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Suggest Ways To Manage Severe Depression
Question: my wife is having severe depression and gets volatile during her PMS. Its not like a regular PMS, she is abusive towards me and kids, has fits of rage and just destabilizes our home entirely. 2 weeks out of a month, we live in hell. She goes out of the house and pretty much behaves normally, so other people dont make out whats wrong. But to us she literally hates and spews all sorts of deepkly hurtful statements towards me and the kids. However once the episode is over, she becomes normal, albit a little depressed. This is going on for 7 years with out any sort of treatment. But we are getting terribly affected by it. She is not willing to accept that this is a problem, she thinks the problem is with us and that we are falsely blaming her for our problems. She had history of this sort of behaviour in the past before our marriage too, but initially i dimissed as a one off episode. In recent months the symptoms are getting worse and worse, my work is getting massively affected, our children are severely traumatized and cant seem to figure out what happens all of a sudden.
I have tried multiple times to get her to a counseller, however she gets violent and totally mad as I even suggest for a counselling session.
I have tried multiple times to get her to a counseller, however she gets violent and totally mad as I even suggest for a counselling session.
Brief Answer:
She might be showing mood disturbance.
Detailed Answer:
Hello thanks for asking from healthcaremagic.com
I can understand your concern. She is showing symptoms like violent abusive behaviour and depressive symptoms especially during specific periods of menstrual cycle. Yes PMS could cause mood swings and these symptoms might be occurring due to PMS only.
But other causes of mood swings should also be ruled out. You have mentioned that she also had such episodes prior to marriage also. This could be due to bipolar disorder too. Persistent violent abusive behaviour is commonly seen in bipolar disorder.
Other possibility is some personality issues. Personality issue can lead to repetitive behaviour of violence and abusive spells.
So these causes should be kept in her evaluation. With proper treatment her symptoms will improve but main challenge to make her ready for psychiatric evaluation. Try to convince her along with your children that for her anger she should consult a psychiatrist. If she becomes ready then no need to worry but if she doesn't agree then you can visit a psychiatrist and explain her symptoms. The doctor can advise medicines for some time and these can be given to her without knowledge. Olanzapine or Risperidone etc drugs are available in tasteless and odourless preparations and can be given even without knowledge by mixing with food. Once she become stabilised then she can be shown to a psychiatrist.
For PMS low dose antidepressants like SSRIs like Fluoxetine or Escitalopram etc can be used. Duloxetine has also great roles in controlling the symptoms. Along with these drugs low dose Olanzapine OR Risperidone will help to control her anger issues too.
So please don't remain stressed due to her symptoms. These symptoms can be controlled easily with proper medicines and she will be alright. Try to convince her to visit a psychiatrist at least for evaluation.
Thanks. Take care
You are welcome to ask follow up doubts.
She might be showing mood disturbance.
Detailed Answer:
Hello thanks for asking from healthcaremagic.com
I can understand your concern. She is showing symptoms like violent abusive behaviour and depressive symptoms especially during specific periods of menstrual cycle. Yes PMS could cause mood swings and these symptoms might be occurring due to PMS only.
But other causes of mood swings should also be ruled out. You have mentioned that she also had such episodes prior to marriage also. This could be due to bipolar disorder too. Persistent violent abusive behaviour is commonly seen in bipolar disorder.
Other possibility is some personality issues. Personality issue can lead to repetitive behaviour of violence and abusive spells.
So these causes should be kept in her evaluation. With proper treatment her symptoms will improve but main challenge to make her ready for psychiatric evaluation. Try to convince her along with your children that for her anger she should consult a psychiatrist. If she becomes ready then no need to worry but if she doesn't agree then you can visit a psychiatrist and explain her symptoms. The doctor can advise medicines for some time and these can be given to her without knowledge. Olanzapine or Risperidone etc drugs are available in tasteless and odourless preparations and can be given even without knowledge by mixing with food. Once she become stabilised then she can be shown to a psychiatrist.
For PMS low dose antidepressants like SSRIs like Fluoxetine or Escitalopram etc can be used. Duloxetine has also great roles in controlling the symptoms. Along with these drugs low dose Olanzapine OR Risperidone will help to control her anger issues too.
So please don't remain stressed due to her symptoms. These symptoms can be controlled easily with proper medicines and she will be alright. Try to convince her to visit a psychiatrist at least for evaluation.
Thanks. Take care
You are welcome to ask follow up doubts.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
According to symptoms is the diagnosis in this case PMMD (premenstrual disphoric disorder) or Depression? You are true that along with that she has a social withdrawal as a symptom. She never likes to attend any meet ups/events. Till date since last 7 years we have attended only 2-3 functions together, otherwise its just me going alone to these things. Is such a case (along with episodic worsening during PMS) completely curable? Are we looking at longtem/permanent treatment or a short term management?
Brief Answer:
Before PMDD other diagnoses should be ruled out.
Detailed Answer:
Hello again
Usually the patients of PMDD show mild to moderate symptoms and there is clear cut evidence that the symptoms occur around mid cycle. But her symptoms are occurring for around 2 weeks a month so before labelling her as PMDD I'd rule out depressive (atypical depression) or bipolar depression first.
Her symptoms are severe enough to hamper your work. She is not getting ready for treatment and is not accepting the problem. These point more towards other psychiatric diagnoses. She is not going out with you for functions and this is persistent for 7 years. This also can't be ignored. We can say that the symptoms are worsening with menstrual period and there is some PMS component but depression or bipolar depression should be ruled out first.
The treatment should continue for at least 6 months but that too will depend upon the response she shows with medicines. Most of individuals with treatment show great improvement.
Thanks.
Before PMDD other diagnoses should be ruled out.
Detailed Answer:
Hello again
Usually the patients of PMDD show mild to moderate symptoms and there is clear cut evidence that the symptoms occur around mid cycle. But her symptoms are occurring for around 2 weeks a month so before labelling her as PMDD I'd rule out depressive (atypical depression) or bipolar depression first.
Her symptoms are severe enough to hamper your work. She is not getting ready for treatment and is not accepting the problem. These point more towards other psychiatric diagnoses. She is not going out with you for functions and this is persistent for 7 years. This also can't be ignored. We can say that the symptoms are worsening with menstrual period and there is some PMS component but depression or bipolar depression should be ruled out first.
The treatment should continue for at least 6 months but that too will depend upon the response she shows with medicines. Most of individuals with treatment show great improvement.
Thanks.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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