Dear Dr. Archer,
I'm writing to find help or relief for my wife. A quick background: She has struggled with depression since childhood, most likely because her mother also suffered from depression. She had a normal childhood -- no physical abuse, and though her parents divorced, both remained in her life.
She has a plethora of diagnoses, ranging from depression, PTSD, Bipolar, schizophrenic and now major depression with psychotic features. From 2001 back to childhood she hasn't had any delusions or hallucinations, just abnormal behavior and/or thinking with only a couple of suicide attempts.
Since September, 2011 her symptoms started getting worse, becoming very paranoid, thinking others were out to get her, and she is experiencing audible hallucinations. She's been hospitalized five times since September for this. The doctors would adjust her medications and she'd normalize, but a few weeks later everything would return again, landing her back in the hospital.
Her last hospitalization was mid May to June, when the doctors labeled her bipolar. They released her and she was prescribed Lithium, Klonopin and Respiridone. Even though she was extremely tired all day from taking those medications, when she was awake she was herself, just groggy.
We have told this to her doctor who now has her on Saphris and Lexapro. She's only been on Lexapro for a week, but I see no change in her moods; since she's been on Saphris, two weeks ago, her behavior is very abnormal. She bursts out loud with laughter, mutters things to herself and constantly paces the house. When she takes her meds, twice a day, it just puts her to sleep. When she wakes up, she's back to laughing, pacing and muttering.
It's very painful to see her like this when I know she's such a beautiful woman, with a very pure spirit, and I feel like we're at the mercy of the doctors who insist on tweaking her medication and "wait and see" when the results have always been the same. She's been on so many different medications since the delusions and hallucinations appeared just less than a year ago -- Trazadone, Respridone, Haldol, Topamax, Klonopin, Neurontin, Adderall, Wellbutrin, Celexa, Seroquel, Zoloft and Xanax.
All the medication she's been on are not helping her. What other options are there? We're involved in talk therapy now, but how can that work if she cannot concentrate on the conversation? I can only sympathize with her, as I have no idea what she's going through emotionally, but I do know it has been emotionally draining for me to watch her go through this.
Thomas
Dear Thomas,
First, it is clear that your wife is suffering from a serious psychological problem. The good news is that this has only been severe for a year or so. Trial and error is a very important part of treating psychiatric conditions. When dealing with the brain, every person is different.
There are excellent medications out there -- it's the process of finding the right meds or combo of meds at the right dosages and this takes time. Once that is done, you will once again see your beautiful, pure spirited wife again. Tough, I know, but please do not lose hope.
I suggest you keep a journal of your wife's medications and her reactions to them. Be as thorough as you can, and write what works and what doesn't. Be sure to include all side effects and share your findings with the treating physician at every visit. If this is done as a team effort, you will find the right medications for your wife more quickly.
You are to be commended for taking such good care of your wife, Thomas. The love you have for her comes through your letter loud and clear, but be sure to take care of yourself, as well. Be sure you have your own support system, even if it's a trusted friend to vent some of your frustrations.
While you go through this process, don't become overwhelmed with anxiety -- these symptoms are treatable. You really are doing great, and your wife is very, very lucky to have someone in her corner, as you obviously are.
Keep in touch with your friends, and get together with them on a regular basis for stress relief. Arrange help so you can go out and play a sport, watch a game or take part in a hobby. If you do these things, not only you, but your wife will benefit, as well.
I sincerely wish you much luck!
Dr. Archer
