In a response to Sisyphus' thread "Eerie Silence..." you said<BR> <BLOCKQUOTE><font size="1" face="Verdana, Arial">quote:</font><HR><B><BR>my ex-wife is a survivor of child sexual abuse. Her family turned a blind eye, and kept it's secrets. Now my marriage of 15 years is in ruins, and my ex-wife is in finally in therapy where I pray to God she finds some peace.<P>It's almost certain that a good proportion of the troubles you had in your marriage stem from your wife's childhood trauma. Let me tell you what I have had to contend with and you tell me if any of it sounds familiar:<P>- chronic depression<BR>- outbursts of uncontrolled rage<BR>- threats of suicide<BR>- suicide attempts<BR>- self injury, ie. cutting<BR>- emotional and physical withdrawal<BR>- sexual affairs<BR>- lying, lying, lying<BR>- suspicious reactions when receiving gifts<BR>- dissociation<BR>- infantile regression<BR>- multiple personalities<BR><HR></BLOCKQUOTE></B><P>My wife suffered sexual abuse from both inside and outside her family, and was stalked. There was also other abusive behavior in her family. We've had to contend with numbers 1-3,5,7&10 from the list above, along with two breakdowns on her part.<P>The first was 10 years ago, and we attributed it to PTSD (post traumatic stress disorder). The second was about six months ago, and she was diagnosed Bipolar I--the more severe kind. However, she was on Paxil at the time, without the corresponding anti-manic medicine (she now takes Depakote), so that may have been a contributing factor. Both breakdowns included elements of psychosis (loss of touch with reality), and she was hospitalized for a week during the second episode.<P>I believe you posted some time ago that your ex had been diagnosed as bipolar. I'm wondering how much of your list above you attribute to bipolar disorder and how much to childhood abuse. My wife still has problems, but has gone through a fair amount of counseling. On the other hand, while therapy can be helpful for bipolar disorder, the main treatment seems to be drugs, since the predominant theory is that its just a chemical imbalance not necessarily related to any childhood trauma.<P>What's your opinion as to which was more important in your wife's problems? Do you see a connection between her bipolar disorder and the abuse?<P>Anyone else with knowledge or opinions here is also welcome to chime in.<P>Steve <P><BR><p>[This message has been edited by StillHers (edited February 19, 2001).]

I'm wondering if abuse can do more than trigger bipolar, perhaps <B>cause</B> it. I heard something once that stuck with me, and that is that a single event can change brain chemistry permanently. <P>As an example, I'll give Steve Martin. You've heard of "hair turning white overnight" from a fright? Well, it really takes about a month, but it DOES happen. What happened to Steve? He was, supposedly, a heavy pot smoker. One night he had a powerful paranoid episode, and became so scared he never smoked pot again. Also, his hair turned white. I heard this on the radio (but I don't think it was Paul Harvey's "The Rest of The Story").<P>The brain adapts to what you face in life. My guess would be that bipolarity, borderlineism, etc. would be adaptations to episodes of abuse. <I><B>Maladaptation</I></B>, of course, once the abuse stopped. <p>[This message has been edited by Sisyphus (edited February 20, 2001).]

To Stillhers,<P>I have pondered those same questions you raised a great deal. I find it hard to draw a clear line between some of the bipolar symptoms and some of the abuse symptoms. I guess one feeds the other. I use the metaphore of a stew: the meat & potatoes is the abuse, and the bipolar is the spice. <P>To give a weighting to the factors in our marital breakup, I would estimate 70% abuse affter effects, 20% bipolar, 10% interpersonal strife. Of course, without the abuse after-effects and the mood disorder, it would have been easier to deal with the interpersonal troubles.<P>I have read that when an adult begins recovering abuse memories, the effect is very similar to post-traumatic stress syndrome. <P>It is very interesting that you mention your wife was taking Paxil at the time of her last episode: so was my wife! Paxil, and other anti-depressants, can trigger manic episodes in about 2% of patients. As one therapist described her condition, "the Paxil initiated the manic episode and tore the lid off the repressed memories of child abuse. These recovered memories flooded her psyche, which was structured by the Paxil, resulting in a severe psychological crisis."<P>She was taken off Paxil and was on Welbutrin for a while, and now Serzone. She refused to take an anti-manic medication and dumped the psychiatrist who tried to prescribe it to her.<P>As I understand it, bipolar is best treated with drugs, however talk therapy is very helpful in educating the patient about the condition and in anticipating any rising symptoms. <P>For adult survivors of child abuse the best therapy is a form of specialized therapy, generally practiced my MSW's and psychologists. Psychiatrists just don't have the specialized training and their backgound leads them to treat the patient with drugs only, which doesn't help, or with traditional psychotherapy, which is ineffective on these patients.<P>I recommend this support group for you. It has helped me to understand what is happening.<BR> <A HREF="http://clubs.yahoo.com/clubs/positivepartnersofsurvivors" TARGET=_blank>http://clubs.yahoo.com/clubs/positivepartnersofsurvivors</A> <P>To Sisyphus,<P>I have heard that child abuse can cause borderline personality and possibly bipolar disorder. However, there is strong evidence that bipolar has a hereditary factor. My ex-wife's father was diagnosed as bipolar, and like her is in total denial of it. This resort to denial, of course, is a classic coping mechinism in abusive families. The knot weaves around. <P>Interesting that you mentioned Steve Martin's paranoid episode from smoking pot. In my ex-wife's case, the sexual abuse involved the perpetrator giving her marijuana, cocaine, peyote, LSD, and God know what else. It's easy to imagine that these drugs amplified the trauma of the abuse and impressed in her psyche a deeply ingrained pathology.<P>Kenneth

Kenneth, thanks, I'll check out that link. It's been a while since I did my reading about bipolar, but you're right that it has a strong hereditary factor. An interesting autobiography is "An Unquiet Mind" by Kay Redfield Jamison who both suffers from bipolar disorder and is one of the foremost experts on the subject. As I recall, although her parents eventually divorced, she had a relatively normal childhood.<P>As for your wife's reluctance to take an anti mania medication, this is a common problem. People enjoy being manic, and tend to want to go off the medication.<P>On the other hand, some things in your list can clearly result directly from abuse. I know of another person besides my wife who learned to dissociate because of the shock and pain of being abused.<P>Sisyphus, interesting story about Steve Martin. I did not know that hair could really do that. I do think it possible that abuse could also bring about changes like you suggest. I don't think anyone really knows the cause of bipolarity. It's like ADHD--we make a list of symptoms and give those who exhibit them a name, but really don't know the cause or causes, which may differ from case to case.<P>Of course, even if the cause is environmental, if irreversible changes have taken place in the brain then drugs may be a better answer than therapy.<P>Kenneth, I like your stew metaphor--it's what makes things so difficult. You have relationship dynamics, along with behavioral problems which are partly brain chemistry based and possibly partly due to childhood issues.<P>Thanks for your thoughts, guys.<P>Steve<p>[This message has been edited by StillHers (edited February 20, 2001).]