Dear Abby:Man's Moodiness Following Heart Attack Puts Wife on Edge

[cereta]

DEAR ABBY: My husband had a heart attack last year, and since then he has become extremely volatile. He explodes for no reason and threatens me. He does not want me to talk about it to his doctor, and he's scaring me regularly. I don't know what to do. I think it may have to do with all the medications he's taking, but I'm not "allowed" to talk to the doctor. He is moody and making me fearful. Help. -- SCARED IN NEW JERSEY

DEAR SCARED: Obviously, something isn't right. Call the doctor anyway. If the doctor refuses to talk with you, write him a letter about the changes in your husband's behavior, his explosive temper and your concern that it might be medication-related. If, after that, nothing changes, talk with a licensed mental health professional about what has been going on.

If you feel you are in danger, call 911. You should not have to live in fear, and if this isn't resolved, you may have to leave the marriage for your own safety.

Comments

[cereta]

Can I just say how gratified I am that so many of the commenters at the site echoed Abby's advice? I was expecting a lot of shaming of this woman, "in sickness and in health!", etc.

Which, yes, is the vow, but it doesn't say she has to put up with abuse. It would be one thing if there were any indication that the husband saw that there was a problem (which it seems from the letter that she's been telling him there is) and was willing to do something about it. I know a bit about living with someone with anger management issues, and it's everything to have them aware of the problem and actively working on it. It's not always enough, but its absence is pretty much a deal-breaker.

Abby's advice is pretty much spot-on. Apparently, this kind of personality change isn't unusual after heart trauma. His doctor needs to know, and she needs to know how to handle the situation. If that means leaving, that means leaving.

[jadelennox]

I'd say her advice is well meaning but missing a lot of nuance of U.S. law. There are good reasons the doctor can't talk to the spouse, and Abby's advice starts and ends with discussing the husband's health (huband's doctor, licensed mental health professional). Actually, no, it's worse than that. Abby's advice goes:

1. Discuss the husband's health with doctor, who may not be able to talk to you.
2. Discuss the husband's health with a different doctor who's never met your husband, who has a different professional ethical guideline preventing them from diagnosing a stranger, and the same legal obligation not to tell you anything without your husband's permission if they have diagnosed your husband.
3. Call 911, which has a less-than stellar reputation for safeguarding the lives of (a) people in mental health crises, and (b) people who call 911 in fear for their lives but who try to save the life of a loved one in a mental health crisis.

If the LW follows this advice and doesn't move beyond it, they could get pulled into a runaround (that, again, exists for good reason), leaving them to stick around long enough that they are hurt or killed, or they call 911 and the LW or husband are then in more danger of being hurt or killed. There should be further advice about how the LW needs to protect themselves, regardless of whether doctors will help them or not. I don't know what that advice is but I'm sure the national and New Jersey domestic violence charities do, and they know what legal rights the LW has as a spouse concerned about the husband's mental health.

[cereta]

Fair points. I do think the the doctor can receive information from the LW, just not give it, but I am not an expert, and my spouse has had me on the confidentiality list since before we married.

[jadelennox]

And actually, the LW can talk to their doctor. Most doctors in the US these days have the "do you feel safe at home" question on their forms, and they are at least theoretically trained to know what to do if the answer is no.

[lilysea]

I think the wife should say

"Love, I am worried about your physical and emotional wellbeing. You've been exhibiting [behaviours], and I'm worried it could be caused by your meds or by an infection. You are also treating me in an unacceptable way by doing [behaviours], and that is not fair to me and is harming my mental health and my ability to feel safe in my own home. I want you to see a cardiologist and a psychiatrist by [date], or I am leaving."

[shirou]

My parents knew a man who suffered a traumatic brain injury that completely changed his personality, making him angry and violent. His wife tried to get him help, but when it became apparent that he wasn't going to return to his old self, she took their kids and left. Of course that was incredibly difficult for her, but what else could she do? The man she loved and married was gone, and in his place was a violent man who posed a real danger to her and her children. Staying was untenable.

[fairestcat]

We had a family friend when I was growing up who had the opposite experience. He had a brain tumour removed and it completely changed his personality for the better and probably saved his marriage. Bodies are weird.

[malnpudl]

FWIW, I faced a situation a year or two ago where a friend who'd been prescribed a long-term regime of oral steroids had a side effect of significant personality changes. They made her so short-tempered and critical and negative that I feared she might end our friendship. She and I have the same primary care doctor so I described the situation without naming "my friend" and he said that I should tell her doctor(s) about what I was observing. The doctor(s) wouldn't be able to discuss their patient with me, but it would be acceptable and helpful for me to communicate with the doc(s). He said writing it in a letter would probably work best. I said I'd do that with the prescribing doc (someone else), but by the way, I was talking about [friend's name] so he could consider himself informed, and enough said.

Bottom line: Doc may not be legally permitted to talk with the wife about her husband's health & care (depending on the law in the country where they live and release docs signed or not). But the wife is definitely allowed to tell the doc about her husband.

[redbird]

This also misses that 911 is for emergencies: things that can and ought to be dealt with immediately. You call 911 if you (think you) had a heart attack and want an ambulance, not because you want to adjust your blood pressure medication.

"I'm afraid of my husband, please help me leave" is something the police might be willing and able to handle. "I'm afraid of my husband, please make him talk to his doctor about his medication side effects" isn't.