Abusive on a Camping Trip. What Can I Do to Fix It?

Reader’s Question

I was diagnosed with Generalized Anxiety Disorder (GAD) a little over 6 months ago. I recently went into a manic episode. The doctors I have spoken to don’t think I am full-on bipolar, but that is all that can explain the episode. During the episode I said hurtful things and made ridiculous requests. I felt it coming on but couldn’t vocalize it correctly in order to prevent it. I am on medication. During this episode I didn’t have my medication since we were camping and I forgot it. What can I do for my spouse who is often the person attacked during an episode, not physically but emotionally? She has told me that she can’t do another episode so this is my last chance to keep my relationship, which is great other than dealing with my anxiety. How can I help her to understand what is going on and communicate with her? I need help and so does she. What can I do and what can she do to try to prevent any further disruptions in our life? Thank you for any insight you can give me and my spouse.

Our Consulting Clinical Psychologist’s Reply

I don’t have a good understanding about the nature of your manic episode. You may have experienced what we call an SSRI-induced Hypomania — an episode of hyperactivity, elation, intensely happy mood, and talkativeness — linked to the use of certain antidepressant medications. On the other hand, sudden withdrawal from your medications may have produced an episode of significant irritability, agitation, aggressiveness, and anxiety. I tend to think the medication lapse produced a period of agitation which would be consistent with excessive demands, verbal abuse, and aggressiveness.

You and your wife can take several approaches to fix the damage done by your recent episode. I would recommend:

• The episode is strong evidence that you need to remain on your medications. With your wife, develop a marital plan to make sure you remain on your medications and don’t have a lapse or accidential withdrawal reaction. In some situations, allowing the spouse to monitor and dispense the medications is helpful.
• You need to develop plans that make her feel safe. Being alone with a verbally abusive spouse on a camping trip would be very traumatic. She was basically trapped in the woods with a mean, abusive partner. Her emotional recovery will take time. I’d suggest marital counseling to deal with the events of the trip.
• Involve her in your treatment. If possible, both go to your sessions with your mental health provider.
• You’ll both need to work on identifying early warning signs that your anxiety or agitation level is increasing. In marital discussions, for example, use an egg timer, allowing each person to speak for 1 - 3 minutes, then turn the timer over and the partner talks. These breaks prevent your anxiety from building into agitation.
• Recognize that the situation is not a “misunderstanding” but rather she was fearful and felt abused by your behavior during the incident. This is a serious point in your relationship and I would make every effort to repair the emotional and relationship damage done.

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