The Legal Guardian Angel
by Morgan Claire
My husband and I live in the Commonwealth of Virginia. I am not providing our real names at this time. My husband is currently on disability and hopes to return to the work force in the near future. I would not want him discriminated against in any way.
I hope this will help to educate people and let them know there are solutions for those seeking help for people with brain disorders. I am no stranger to neurological disorders or diseases. My first marriage, which ended in divorce, was to the late Dr. David Smith, now the subject of a new book titled The Tennis Partner by Dr. Abraham Verghese. David was perhaps bipolar or suffered from clinical depression, which was only aggravated by a predisposition to addiction or, perhaps, he would have had a dual diagnosis. He committed suicide. My second marriage was to my long-time friend and love who was of great influence to me. He was a brilliant musician who died of Lou Gehrigís disease (ALS). My stepfather has Alzheimerís, and my current mother-in-law has been battling multiple sclerosis, which recent discoveries have indicated it may be caused by a Herpes Simplex virus attacking the brain, for 20+ years. I am being treated for panic disorder.
What follows is the story of my current and beloved husband of six years. I am 42 years old, and he is 34. We have been through a traumatic three years with his bipolar illness. He is not diagnosed as a true schizophrenic, but his illness is so severe that it closely mimics it. During our long and bumpy road to regain his mental health, we have on occasion referred to ourselves as Thelma and Louise ñ except that we made it to the other side of the canyon and will continue using a road map for long-term success.
I am outraged at the level of ignorance commonly expressed on the issue of mental illness. Through research, I have discovered that mental illnesses are more common than cancer, diabetes, or heart disease and are the number one reason for hospital admissions nationwide. People are often prone to simply sweep such issues under the carpet without addressing the very real needs of the mentally ill. I know from personal experience that the only way to provide help to those suffering from such problems is through education. Someone who is bipolar, like my husband, is suffering from a defined and treatable brain disorder, not anything that can be correctly described as character flaw.
It takes more than reading a few pamphlets; it takes guts to help a significant other who is mentally ill. It takes the willingness to follow through in a judicial setting, if need be. Various states have different laws and procedures for ensuring treatment of the mentally ill. I, for one, am a strong advocate in making certain people with this illness ñ and other types of dementia ñ are required by law to take their medication. One would not think about letting a person with Alzheimerís roam the streets bereft of proper medical attention. Yet, people who are suffering from treatable mental illnesses are often neglected, placing themselves and others at risk on a daily basis.
After years of treatment in his late teens and early 20s, my husband went on to complete a Christian missionary assignment, graduate on the Deanís List from one of the top schools in the country, and was enjoying a promising career in the U. S. government. Because it became expensive for him to return to his home state each year to see his doctors indefinitely, he eventually started seeing a doctor at a nearby clinic. This doctor never conferred with past doctors or got paperwork on his history, never monitored his lithium levels and took him off an anti-psychotic he had been on for over 10 years.
It sometimes takes a couple of weeks to notice anything, but in such an instance when my husband goes off his prescribed medication, he initially exhibits the occasional depressive side of his illness which more closely resembles a repressed state of anger. He has never been known to swing to the catatonically depressed state but has expressed suicidal tendencies. He then becomes highly energetic, swings to the manic and his emotions just take off like a rocket. It took a mountain of strength for me to learn not to take things that he said or did personally. Needless to say, it was a very stressful experience. There were terrible outbursts of temper where he would call me every horrible name under the sun. He would be totally unable to reason about anything and went on spending sprees running up nearly $30,000 in credit card debt in less than 4 months. He gave away material possessions including his wedding ring, plus a replacement for it I had bought for him, his prized college ring, clothes, a cellular phone, and a variety of other memorabilia. Making gifts of personal heirlooms is often a bad sign that typically leads up to suicide attempt for most with his disorder. He would roam the streets of D.C. where on several occasions he placed himself in extremely dangerous, potentially life-threatening situations. He had a super-charged sex drive and sometimes exposed himself in front of our friends. He self-medicated with alcohol. (For others who are bipolar, self-medication can be done with illegal drugs or a combination of both drugs and alcohol). He eventually became so delusional that he actually thought he had served in the Persian Gulf War when, in reality, he held a job in sales during the war, and claimed to have gone from being a First Lieutenant to a Brigadier General.
People would ask me, "Why doesnít he take his medication?" In response, I could only say, "Because the neurons are cross-firing so rapidly, it renders the responsible part of the brain completely unable to recognize that anything is wrong." The person who is ill believes he or she is right about everything, and everyone else is the enemy. They will also typically stop taking the medication only after a few weeks or months before it has really had a chance to kick in and start the healing process, thus starting the entire cycle all over again. In my husbandís case, it took nearly 9 months for him to finally comprehend the fact that he can never stop taking his medication; it is, literally, a matter of life or death. He still has a way to go before he will be fully recovered.
I learned the hard way that calling the police was not the answer to getting him hospitalized as they could not do anything without recommendation from a mental health professional. I then made numerous attempts to get help from the mobile crisis unit, a team of psychologists or others with mental health related backgrounds, which will come to your home to make evaluations. If they deem treatment necessary, they place a call to the police. The police then come to the house, handcuff them in front, and take them to the psychiatric unit at whatever hospital has a bed available where they are detained for a period of 72 hours until the hearing takes place (usually in a room at the hospital). They are further evaluated at the hospital prior to the hearing. I pursued two court commitments by a judge who held hearings at the hospital. My husband made this process even more aggravating by refusing to sign a release for the doctors to speak with me. Even as his wife, without his signature, they could not talk to me about my husbandís case although the rules let them listen to what I had to say. Within a few days, he would be released when the reality was that he needed to be there for MONTHS in order to get well again. I decided there had to be a better way. The crisis units would only take him to the hospital (under police escort) if he was a) being a danger to himself, or b) a threat to someone else. In my view, therein lies the true harm ñ blatant ignorance mandated by antiquated laws. They could clearly see that he was totally psychotic sitting there babbling away and talking total nonsense, laughing, rocking, etc. Pathetic.
He only met the criteria when he poured beer on our cat and me and threatened to set us on fire. On a separate occasion, pushing me down to the floor did not qualify, when it should have because of the violence towards me. By the time they arrived, he was calmly rocking in a chair saying nothing. The few questions he did answer were answered politely as he (and others with these disorders) has an uncanny ability to briefly mask symptoms of the illness. The team suggested I have him arrested. What good would him going to jail do? He needed medical help. Once, he verbally threatened one of the crisis team, so they took him.
After being in the hospital for a short time and being released to attend a volunteer day program, he stopped going to the program within days and refused to resume taking his medication after a follow-up visit with his regular psychiatrist. The situation was complicated by the fact that this doctor practiced in the District and had no jurisdiction in Virginia.
I knew the worst was yet to come. By the end of the year, I was at the end of my rope and felt that all hope was lost. Not knowing what to do, I sought the advice of a divorce attorney. I really did not want a divorce as I knew he was "in there" somewhere ñ he just needed to take his medication.
I met with the attorney on January 2. Our state had, literally, just instituted on January 1, outpatient commitment, where the court can mandate that one follow a prescribed course of treatment by a doctor and comply with that treatment course outside of a hospital setting. That would do me no good because my husband needed to be in the hospital under close care for a long period before something like that would benefit him. It just so happened that our state had also made some reforms in Adult Guardianship, primarily to help people with a spouse or parent with Alzheimerís or similar type of dementia, but we were convinced that my husband would meet the criteria.
It is important to note, at least in our state, that one does not have to be related to the person who is incapacitated in an effort to seek judicial proceedings. Anyone can file a petition for a commitment, whether outpatient or in-patient, or guardianship/conservatorship.
One thing the new reform did was deny the "defendant," in this case, my husband, to the right of an attorney if the judge in consultation with a guardian ad litem saw fit to do so. The guardian ad litem is the person appointed by the court to determine also if I was the right person for the job of guardian, whether the defendant clearly needed medical attention and was unable to care for him or herself, and if the defendant had no financial means to pay for an attorney. Even if one had an abundance of wealth, an attorney could be denied if it was determined that it would be futile to waste money when one was clearly in need of treatment. However, if denied an attorney, the defendant is entitled to request a jury trial under the guardianship provision. I decided that I had to file for a hearing in this matter in an effort to try and save him and our marriage. I secured a letter of recommendation from his last treating psychiatrist. His entire immediate family was notified in the event they wished to contest the petition. I had the full support of every single member of his family and all of our friends, though some thought I had taken leave of my senses to go through with it because of what my husband had put me through already.
I filed the petition. Two days later, my husband was arrested for the first time in his life for yelling at an ATM machine "that was telling him of people conspiring against him" at a local 7-11 and screaming at a police officer who was just getting a cup of coffee. His true "crime" was being mentally ill, but the arresting officer had no clue, and arrested him for disorderly conduct. Needless to say, not one of his friends or family members would bail him out of jail because he was in the safest place he could be until the hearing 4 days later. It also meant he couldnít run away. I constantly called the jail to make sure the officers knew of his condition and that any mistreatment of him would not be tolerated.
The pre-trial hearing took place on a Friday. It was an open and shut case that my husband would be denied an attorney, and all of the other parties were prepared to appoint me guardian/conservator right then and there. However, he requested a jury trial, unwittingly costing us another $2,000 we didnít have, whereby he would now have to act as his own attorney. Seeing how serious this situation was, the judge took one look at my attorney and the guardian at litem and asked, "Can yíall have a jury trial ready by Monday?" "Yes, sir!" came the reply.
The trial the following Monday was a real sight to see. Questions of the potential jury members revealed that several of them had relatives who were bipolar or schizophrenic. My husband was so delusional, he never caught on to the fact that he could have dismissed these and other jurors from the panel who might be harmful to his case. They were most interested to see how this would turn out because maybe they, too, could help someone. The result of the case was that I was appointed "guardian over his person," which includes making medical decisions and whether he can drive, etc. It also made me "conservator," giving me control of all finances in our marriage. In effect, it basically makes him a minor subject to parental control. The court order also specified that he take his medication in front of me ñ to do otherwise would be breaking a court order, and he could again be hospitalized against his will by whatever means I deemed necessary (police, guards, etc.). Although with the remarkable progress he has made, I doubt I will have to use this power granted by the court. Then again, there is also a slim chance that he could have a psychotic episode even while taking his medication, so that still gives me the insurance I need to hospitalize him again should that unlikely need present itself.
The next big step was to get him out of jail and to the hospital as soon as possible to begin what I hope will be the last time he will have to receive such closely supervised care. I had to move quickly because the laws were so new that the uneducated at the county jail would not give him his medication when I asked them to as was my right under the court order I had secured. Also, if I posted bail, the police would not escort him to the hospital. Although he had just been declared mentally incompetent or "incapacitated", he was not "threatening" under the crisis team rules and because they, too didnít know the law, they wouldnít recommend a police escort unless he was threatening. I could not just leave him there in jail for another 2 weeks until his disorderly conduct trial came up. So, I hired two, big, burly private security guards with prior military service who dressed in military-type uniforms and had titles such as Captain and Lieutenant.
The two guards, my husbandís wonderful brother, and I hopped in a van and headed for the jail. The brother and I informed the guards that they were about to witness a show of a lifetime. They were not armed, but I instructed them that although my husband had a vague idea he was going to the hospital, he might try to run, and they had my permission to wrestle him and do whatever it took to restrain him. As my husband thought he was a general, I explained that the Captain and Lieutenant were there to provide him a "military escort" to the hospital so he would not have to endure the "abuse" he had suffered at the jail. Miraculously, this worked, and we got him to the hospital without much incident other than laughing to keep from crying ñ my husband was really on a psychobabble, mood rollercoaster. As sad as it can be, it is also an enormously fascinating experience to witness ñ just totally unbelievable to think that oneís brain can be sending neurotransmitters in such a crossed fashion. Thank God it is treatable.
The admitting process was traumatic. I had to provide a multitude of papers to prove that I indeed had the authority to admit him against his will. I even produced a copy of the bylaws of the court settlement that showed I would be the one to consult with the doctor whom I had already called. He had previously treated my husband on his last hospital stay, which was on a volunteer basis at the time, and he knew how serious the situation was. Finally, someone saw the light, and we got my husband admitted and medicated. One doctor remarked how wonderful this was and if only more people knew about it and acted upon it. It would save tremendously on the people who are just committed for a few days, or volunteer and walk out a few hours later ñ people could actually have a chance to get well.
My husband was hospitalized for over two months. The first few weeks were pure hell because I was the brunt of his uncontrollable anger. However, after living like this for nearly two years, I was able to brush it off. I knew it wasnít my husband ñ it was the illness doing the talking. After that, things gradually started to improve, and my husband realized he was in trouble and was where he needed to be. He further completed a day treatment program upon being released as an inpatient.
The outcome of my husbandís disorderly conduct charge was simply unbelievable. After I provided a stack of close to 3 inches of documentation to the attorney, the prosecutor nor the judge even so much as looked at it and ordered him to do 75 hours of community service in order for the charge to be dismissed. Not to mention the fact that my husband was purely innocent of any criminal behavior, I had to think to myself, "Here is a man who has been declared a court documented psychotic, has just been released from a psychiatric facility, is on medical disability (and heavily medicated) ñ and they put him in a community service program? How were they to know whether the papers I had provided showed that he was a possible Jeffrey Dahmer or not?" On top of that, he was sent to "assist" in a nursing facility with severely physically and mentally disabled patients with absolutely no regard for what effect this could have on his recovery plan. He was so heavily drugged (15 mg. of Risperdone plus heavy doses of Depakote, Cogentin, and Neurontin at the time), he could have hurt himself or someone else. My blood just boils every time I think about it and the absolute ignorance of some of the people in our judicial systems. I still simply cannot fathom it.
It has been 12 months now since that wacky ride with the security officers, my brother-in-law and my husband to the hospital. Over time, my husband has come to realize just how much we lost in terms of time, money, and his job. He is on long-term disability, which unfortunately is arbitrarily ended after only two years for mental illnesses unlike long-term disability for other medical problems which routinely receive coverage for a much longer period of time. He has made remarkable progress, and we are hopeful he will fully regain the level of concentration, focus and function that he once possessed and will be able to return to work in the near future. We both have a firm foundation in our Christian beliefs and know that God has been and will continue to be with us every step of the way.
This entire epic journey has strengthened our marriage. There are no arguments about taking medication. I simply keep the dispenser filled and quietly monitor. I have a hereditary panic disorder that can mimic all sorts of other illnesses and gives me occasional heart palpitations, choking and numbness. I have to take medication to keep it in check, so he has a better appreciation for the fact that I DO understand certain disorders of the brain; and like it or not, some of us have to take pills to make our brains work properly. He has no problems with me taking care of the finances, and I was able to work out something with all of his creditors to avoid bankruptcy. It will take us well over 10 to 15 years to repay the debts.
The happy ending to this is that I still have my husband, and we still have our lives. Gone are the days of having to deal with his diatribe of abuse and reckless behavior as his recovery and healing process come gradually to fruition. Every day, he tells me how much he loves me and thanks me for his being alive and having a chance to make it. He calls me his "real and legal guardian angel". I just tell him I loved him enough to do whatever could be done because I didnít want to lose my husband and best friend; he is more precious to me than ever.
If one is serious enough about wanting to help someone, I strongly urge you to see what statutes your state has in place regarding in or outpatient commitment and guardianship, since it is highly doubtful that someone in a psychotic state would give you Power of Attorney. This is also important if you have a relative or friend with Alzheimerís (my stepfather is in the near final stages and, mercifully, my mother got him to sign a Power of Attorney while he still had some comprehension). In our state, the guardianship/conservatorship can also be amended or rescinded at the request of the guardian/conservator or the "ward", depending upon the circumstances. Again, a hearing would take place to determine the best course of action for all involved.
Also, keep in mind that there are numerous people who have bipolar disorder but may only exhibit symptoms to a lesser degree. In hindsight, I know of several people who, at the time, I thought were just mean-spirited, argumentative jerks (male and female) in need of a serious attitude adjustmentñ some who were very productive and others who could not maintain a steady job and were major substance abusers. I know better now. Some were eventually able to realize something was "off kilter" and get the help they needed. Others have never fully realized it and are, surely, incapable of doing so. Sure, some people ARE just jerks ñ but pay attention. Maybe something else is amiss, and I am sure that many readers can possibly relate these types of behaviors with a friend or relative. And, just thinkÖyou may be able to make a difference in that personís life and all the other lives surrounding them, including your own.
The information on Mental Illness Policy Org. is not legal advice or medical advice. Do not rely on it. Discuss with your lawyer or medical doctor. Mental Illness Policy Org was founded in February 2011 and recently received 501(c)(3) status. In order to maintain independence MIPO does not accept any donations from companies in the health care industry or government. That makes us dependent on the generosity of people who care about these issues. If you can support our work, please send a donation to Mental Illness Policy Org., 50 East 129 St., Suite PH7, New York, NY 10035. Thank you. Contact firstname.lastname@example.org Contact DJ Jaffe, founder http://mentalillnesspolicy.org.