Dr Phelps,

My wife's diagnosis was recently upgraded from cyclothymia to bipolarity (Bipolar I). Her manic phase started around the beginning of August, and under the supervision of her psych, 10mg. Zyprexa, 50 mg. of Lomictal and some Klonopin to help her sleep, she is returning to a more normal state. She is not completely there yet, but I thought it was appropriate to address some of her destructive symptoms at a counseling session last week.

She spent, by my most recent estimate, $7,000 over "budget". I talked with her about this and at first she was repentent. Now she is defiant and in denial and I am at wits end.

I am lucky that she is not into illicit drugs or illicit sex and that she has, as she describes, K-Mart tastes. However, I am at a real loss on what to do.

Please advise at your earliest.
-awm

Dear Mr. M' -- 
Sounds like the money issue has changed from a "bipolar" one, to a "power struggle" one.  Advise: get therapist to help the both of you set expectations around money; then later, if needed, together or with the therapist you and your wife may have to set up mechanisms that prevent unagreed-upon spending (eg no credit cards, no checks without both signatures -- at least at times, or when some "trip wire" has been triggered).  

Dr. Phelps