Q: My husband has just come out of a week of rehabilitation hospital for alcohol/pain pill addiction and severe bipolar disorder linked with depression and anxiety. We have two children. The stress levels are very high for both of us. I believe that he is being over-medicated. I feel as if I do not know him anymore. It has only been two days. I am wondering if I will ever get my husband back. I feel that he is very selfish. He has not apologised for anything that he has put us through. I don't feel loved or even appreciated and I feel that I have been more than understanding and caring. I am there for him whenever he needs me. I feel like I am just being walked all over. I want to be there for him and help him in anyway I can, but my needs are not being met and I don't want to get walked on forever. I love my husband very much and have poured my heart into our marriage. I just want the same in return. I just wanted to know what my part in his recovery should be? He seems to think that no one understands what he is going through, but when we try to listen or discuss anything he just gets agitated. It is very difficult. How can I cope with this situation?

A:Yes, I would agree with you it is pretty traumatic, stressful and difficult. It is so for the individual who is suffering from a mental illness too, as he feels the loss of control over the symptoms and also the stigma from people. I am sure you would agree that the individual (in this case your husband) has become very dysfunctional and there would be problems in the social sphere as well as the work sphere besides in the day-to-day functioning. Besides the whole family and house is affected, that is the backlash of mental illness. The family has to bring about a continuously, consistent supportive role, not overdoing things by tolerating anything but encouraging the individual to take responsibility of behaviour, encouragement to resume normal functioning, normalizing things situations, keeping arguments and discord to bare minimum, having clear, unambiguous communication, carrying out their necessary activities of caring for children, cooking, cleaning, etc. Besides, the role of the family is to help ensure regular medications; regular visits to the psychiatrist and also regularity in functioning. The family also has a role in picking up the early warning signs of relapse and helps the individual to take immediate help, rather than be overly critical of him. There are various organizations in India these days, which are groups of carers where there is bipolar illness to a family member. Attending one of these groups helps to alleviate distress, keep in touch with others who face a similar problem, derive strength, means and techniques of dealing with difficult situations. The focus, these days, is also on caregiver stress, which is being dealt with group therapy, individual therapy, etc. More information about these can be provided by the local medical college Psychiatrist or a private psychiatrist.