i and many others here understand what you're going through. does your wife acknowledge her BP? if she does and actually wants to help you help her, i wondered if you'd ever heard of a Ulysses Agreement? This is something that my husband and I are working on with a counsellor that involves him and I and his and my family so that we can recognize when he's "going into" an episode and what steps we need to take to prevent it (or) lessen the damage caused by them.
A Ulysses Agreement is an advance planning document which spouses (or anyone) complete when “well” with their community team (informal & formal supports) to direct care of their children, should they become ill. For example, it gives a person at risk for relapse, the assurance that the support team will monitor and respond to early warning signs in ways s/he would approve. While it is not a legal document and depends on good faith, just going through the advance planning process has many benefits.
Advantages of making a Ulysses Agreement (a care plan for children in case of a parent’s relapse) are that it:
• honours the parent as a good parent at times when they are unable to parent well
• addresses the needs of children for ongoing care, consistency and predictability
• helps children have a voice about their parent’s mental illness and provides a mechanism for them to act in a way that maintains connection and support
• helps parent understand the impact of his or her mental illness may have on their child
• empowers parent and enables them to have their wishes, concerns and intentions be clearly known before they may be feeling out of control with their illness
• allows parent to minimize disruption for the child by communicating about their child’s particular needs
• assists the parent to identify and build their support network by opening up therapeutic conversations about their illness and its impact on their family fosters increased commitment and responsiveness from the parent’s network of support
• helps their support people to take action in the moment (support people often say they feel more confident that they are doing the "right thing" when there is a plan in place)
• allows the parent to determine amount of information to be shared with support network rather than leaving this to the sole discretion of mental health workers during a crisis
• helps support people to understand that the illness is causing the problem (eg: a lack of insight in the moment of relapse) and allows for easier reconciliation afterwards if the parent tries to rescind consents or refuse intervention
(some of what i'm going to post below is for children to deal with an unwell parent) i've tried to change the wording to generalize it or make it applicable for spouses.
Components of a Ulysses Agreement include:
* the nature of the mental health problem
• typical symptoms noticeable in the parent
• early warning signs of illness onset
• what their personal wellness looks like
• the strengths of the patient
• information about the children and any special needs
• specifies plans for the children if the parent becomes ill.
A Ulysses Agreement should be developed with individuals who have close contact with the patient and their family. Most importantly, support people who can fill in some of the parenting role for the parent and those who can provide support to the children in times of hospitalization should be part of this plan.
For the agreement to be a good plan it requires ongoing review to meet family structure changes and child development considerations. It is often a work in progress.
Elements of Advance Planning
Details: lists the date, the people named in the agreement and phone numbers; also contains a list of people to inform about the agreement
Statement of Purpose: the purpose of the agreement is to provide a clear set of guidelines (actions) to be taken by members of the individual’s support team if the person exhibits illness symptoms that interfere with his or her ability to provide good care for the child.
My symptoms: lists specific symptoms the parent experiences that others can notice and respond to. See Common Early Warning Signs:
Plan of action: describes the most helpful way to respond to early warning signs/relapse and records how the parent would like to deal with the issue of confidentiality as well as attaches signed consents if desired. Even with consent, no more information than is necessary for the implementation of the agreement should be shared.
Record of parent’s wishes for support services: advance plans can include planning for therapy (if necessary) and support for the child, even if alternate care arrangement is not needed.
Record of parent’s wishes for care of child: any information about special needs such as allergies, sleeping routines, etc.
Cancellation: describes the manner in which the agreement can be cancelled. It is recommended that cancellation agreements include a period of time and a set of steps.
Periodic Review: describes the manner in which the agreement will be reviewed (eg: annually)
The agreement is named after Ulysses who ordered his crew to lash him to the mast of his ship and disregard his orders when he was being serenaded by the sirens as he sailed his ship through dangerous waters.
A Ulysses Agreement may take extra time, but it holds significant benefits
This is a good link:
as is this:
Again, it isn't a legal document but it enables you some control over a potentially uncontrollable situation. It's something my husband and I are doing and it can be done on your own as well. (second link).
"Twenty years from now you will be more disappointed by the things you didn't do than by the ones you did do."
-- MARK TWAIN