Progress on my wife's treatment and her issues

[Think About It...]

The last I posted on here, my wife was on her way to being hospitalized.  The thing is during the final evaluation meeting before being admitted, my wife's Pdoc asked me what was going on.  I told him that my wife was feeling nervous because her father was getting out of jail.  It turns out my wife left out that detail, along with a few others that came out after questioning.  Once that happened, the Pdoc decided that she would be better served with a partial hospital program, with lots of intensive group and individual therapy.

Since she's started, she's been much more involved than her last go-round with the partial hospital.  Last time, she was trying to do what she could to get discharged as soon as possible.  This time, she's talking in therapy, and a lot of issues are coming out.  I don't want to put all of her issues out there, but she has had more abuse than I already knew, which is saying something.  As a result, she's suffered a few panic attacks in the partial hospital program.  Also, the facility where she's at is not recommending further DBT, as she isn't suicidal or self-injuring.  To be fair, there's only been one such incident in the past six months, and she hasn't threatened it either, so that's all we can do right now.  There are other facilities, but it would be difficult for her to get to due to various and sundry logistics issues.

I have a few questions.  First, how is the best way to deal with the constant panic attacks and psychosomatic issues from her therapy?  Two, how should I deal with the fact that my wife is likely not going to be in DBT after this?  And three, how is the best way to help her cope with the trauma that's being brought up?

[iluminati]

The last I posted on here, my wife was on her way to being hospitalized.  The thing is during the final evaluation meeting before being admitted, my wife's Pdoc asked me what was going on.  I told him that my wife was feeling nervous because her father was getting out of jail.  It turns out my wife left out that detail, along with a few others that came out after questioning.  Once that happened, the Pdoc decided that she would be better served with a partial hospital program, with lots of intensive group and individual therapy.

Since she's started, she's been much more involved than her last go-round with the partial hospital.  Last time, she was trying to do what she could to get discharged as soon as possible.  This time, she's talking in therapy, and a lot of issues are coming out.  I don't want to put all of her issues out there, but she has had more abuse than I already knew, which is saying something.  As a result, she's suffered a few panic attacks in the partial hospital program.  Also, the facility where she's at is not recommending further DBT, as she isn't suicidal or self-injuring.  To be fair, there's only been one such incident in the past six months, and she hasn't threatened it either, so that's all we can do right now.  There are other facilities, but it would be difficult for her to get to due to various and sundry logistics issues.

I have a few questions.  First, how is the best way to deal with the constant panic attacks and psychosomatic issues from her therapy?  Two, how should I deal with the fact that my wife is likely not going to be in DBT after this?  And three, how is the best way to help her cope with the trauma that's being brought up?

[pallavirajsinghani]

Hello Iluminati:  I am chiming in real quick to mention that there are very effective medications for anxiety/panic disorders.  I believe a brand name "Effexor" may be one of these.  Do check with the doctor if a medical regimen can help control the worst of the anxiety (i.e. panic attacks).  This can free up her mental energy to deal with the past issues.  Frequent panic attacks or a constant state of high anxiety will be an impediment in her treatment.

I hope I am pointing you in the right direction.  I am requesting the other board members to please evaluate my suggestion and feel free to criticize/comment/elaborate.

I am proud of you. 

Don't forget to take good care of yourself in the meanwhile...

[Steph]

Panic attacks are not at all fun, but you can learn to manage them via a variety of techniques. CBT works well, also.
And meds. They are pretty scary, tho, until you can get your head around them.

  I would push the DBT thing for when she is outpatient. You dont have to be suicidal to attend DBT or get benefit from it. Perhaps in the program she is in right now, yes..but when she leaves PH, I would push that part, assuming they believe she has BPD.


  Its a good thing she is where she is, tho...

   

   

[momtario]

Those are some very big questions, illuminati.

I'm glad that she is starting to really work on her core issues, but I am sorry to hear that they were much worse than you had known before.

Are you allowed to discuss these things with her pdoc? Her med team may be the best people to answer these questions for you.

[united for now]

at discharge, they have to offer suggestions for follow up care. They can't just toss her out.

Do no harm means they develop a plan to help her.

As for how's to help with panic attacks?
ACT (acceptance commitment therapy) is based on mindfulness techniques and is great for anxiety and panic attacks. There are some good ACT  books out that are great for lay people, easy to follow and very helpful. ACT has been proven to be effective by the Substance  Abuse and Mental service Alliance SAMSA and was chosen by the VA to be used for our returning soldiers. 


I would advocate HARD for DBT. Pressure needs to be applied if we want results. We are the best advocates. No one else...

Do no harm. They can't drag up old wounds and leave her hanging. This needs to be brought up to her team of doctors. As much as you care,  you aren't in a position to help her heal from these old wounds. Empathy and acceptance and being non judgmental are the best you can do...


I'm glad to hear from you.
I hope for the best...

[iluminati]

UFN and Steph, I definitely agree with you on the follow-up care thing.  Allow me to give a bit of background on my wife's mental health providers, so as to make things clear.  The facility my wife is dealing with is a full-service mental facility, providing everything from basic psychotherapy (which I happened to get from there) to full hospitalization and everything else in between, including my wife's current program.  My wife was in the DBT program at this facility in the past, but got kicked out for violating the rules on absences.  A few months ago, when I mentioned DBT to her Pdoc, the Pdoc seemed a bit wary about it, especially since she hadn't been suicidal or self-injuring recently.  However, she did end up getting admitted again to a DBT skills course, with the understanding that if she didn't do well there, she'd go to the full DBT program.

I haven't been on top of my wife's treatment due to my own issues.  I've been traveling often for the job hunt, and I barely have time to talk to my wife's doctors.  That said, I'll find some time to give them a call sometime today and get the whole story.  After all, it's their job to help, not mine, well educated as I may be.    Also, the ACT therapy thing might definitely help.  I'll definitely bring that up. 

MTO, I'm glad that she's working on her issues as well.  Finally, she's decided to do the work because my wife has managed to hit rock bottom, and she knows that she's run out of chances.  A lot of it has been thanks to the good people on the board, as I've detached with love and let her fall on her own accord while taking care of my own life.  A lot of it has come from my wife having to fail without someone else bailing her out or covering for her.  We'll see how all of this turns out.