I confess I haven't waded through all 22 pages of letters, but so far I haven't seen anyone address this, as well as being surprised that the author didn't mention it at all. I am a health care provider, and in addition have had experience with 3 people in my personal life history who were, rightly or wrongly, diagnosed as bipolar and medicated for that condition.

This elephant has two faces. One is the highly subjective original diagnosis of so-called bipolar disease, which can be based on something as simple as a 15 question behavioral survey administered in a school or other non-clinical setting, by people who are not trained health professionals, and yet which can result in what is a questionable at best referral to an MD or psychiatrist for treatment.

The second face is what almost inevitably follows this referral/diagnosis: psychological medications. Over-diagnosis and over-prescription are the controversial and yet highly significant issues in the treatment of so-called bipolar conditions.

The historical and potential role of psych meds in the case of this unfortunate woman should be fully explored, as the promise of 'cure' or 'management' by this means is certainly no sure thing. And more and more, psych meds are causing more problems than they solve. SSRI medications (and others) can create permanent alterations in brain chemistry and even brain physiology, as the body permanently disables receptor sites in its attempt to rebalance its own realm in a reaction against the changes the drugs create. Many suffer from medication addiction and a host of other toxic effects. Significantly higher rates of violent behavior, including suicide and homicides, are one of the results of the growing and widespread reliance on medication as the approach of preference. This kind of change in behavior and manifest personality can take place within days of beginning to take these substances, or not occur until quite a while later.

Pysch meds viewed both individually and as a whole are generally not anywhere close to being scientifically (in pre-approval drug trials) or clinically (in real life) proven to be safe and effective for their stated purpose, and are typically approved based on studies of 5 to 6 weeks on length. Negative side effects are often under-reported or not reported at all in study results. Long term effects, and effectiveness, are rarely studied: the FDA employs 1500 doctors and staff to evaluate new drugs up front and 6 to carry out follow up studies. There are billions of dollars at stake which tend to argue against close scrutiny of these meds. You may start to get the picture here.

Anyone suspected of having behavioral and/or psychological problems should first begin working with a competent practitioner who can evaluate the role of poor diet and dietary poisons such as Aspartame, refined sugars, High Fructose Corn Syrup, and MSG, the intake of other environmental toxins such as lead, mercury, and other heavy metals, and nutritional deficiencies such as low Magnesium levels (critical for detoxification carried out by the Liver), all of which can have strong behavioral consequences. It's likely that someone suffering from such disorders will have multiple problems both with both substances that are aggravating imbalances ('toxins' and allergens) and deficiencies. Thus it's unlikely there is a single 'magic bullet,' but rather the progress toward health and balance will be best supported by addressing all the known issues together.

These things should be done before the first psych medication is prescribed and taken, since the medications are powerful agents and tend to blur the picture almost immediately, creating their own litany of side effects which are often treated by changing meds, multiple medications, diagnoses which blame the person rather than the medications as the cause for the growing imbalances, etc.

Being bipolar is not an easy road to walk, but there are a number of natural approaches which used together can help many lead a normal life, and minimize the need for medications. Neurotransmitter levels can actually be tested (though they rarely are by psychiatrists) and rebalanced to a good extent with quality amino acid supplementation. The Natural Medicine Guide to Bipolar Disorder (The Healthy Mind Guides) is one good reference for a natural healing/living approach. A quick and fairly well-rounded primer for the layperson on the larger issues surrounding psych meds is the Gary Null Video "The Drugging of our Children' available on iGoogle.

Successful life management for someone struggling with challenges such as these, to stay in balance and avoid manic or depressive crises, and so on, involves not only the individual but their extended family taking long-term responsibility for a big picture approach, communicating openly, honestly, and lovingly, and not expecting that the prescription of the right pill alone will make it all go away.

Dear one:

I've had bipolar disorder for most of my life. My husband never went to the doctor with me, so I struggled on my own. I've been on 14 medications and have finally got the right 'cocktail'. I hope you will stay with your wife. It is for better or worse, in sickness and in health. Please check out my site: bipolaroni.com She can get better. Please support her and get her the help she needs. This disorder can be easily managed. May God be with you, her, and especially your children.

Rita

Where were you and the kids on Christmas? Why was your wife home alone? Did she want to stay home, because she was depressed or symptomatic? If so, why did you leave her there alone, and do your children blame you for that? Did you have to visiting other, more important, branches of the family?

You say:

"by last week I was able to let her know that I was there to support her and that I did not judge her for what happened in the past. And I actually meant it."

But that support only lasted for A WEEK? Really? ONE WEEK?

You say:

"Yesterday she struggled with making plans to meet another couple for dinner."

Why? Why? Why? If she was desperate to see this other couple, and it was important to her, it would have been SUPPORTIVE of you to make the plans so she didn't have to STRUGGLE with it. If she wasn't desperate to see this other couple, why were plans being made to begin with? Was it your idea? If it was, then it was a really bad idea, and an even worse idea to have your wife make the plans.

You say:

"I know that I cannot subject my kids to that again."

At least you're honest here, YOU ARE the one subjecting your kids to this again.

You say:

"Giving up on someone you love to protect people who need you is horrible, but for now it's a necessity."

Yes, so quickly you go from "support" to "giving up" and all it took was one week and a cry for help with a "fairly dull steak knife".

But the kicker is that you don't really even give a shit about any of that. Your actual question is: If I leave my chronically ill wife, it may ruin my credit. Should I leave her anyway?

Every time I re-read your letter, you sound more and more selfish. Horribly selfish. I bet you'd be relieved if your wife actually killed herself (maybe that's why you left her alone on christmas and pushed her into social engagements too quickly) at least that way it wouldn't RUIN YOUR CREDIT.