Disassociative Episode IN PUBLIC

[WitzEndWife]

My uBPDh has been severely depressed for a couple of weeks after quitting his job. Saturday night, we were in the store, and he was telling me how worthless he felt, and then he started oddly spinning around in circles. I said, "What are you doing?" He said, "I'm looking for something." I dropped it and kept shopping, figuring he was just being dramatic (as he is often). When I looked at him again, he was mumbling to himself. When I leaned in to listen, it sounded like incoherent jumbles of words. Uh-oh, I thought, he's having an episode here in the store.

He's had a couple of disassociative episodes in the past, but they were always at home. He would mumble incoherently, and often talk about his dog that he had as a child. One time he started petting our dog and calling her by his old dog's name. This time, he was coming apart in public.

I tried talking to him, but that wasn't helping. He was coherent enough, somehow, that he was able to help pack up groceries and take them to the car. I drove home, but I contemplated just driving straight to the hospital.

When he "came to" I told him that he'd had an episode in public, and I told him that he needed someone to help him. He bluntly refused, saying he didn't trust psychiatry, and that it was all a "big pharma" scam.

Later that evening, he asked me, ":)o you think I have DID?" I said, "I don't know, but it was scary."

What do I do?

[LightAfterTunnel]

Hi WitzEndWife,

Dissociation is scary for us bystanders so I can only imagine for your husband. I must admit that the fact your husband realizes he had it, admits it, and is questioning it is a great starting point!

I don’t have any great advice but I’m sure others will. BUT I would definitely validate his being open and honest about what he’s experiencing so hopefully with the help of a T he is able to diminish their occurrence.

My BPDw’s dissociative episodes have truly been scary in the past but she never never would talk about them afterward. For her they simply didn’t happen. Didn’t exist. Even in joint therapy setting and me bringing up a very scary episode that occurred the night prior she wouldn’t back down from her distorted feeling-driven reality. It was actually quite sad to witness, it’s when it sunk into me how “sick” my BPDw was.

So... .if you two are not in some form of therapy then I would try to get him in with you while the blinds are down and hopefully the open discussion will help him, and you in consequence.

I am interested in hearing what more senior knowledgeable members recommend.

Best of luck,
LAT

[WitzEndWife]

I am fortunate that he is aware of these episodes. He said that he could feel it happening, and that everything became all "jumbled."

The problem is getting him to get help. I might have to wait for it to happen again, and record it, and play it for him afterward, for him to get an idea of the impact. I still don't know if he'll see someone. He claims that he saw therapists when he was younger, and that he was medicated, and that it did nothing (well, if he's BPD, that explains why it did nothing). And, if he was put on the wrong meds or misdiagnosed, they didn't do him any favors, because now he's totally gunshy of any therapy.

The fact of the matter is that he's doing really poorly mentally, and there's nothing that he is willing do about it. I don't know how much longer I can keep doing this before I run out of options.

[formflier]

  but I contemplated just driving straight to the hospital.

I think you should have taken him.  He may have walked out, but... .you would have done the healthy thing.

I would suggest asking him if he wants to call and make the appointment with his GP, or if he would like you to do this.

Do you guys share the same GP? 

I would suggest that if he refuses, that you go anyway. 

He clearly understands that something is wrong... .he is clearly wrestling with it and he is clearly using his relationship with you to "prop" himself up while juggling all of this.

If you want to continue in this role of "propping", rescuing, worrying, hoping... etc etc... .then take no action or leave it up to him.

If you want your life to be different YOU can act.

Ultimately... .it may be that this is another distraction from the work thing... ."Oh look, she won't hold me accountable for not working and looking because I'll do this... .ok... that bought me some time and now I'll do this... .some other odd thing... ."

Now, I don't want to suggest that he is sitting around "plotting this", but I do want to suggest that this and the work stuff will likely continue, unless both of you walk a different path.

No chance he will walk that path alone.  He may choose to let you walk that path alone.

Do you think he will start down the path towards health, without you going first?

FF

[Sunfl0wer]

Based on what you describe, I don’t think DID should be off the table.  Folks with DID or OSDD often get medicated for things like depression or psychosis and such and the meds do not address underlying dissociative issues, therefore are not too effective.  

(I found out last year that I have OSDD, which is like a mild type of DID.  I have lots of coconscious so rarely have memory gaps of “losing time.”  I had no idea that it was possible to have a dissociative disorder the way I present, as I appear mostly normal. Persons with DID or OSDD often also have BPD.  Not always, but it is a common comorbidity.  The prognosis for someone treated for dissociation vs BPD much more promising ... .with a good trauma therapist.)

Also, it is not uncommon for persons with a dissociative disorder to have a lot of fear and resistance about learning about the different aspects of their Self.  It is an inherent part of the disorder to be phobic of facing different aspects of the self, also inherent is some denial of the dissociation/disorder.  Reason is, compartments were created as a survival mechanism, so facing such things may intially feel like a threat to the person.  Also, persons with such issues had to be one person at home and another out in public so they adjust and create themselves to hide the disorder pretty darn well.  Many do not get diagnoses until after 30’s.

(If it is DID or OSDD, and not psychosis, then inpatient is not needed as long as he is not harm to self or others.)(what makes me lean towards dissociation and not psychosis is you say he seemed to be living in the past vs conjuring up any hallucinations.  More like his mind went to the past.  Not like it went to another planet.)

What helps me most is knowing all my Parts are going to be accepted to exist.

[formflier]

Sunflower brings up a point here... .there has been self harm and harm to others.  I'm going from memory but suicide threats and locking himself away is part of this.

Also physically threatening behavior to others, perhaps throwing things (I'm going from memory)


Here is where I'm going.  There are obviously some very serious things going on with your hubby.  The thing is, he knows it as well. 

There is only so much support that an online group can give.  I would feel best if both of you were involved with and complying with medical professionals to get yourselves and your relationship to a healthier place.

If he won't go, I would still encourage you to go, because that way at least a true medical professional is "that much closer" to the issue and can provide you guidance about how to reduce tension in your home.

Thoughts?

FF

[Fie]

Dear WitzEndWife,


I am so sorry you have so much on your plate. It cannot be easy.

I don't know anything about DID, and I think people like Sunflower can offer you a lot more information than I can.

I do remember though from your previous post that you mentioned your husband did / said something that seemed paranoid to me. I don't remember specifically what it was, but it didn't seem very healthy. It stroke me since my BPD ex was also paranoid, and it didn't get any better, to the point I started to wonder if he was psychotic.

I tend to agree with FF in that it takes a qualified therapist to determine / treat. Also, this is all so much for you, you need to think about yourself too.

[WitzEndWife]

I'm certainly not a medical professional, so I can only go off of what I know. I don't think that H is dealing with psychosis. He might, like many BPDs do, start with how he feels about something, and then connect random "facts" to build a "case" around it,but I don't think he has psychaotic delusions or anything. When he disassociates, it is always about the past, like he's reliving certain things, almost always around animals he's had in the past (he has a deep love and connection to animals, so I think that's where his mind goes).

Regarding medical help, yes, he does need that. I have decided to look into getting a therapist in my new city, so at least I will have some support.

I don't believe that he is a danger to himself, or to anyone else. He is just crying for love and attention. He wants so badly to be noticed.

My one hope is that maybe once i start going to therapy again, he might join me. Or if he sees it making me more "chilled out" maybe he will be motivated to try again. I guess we'll see.

[formflier]

Please go to therapy for you.

There is this illusion/ideal that we create for ourselves that if "we", the nons, are good enough... .do good enough at (fill in the blank) that our pwBPD will be inspired to fix themselves.

I'm all for you working on you and getting better, gaining better relationship skills.  I'm 100% against ANY thinking that goes like "Oh, I'll do this and he'll see it's better and he will want to xyz... "

That is setting yourself up for disappointment.

Much more effective.  Stay succinct.   

1.  Encourage him to call and take action.  Give that a few days.
2.  Continue encouragement and let him know you will be calling and taking action.  give that a few days
3.  (assuming he takes no action) let him know you won't be living this way and start taking action to detangle your life from someone who clearly needs help and clearly has chosen to not get it.


There is a lot going on here... .a lot.  Keep in mind that your have decided to reduce support because of his choice to not work.  Keep in mind that could be stressing him out.  Keep in mind he could be trying to distract from that issue or create more reasons that he "can't" work.

So, what would it look like/sound like for you to express concern and ask him directly to call his GP to talk about the grocery store incident?

FF

[Sunfl0wer]

Idk, I feel like if your husband asked you, “So you think I have DID?” ... .maybe that is an opportunity to simply say, “maybe, idk but it is certainly worth ruling it out or looking into that via visiting someone qualified to determine such, what do you think?”

(Most therapists are not able to diagnose DID/OSDD or work with these clients... .so finding one that can diagnose such imo, is only person I would trust to tell me if I have or don’t have that.  ... .cause if you are not qualified to tell me I have it, then how the heck would you know I don’t?)

[formflier]

And because of co-morbidity and that it's obvious a lot of stuff is going on with your hubby... .and because you are not a medical professional yourself, the best place to start is with your GP.

1.  So that you have a solid physical with a lot of bloodwork/labs.  Your GP needs to know the behavior so he can think of any physical causes/influences and test for them.

plus

2.  As Sunflower said, some of these things can be very specialized.  I would trust a GP to be able to refer properly and ask questions of another medical professional to see if they are qualified to make a determination about (fill in the blank).

I would resist any effort by hubby to self diagnose or "only" be evaluated for DID or (fill in the blank).

I do think the "language" of "ruling out" an issue would perhaps be better than "let's get you diagnosed as... "

Thoughts?

FF

[WitzEndWife]

I gave him the name and number of my GP, and he needs an inhaler anyway, so he'll likely make an appointment. Again, I'm not pushing, because that usually has the opposite effect. We'll see what happens.

[formflier]

I gave him the name and number of my GP, and he needs an inhaler anyway, so he'll likely make an appointment. Again, I'm not pushing, because that usually has the opposite effect. We'll see what happens.

Right... .I don't suggest you "push" at this point.

Just to clarify... .does he not have a doctor?  I saw you mentioned "your" GP.

What did he say when you have him the information?

I hope you understand there is little chance of this working without you "pushing" at some point.  And yes, it may have the opposite effect for a while. 

As you saw with his first attempt at working, if I remember right there was some pushing. 

Offhand, I think you will know in a few days which direction his initial steps will be.

Any new news on job search?  Chores around the house?

FF

[WitzEndWife]

Yesterday, he went to an office and spoke briefly to the manager there about joining, but changed back into sweat pants for the remainder of the day. He was mildly helpful for part of the day, but also still depressed and pessimistic.

Regarding the GP, he says he will call them. If he doesn't he will be in a bad way because of his allergies, so there's no reason for him not to. He hasn't been to a GP in years, so it's probably a good idea for him to go. I will ask him to make sure he has made the appointment today, out of concern for his asthma, but not regarding anything else.

[Sunfl0wer]

https://www.amazon.com/Coping-Trauma-Related-Dissociation-Interpersonal-Neurobiology/dp/039370646X/ref=pd_sim_14_1?_encoding=UTF8&pd_rd_i=039370646X&pd_rd_r=SJSDSV4W7P7K77Y39H53&pd_rd_w=ipZv8&pd_rd_wg=wyKCh&psc=1&refRID=SJSDSV4W7P7K77Y39H53

Adding just in case.
Really helped me understand I’m not crazy.  I like just reading the book preview in it defining dissociation a bit
It is considered the “handbook” or “manual” for dissociative issues.  Does not have to be DID, but is for any level/severity of dissociation. 

(Many therapists work through this book as part of the therapy process.)
(Personally if I were trying to rule out a dissociative disorder, I would contact an organization of dissociative disorders and ask for a referral. isst-d.org/default.asp?contentID=83 Or I would look up a course and contact an instructor and ask who they recommend.  Reason being is that I have been in therapy since 5 yrs old and have had dozens of therapists.  They all missed this crucial issue.)

(Apologies if I am seeming agenda driven, am not at all.  Do not at all feel there is any one path to these things.  I just am personally astonished how little info and understanding there is out there on DID type issues... so maybe that is my peeve here... srry...   My own therapist teaches classes.  When I complain about how was this missed, been in/out therapy all my life? He reminds me that dissociation and trauma was only a small section of his training and it was only a day lesson.  He has gone on to specialize in this on his own.  Most therapists do not get that knowledge... .even less likely a GP or such will have any idea or believe they are encountering a dissociative disorder.)

Anyways... .done rambling

Am glad other members like FF can thread together your story from past posts and grasp more aspects of your situation for fuller feedback.

[WitzEndWife]

Thanks Sunfl0wer - I appreciate your responses and perspective. I will check out the book. Honestly, at first, I guess I was in denial that he was actually disassociating. I just felt that he was traumatized and recalling tragic things. But the last two times he did it really scared me. Like, when he was petting our dog and calling it his childhood dog's name. That really drove home that this was something else.

I will do some searching locally as well for someone who has expertise in this field of study. I hope it doesn't happen again any time soon, but if it does, I'm going to record it so that he can see what actually is happening. Let's hope it doesn't happen in public again.

[formflier]

  That really drove home that this was something else.

 

Just as strongly as I am encouraging you to forge ahead with pushing your hubby to get healthier, GP, T, etc etc.

I also want to encourage you to step back from labels.   I would use labels in a "rule out" sense, and perhaps at the end of that process of attempting to "rule out" you realize... .wow... .we did a, b, c, d in an attempt to rule out xyz and we can't rule it out... .therefore... .

I think sunflower's story is illuminating.  With co-morbidity and the wide range of presentation of some things, diagnosing can be a tricky thing to do.

Last thought... .I'm all for "gently" bringing up the doctor for another day or two, then I'm going to be much more concerned that lack of direct, succinct words from you will be "saving" him from reality, vice working with/around his limitations.

It can be done in a positive way (it being directly talking about DID and the episodes you have witnessed).

My goal is not to teach you "how to walk on eggshells" it is to teach you how to walk in a healthy way, understanding your hubby may think you are cracking lots of eggs in the process.

Make sense?

FF

[WitzEndWife]

When it comes to walking on eggshells, I have come a long way. I used to be afraid to do things for myself out of fear of his not liking that. However, it's been healthy for both of us. Concerning his issues, I honestly just feel exhausted about it. I present solutions and he rejects them over and over. On top of that, each time I do this, the more negative he is about the prospect. If I felt that it was helpful, I would continue to push, but I don't know that it is. I DO know that he cannot go on like this. And I feel as though I'm going to have to hospitalize him if he gets worse. If he cannot function in the real world, he's going to have to get help so that he can. But I do feel like it's going to have to take another "episode" to really get him into regular treatment. Even if I left him over it, and he agreed to get help, he would only be doing it to get me back, not because he wanted to get better. It's got to be on him to want to change. I have to plan my actions along the way, and I'm not perfect. Sometimes I feel like I cannot deal with yet another battle, so I withdraw. That's kind of my way.

He's been in a foul mood for the past few days, every little thing setting him off. He's just generally grouchy. He does have a dentist appointment today (he hates the dentist, so this is surprising), and an appointment with a new agency tomorrow, so at least he's moving himself in the right direction. I'll nudge him about the GP today too. Generally, I've been trying to keep the mood upbeat and not let his grinchy behavior get to me. It's hard. Thankfully I have good friends and cute dogs!

[formflier]

 Concerning his issues, I honestly just feel exhausted about it. I present solutions and he rejects them over and over. On top of that, each time I do this, the more negative he is about the prospect. If I felt that it was helpful, I would continue to push, but I don't know that it is. I DO know that he cannot go on like this. And I feel as though I'm going to have to hospitalize him if he gets worse. If he cannot function in the real world, he's going to have to get help so that he can. But I do feel like it's going to have to take another "episode" to really get him into regular treatment. Even if I left him over it, and he agreed to get help, he would only be doing it to get me back, not because he wanted to get better. It's got to be on him to want to change.  

You have gotten a lot better... .much better.  I think you are "well over half-way there".  Please don't loose sight of how this would have gone for you ... .what? ... .say 6 months ago?  

Take a step back and understand that YOU are getting better.

This is me cheering you on to "stay strong in the 4th quarter"... .there is not much time left to play on the clock.  I know you are tired.  You and I both know that some big changes are coming to your relationship.  I'm praying and hoping they are for the better.  Even a change that "looks negative", can perhaps have a long term good outcome.  Remember  3 steps forward, 2 back.  Stay big picture, you are still 1 step forward.

Look at some of the bolded items.  I need you to work with me to consciously shift your thinking.  Take big deep breaths of air along the way.  

He can go on like this for as long as he chooses.  Please understand that.  You are the one that can't and shouldn't go on.  You married him to be a wife, not a mental health professional.  As you say, you are tired, worn out and worried.

Please remember my advice.  Focus less on "why" people do things and focus more on "what" they do.

If he is in therapy and complying with treatment... call that good.  Plus... .be honest with yourself, you will never know why he is doing it, even if he says he is "only doing it for you"  Repeat that to yourself... over and over.

Focus on the "what"... .not the "why".

You can do this, even when you are tired.  

FF

[Sunfl0wer]

Admitting I do not grasp all the dynamics at play... .
Just wanted to add a tidbit in case it helps keep things in perspective... .

I think this time of year IS a really difficult and triggering time for many folks.  Holidays do tend to exacerbate many mental illness symptoms and even cause those without psychological difficulties to struggle emotionally.

So while I do not know if this is the case for you or your H, just adding that in case it appears things are generally decompensating... .while it could be a case of temporary exacerbated holiday stresses.

Idk, just saying it could be best to wait out holidays before deciding if anyone’s baseline has devolved.

[WitzEndWife]

Welp, I have confirmation that H is going to make his appointment with the GP today. There was no fuss about it when I inquired, so that is a good sign.

He seems to be in a better mood now than he was in this morning. I'm not saying that mood will last all day, but it's promising.

I realize that something big has to happen in the relationship, and I know it will either be good or "bad" (I know that will ultimately lead to good for me, regardless). The whole relationship seems to have been me "waiting" for something or other to happen. When we first got together, we were waiting for the DA to contact his lawyer regarding his special visa case (which didn't end up happening until almost 2 years later, after we'd switched to getting a marriage visa) so that he could get a work permit. Then we were waiting for his work permit. Then, we were waiting for final approval on the marriage visa (which took forever). Then, I lost my job and we were waiting to figure out what to do in terms of our living situation. Then, we moved and I was waiting for him to get out of his huge funk and get back into wanting to get a job or go to school. Then, I was waiting for him to take his real estate test. Then, get a job with an agency. Now, I'm waiting for him to get back into it, and I'm waiting to see whether he'll blow up again, or whether he'll have another episode. It's like we have to complete one stage to get to the next stage. Does that even make sense?

Anyway, Sunfl0wer, yes, I think he does get into a seasonal "funk." He was really bad last year, when we were living with my parents. My mother and I likened him to a dark cloud, floating around the house. He rarely came out of his room, and would spend whole weeks in bed. I told him that if he was unable to function, I would insist on him getting therapy, and perhaps inpatient therapy. He seemed to snap out of it after that point. He did do some therapy via my old therapist's office and Skype, but because insurance didn't cover it, it became too expensive to continue after buying our home. He was doing well with that, but he now claims that it was ineffective (of course).

I'm not sure what to do to help the mood, but the season certainly isn't a good gauge of "normal" for him. It's pretty much the worst of him.

[formflier]

Idk, just saying it could be best to wait out holidays before deciding if anyone’s baseline has devolved.

I would certainly get past the holidays before anything that would seem like a "consequence" has been put into play.

I think it unwise to wait to call or remind to call GP.  I would say wait until after new years to let him know that you are calling and going, even if he doesn't.

Big picture... .a wise addition to the discussion... .keep holidays in the scan, but  in this case particularly... ."don't put life on hold".

FF

[flourdust]

I used to wait for life changes to make my wife better. I figured that once I got a job ... .then a better job ... .then a house ... .then she got a job ... .then she got a better job ... .then a health crisis was fixed ... .then a child care situation was fixed ... .that she would stop making our home life hell.

It doesn't work that way. Outside stressors may trigger or exacerbate the symptoms, but they aren't the cause, and changing them isn't the cure.

[WitzEndWife]

I used to wait for life changes to make my wife better. I figured that once I got a job ... .then a better job ... .then a house ... .then she got a job ... .then she got a better job ... .then a health crisis was fixed ... .then a child care situation was fixed ... .that she would stop making our home life hell.

It doesn't work that way. Outside stressors may trigger or exacerbate the symptoms, but they aren't the cause, and changing them isn't the cure.

I'm not waiting for him to change, I'm just waiting for things to happen to make my next "move" I guess. I'm waiting to see if he majorly blows up or avoids work long term to see if I'll need to leave. I'm waiting for him to have another episode to force him into treatment. There just always seems to be this limbo of not knowing. Me waiting to see what he'll do as I take away my enabling behavior. It's not a settled feeling, to say the least.

[formflier]

 
How long are you waiting? 

What is something that would happen where you would "force" him into treatment?  How would that happen?  Have you researched the commitment laws where you live?

Please don't take this a challenging or disagreeing with you.  Rather as trying to define a pathway for you... that you control. 

I'm very glad you have gotten to the point where it is about you and not him... .this is very good, because it will shift the balance from you "reacting" to a disordered person to a disordered person "reacting" to a person making healthy moves in their life.

Do you see the shift there?  Very important.

I do like the thinking you apparently have which says that with another "move" by him I will do "xyz" rather than wait on another move.

Thoughts?  Am I accurately reflecting your thoughts?

FF

[Fie]

. The whole relationship seems to have been me "waiting" for something or other to happen. When we first got together, we were waiting for the DA to contact his lawyer regarding his special visa case (which didn't end up happening until almost 2 years later, after we'd switched to getting a marriage visa) so that he could get a work permit. Then we were waiting for his work permit. Then, we were waiting for final approval on the marriage visa (which took forever). Then, I lost my job and we were waiting to figure out what to do in terms of our living situation. Then, we moved and I was waiting for him to get out of his huge funk and get back into wanting to get a job or go to school. Then, I was waiting for him to take his real estate test. Then, get a job with an agency. Now, I'm waiting for him to get back into it, and I'm waiting to see whether he'll blow up again, or whether he'll have another episode. It's like we have to complete one stage to get to the next stage. Does that even make sense?  

Yes, it does make sense.
It was the same with me and my BPD/NPD ex.
I was also always waiting for something : visa, work permit, etc.
But then I figure, I was waiting yes, but it was actually him waiting, since he always blamed his bad moods on those external stressors, and me waiting with him, but more in a codependent kind of way. Like some kind of a deux ... .

He had me waiting with him, always with the non spoken promise that things would magically work out once the stressor had gone.