Failed Discharge

Medication is a huge part of our spouse staying healthy but what happens when you know a change is about to have to happen? I would imagine all of us have been here. You are going along relatively managed and then all of a sudden you are going back up the big hill. After a time or two, you see it coming either by the time of year, knowing the triggers or just recognizing the signs. When medication is being adjusted or changed, the fear that we as the spouses feel can seem immeasurable. At least for me. We know that we are going to have to be the police and sometimes the victim at the same time. But most of all, as always, we are going to be the caretaker and the buffer.

The most terrifying to me was when the medication he had been on for upwards of 7 to 8 years suddenly made my husband extremely ill and he had to be detoxed of everything very quickly. The regiment that I felt had helped hold us together as a family was literally killing him. I was scared of both losing him to death and losing us to his illness. His time on this medication had not been a time without any rollercoaster hills, but it had been much more manageable with longer periods of health than we had seen on the first several meds that the doctors had tried him on. He still fluctuated but tended to rest at a bit of a heightened normal, a few steps below manic. He had life in his eyes and enjoyed participating in life most of the time. He still had his triggers (both seasonal and external) but his cycle was very predictable.

He had been medically ill for several months, being tested for all types of illnesses including Parkinson's and Dementia. My fun loving husband had turned into an older man right before my eyes, right down to shuffling his feet as he walked. Some days he couldn't even get out of bed his body hurt so bad and felt so stiff.. Finally, one evening, I felt like he was showing stroke signs so off to the ER we went.

Once there the doctors ran blood levels and the issue was revealed quickly. His body had stopped processing the Lithium and he had double the amount he should stored in his body. It was a toxic level. He was just a short period away from his kidneys shutting down but thankfully, he was spared needing dialysis. Four days into the medical treatment, he was feeling better than he had in months both physically and mentally. Behavioral Health came to address how we were going to introduce him to his new medications. He would be in patient with both therapy and a psychiatrist monitoring him while they found a regiment that worked. There would be family therapy and a session with me, as his spouse, prior to his discharge so that we could be educated on how to handle situations and help him through the adjustment. It seemed very well planned.

Imagine my surprise when less than 48 hours after his transfer, I got a call to come get him, the doctor said he was doing so well he could come home.

I had a very literal nervous breakdown minutes after receiving the call. One he had no idea had occurred. I picked him up, disguising my fears and we went out to dinner just the two of us. The next couple of days were relatively uneventful and then the dam broke loose.

I never knew what real psychosis was until the March of 2018. My daughter was his target this time. Her own severe anxiety (created by several traumas in her childhood) create her to retreat into herself to a point and then her flight/freeze response turns into fight and she will verbally begin to stand up for herself. He hovered over her as she worked in our home office, criticizing, and making snide comments until she finally had it. As always, one of my sons rushed in to get between the two as the argument escalated and my husband pulled the computer she was working on out of the wall and off the desk and said he was moving out. Shaken as we were, it was a familiar scene and my anger at the hospital began to mount.

The relief I felt as he walked out the door uttering the obscenities, threats and nastiness was immense. He didn't say where he was going but knowing how limited his options are, I figured he would end up at his sisters. As much as that bothered me in the past because her support always came in the form of funding his mania, and backing up his plan on leaving, and then expecting repayment when he returned home to us, this time was different. I was done. I love him but my family had been put through enough. I had been through enough. I had gotten used to his family letting us down but when the medical system lets you down, you have no idea where to turn. In the couple of days he had been home I had called the Behavior Health department that had released him, to state that I saw all the signs of mania but had no idea how to handle what was happening. It was heightened from what we had experienced before. The nurses I spoke with were sympathetic and seemed to understand where he was headed but their only ability to help was to advise me to get him to return to the facility or call the police. His refusal of voluntarily returning was loud and included a threat of suicide if I tried to make him. A new development. After speaking with the Behavioral Health Administrator, it was decided that this was a failed discharge and that while he agreed that my husband was severely at risk, there was nothing that we could do to bring him back involuntarily without getting the police involved.. He told me of their out patient program that may be able to be a stepping stone back to the facility.

The next few days was a combination of text messages and phone calls full of divorce demands, obscenities and threats. I tried not to take the calls but that created heightened hostility. If it were not for all six of my kids, including his two biological in NC, I would have been a complete mess. But their support and strength helped me hold it together.

Then the phone call came that he could not stay with his sister anymore, it was a "terrible environment" and that he planned on coming home for a few days so he could get stuff together to move to NC with his kids. I met with him stating that we had to come up with a plan. We had very little money and he was making demands for both a settlement and money to implement his plan. He was in the calmest state he had been in in a week. It was one of the hardest, scariest things I had ever done but I told him that he could not come home even for a short period. I knew that if I let him back in I would be unable to protect my family and as worried as I was for his state of mind, this was the first time I had ever been afraid of him. I had been in touch with our pastor several times over the last few days and my husband agreed to go see him as a mediator.

He became intense again in the meeting as he realized that our pastor was not going to change the circumstances for him. As the conversation went on he became extremely agitated again to the point that our pastor agreed to drive him back to his car rather than putting me in that situation. He went to a motel for the night with a plan to drive to NC in the morning.

Shook up but also relieved, I hadn't been home an hour before he called screaming at me loudly enough that two of my kids and a friend could hear the conversation even without speaker phone. He refused to stay in the hotel, it was filthy and bug infested. I had never seen or heard him like this and it was terrifying. I called the hospital back but again was told, there was nothing they could do except advise me to call the police. I have watched tv shows and movies where you see people in desperate situations and wonder why they don't just call the authorities but for the first time, I understood how those plots could be real. I had no idea what to do but I knew I could not bring him home. I didn't recognize him. Finally, he stated if I would give him $400 dollars, he would drive to NC that night. My youngest son immediately said done and offered his own money.

He wanted me to bring him the money, nobody else but my son said that wasn't happening, he would go. In an attempt not to agitate him further, I went as well. Again, I was scared but prayed that the nightmare would be over soon if we gave him what he wanted.

The meeting was uneventful, he calmly blamed me and the kids a few more times for our failed marriage. I just nodded and prayed it wouldn't hurt for long.

The next week was a blur. I dealt with phone calls that varied from sweet and wanting to get better to realizing he was sick and just wanting me, to needing money for his needs (wants) to anger and nastiness. My NC kids and I were in constant communication without him realizing it. They were worried more than ever, finally seeing what they had only heard about before. Not to say that they were not touched by his illness, we just did not realize it was an illness in their early years. Through all the fear, hurt and anger, I was genuinely worried sick about him.

In the midst of it all, when we were at our lowest, his sister struck again. She publicized a Go Fund Me page with a picture of him looking like he was homeless. Then to add to it, she sent it to many of our friends (including my sister in law from my first marriage) and members of our church, begging for money for him. My kids and I began receiving calls and texts with question after question. Some would say this was an attempt to help, knowing we were short on funds. The reality is that she has a hero's complex and needs to feel like she can control whoever her focus is. If she really wanted to help him she should have learned how to help him with his health. She should have asked his wife and family some questions instead of always just validating an ill person's reactions. She should have educated herself on what her brother was dealing with versus just putting a feel good band aid on a gushing wound. To give a person in mania that much exposure and hand them money or access to money is no different than handing a drug abuser a clean needle and address of a "reputable dealer". You may think you are helping but you are single handedly putting a nail in their coffin.

It was our oldest daughter that saw the page first and alerted me. At some point it was also her that let me know that the same sister that put out the Go Fund Me page also let it be known that she thought I had overdosed my husband. If anyone ever questions why I state that 2018 changed who I am from the inside out, this is why.

$400.00 was gone in less than a week on things that, by our son (who he was staying with), assessment were not even close to necessary. Bedding, beer, clothes and food to stock his kitchen with snacks. Our son was quickly losing patience.

One morning he called me, apologetic and scared. He just wanted to come home. This is when it is the hardest. When he seems scared and vulnerable. This is when you remember that the enemy is a disease, and not the person you married. But I craved peace and growth. The conversation ended with him feeling like he was having a heart attack and screaming out in pain and fear. I called our daughter and son and let them know what was going on and could either one get to him. Our daughter beat the ambulance to him. She took control and tried to give the doctors insight as to his mental state. He was a joy in the hospital. Social and comical. The doctors didn't consider him as being in any need of behavioral evaluation. They did however decide his heart pain was anxiety and prescribed valium to get him through to the time frame he could get home and into a day program. So this was his new plan. He was willing to go back to the hospital as an out patient.

The reconciliation began with an agreement to return to treatment. He does not remember large chunks of what happened nor what was said, during this time frame. His desire to be healthy is shown in his taking his daily medication and attending therapy and trying to learn what his triggers are. This does not mean that the cycles cannot get away from him and when they do, lives change. There is a lot more to how we began to try to find a new normal after the episode and the changes in both of us are extreme. He is medicated at a level of borderline depression/ anxiety. There are few high's but there is also no joy. I am unwilling to help him with his medication like I used to nor attend family functions where I know his sister may be. I have a new level of anxiety about being around people or even leaving my house. Most of the time I feel numb or at least dull. It helps me to not get too hopeful at long term changes. My boundaries are firmer but so is my love for my husband. I feel like I have to protect him, take care of him and buffer for him. In sickness and in health. God put me here for a reason, I pray my story can help others if nothing else, know they are not alone.