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Depression? Bi-Polar? Personality Disorder?

Question:

My husband has been diagnosed with depression and is currently taking medication for treatment. However, I feel that he may be misdiagnosed. He has extreme angry outbursts when he is confronted with issues (i.e. money he has mishandled, relocation, emotional vancancy with me). He will not communicate any other way than screaming.He seems like another person when he is this enraged.He will unknowingly mouth my words, scream at me while looking in the mirror at himself, won’t finish his sentences and when I ask him to, he says he did and then gets even more angry saying I don’t listen. When he isn’t angry he is usually very quiet, rubbing his chin.He also has strange manerisms in that he will draw in his fist like a baby (almost clubbed) when he is walking or thinking about things.In the past he has scratched himself in order to "not feel the pain".He has been in therapy for years, but never seems helped by anyone. Currently he is wanting to relocate us to another state, but he has a history of villanizing everyone he works with if his ideas aren’t met or considered. Usually quitting or being fired after 6 months. I feel that he needs to help himself before dragging his family into his destructive patterns.What could be wrong, is this a mental disorder other than depression?

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Answer:

You are asking important questions about your husband’s behavior. First, it is important for you to know that your husband can be both depressed and suffering with a personality disorder at the same time. It is also possible that he is experiencing Bipolar disorder although I suspect the psychiatrist might have seen this and decided on depression as the diagnosis, probably because his symptoms do not fit the criteria for Bipolar disorder. If your husband does have Bipolar disorder and is taking anti depressants those medicines could make things worse. You need to alert the psychiatrist to what is going on at home so that he is fully aware of your husband’s behaviors and symptoms. Also, be aware that, regardless of diagnosis, drinking or using drugs would only worsen the symptoms of any type of problem your husband has, regardless of diagnosis.

With regard to personality disorders, anti depressant medication will help with symptoms of depression but not the problems associated with personality disorders. Personality disorders are learned patterns of behavior dating back to early childhood. Treatment usually takes many years of therapy and lots of hard work. Changing work and living locals will not change the patterns of behavior if he does have this type of disorder. Borderline personality disorder along with depression would go a long ways to explain your husband’s symptoms.

I would suggest you seek family sessions for both you and your husband and children if you have them. These sessions could be held with the psychiatrist or the therapist he is working with. If neither one does family sessions, you could find a practitioner whose expertise is in family therapy. If none of this can happen then I would urge you to seek therapy for your self.

In a family, one member’s mental illness is not his alone but becomes part of the family system because it affects everyone. All of you need help with your husband’s emotional problems. This is more complicated than just a diagnostic category and medication.

Best of Luck

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