, the withdrawls hit hard and fast so hopefully (as with my man) he learns the first few times that he can't simply stop taking them.
anyways, I guess the only advice I can offer you is the Effexor, staying strong, and most importantly, keeping hope. He will find the right combination of meds.
Good luck, and best wishes.