Wife Diagnosed with PPD refuses treatment

My wife of 25 years was recently diagnosed with PPD. She appeared to have a nervous breakdown from some stressful events almost a year ago. We have two children, 16 and 13, and both have recognized her behavior change. She is a nurse and has always been a very social person and very friendly. She has been more suspicious than the average person I have met and has been jealous on occasion but recently her accusing has escalated. Last summer she believed our house, car, boat and cell phones were bugged and both of our families were doing things to her. She has settled down quite a bit as her mother talks to her a lot and is able to get through to her that her thoughts are not rational. Her mother is a wonderful person and has no paranoid traits nor do any members of her family. It seems like something snapped last summer causing these paranoid thoughts that my family and I are doing stuff to her intentionally. Even a few of our friends she has grown more suspicious about and makes these bizarre connections between numbers and different events that have happened. She has gone to two psychiatrists, the first of whom she thought was involved in the conspiracy against her. The second has a bad "bedside manner" so we did not go back to her. I agree with my wife about the second psychiatrist but I really like the first. Her mother and sister took her to the emergency room last summer as she believed the police were going to arrest her. She has gotten better and was seeing a therapist but now believes she is fine. She was prescribed medication but refuses to take it because of the side effects and her nursing education. I continue to tell her she is not fine as she continues to accuse me of doing things and believes I have associated numbers with women and believe the women are her when we are together. I will not go along with her irrational thoughts and I am very direct with her that her thoughts are not reasonable and explain why. I have told her that she is an intelligent, educated person and should know these thoughts are not reasonable. As I said earlier, he is a nurse and I try use her nursing knowledge to convince her to continue therapy since she is not fine like she thinks. She told me that I am controlling and that is her problem, and that she has told her theapist I am controlling and her therapist would like to meet with me to discuss my problem. I have offered to go with her to the therapist but she only wants to discuss my controlling behavior. I don't think she is telling her therapist about her paranoid thoughts so her therapist only knows what she tells her. I told my wife that if I go I am telling her therapist what she is saying so that her therapist has a true picture of what is going on with her. I try to use a nursing analogy stating that if her patients don't give her all the symptoms of their medical condition then how can she properly diagnose the problem and treat the patient. The same applies to my wife and her therapist. My wife told me that if I bring up the other issues about her thoughts then she is leaving the therapist's office. I told her that I guess we will have to drive separately so I will have a ride home when she leaves. We have been arguing a lot because I refuse to accept her dillusional thoughts. I have made it clear to her that if she wants to continue this marriage then she needs to get treatment and continue her therapy sessions as I refuse to live the rest of my life trying to help someone who will not help themselves. I realize PPD is a disease and she can't help it but I have to try to get her therapy as I want to save this marriage but she needs to want to go. I am by no means a controlling person. She comes and goes as she pleases for the most part and I have never, ever accused her of flirting with anyone. She is the extravert, or at least she used to be, and I am the introvert. I never interfered with her having fun at parties, wedding receptions etc as she was often the life of the party. Now she just sits there and seldom talks to anyone. When we ride down the road in the car, I talk to her but she does not pay attention. She will chuckle or say "right" but I know she is not paying attention because when I ask her a question to see if she is listening she asks me what I was talking about or says she thought I was talking to my kids. When she is quiet she oftens has a soft moan or like a soft grunt. That is when I know something is going on with her and when I ask she will say "I don't know. Something is going on with you. You are involved in this but you won't tell me." I tell her there is no "this" and there is nothing to tell since it is all in your head. No one is doing anything to you. You are doing it to yourself.

I am hoping my wife will continue going to therapy but at this point it appears she will not go back. I have told her several times that I will not stay married to someone who will not help themselves. She told me that is fine and I could leave if I wanted. I struggle leaving my kids and my house but I realize it may come to this if she doesn't get help and continues to accuse me to the point that I cannot handle it anymore.

Am I being too direct with her or too harsh? I do love her but if it takes moving out to get her attention then I will.

If you were raised from a child being told yellow is "blue", then later in life, when you tell someone that you like the "blue" ballon (which everyone else calls yellow), and they refuse to agree with your statement regarding the color... you would probably think they are the one who is "crazy"...

Never disagree with the "truth" that your wife believes... Even though you know it is not a reality.
You can't confront PPD away. It's caused by a chemical imbalance in the brain... and unless you or the therapist can physically get inside her head and change the neuro transmission connections and the way dopamine and seratonin is transferred back and forth between the transmitters, you are beating a dead horse. She needs a doctor to prescribe some medication. A therapist is good for handling the emotional distress and depression that stems from having a mental illness, but that's about it.

I'm on my 7th or 8th relapse with my wife... She takes Abilify and is compliant for a while, does better, then stops taking it... she'll do fine for a few months actually, then she goes back to recurring conspiracies of the FBI, the house and cars being bugged, her marriage to someone in the mafia (even though I was her one and only groom). The Abilify is the only medication she needs. Just one small little pill... the cost is restrictive, and generic production is not due out until 2015 sometime. So we have the doctor prescribe for a higher dose and split the tablets into halves or quarters.

I have two sons, ages 18 and 13. They were 10 and 5 when my wife had her first 'episode'. I understand your pain. I haven't given up on my wife... and it's hard, but it's worth it.

My suggestion is to get her in to a psych doctor that can prescribe medication.

Start agreeing with her in the sense that you say that you either don't know what she is talking about or you don't understand when she starts talking about paranoia stuff. Let her know that you're just as confused about all those things as she is. She has to be able to trust you and believe that you are looking out for her best interest. She has to know that she can trust you. And when she feels safe, she'll go with you to the doctor. Let her know that the doctor specializes in helping her find the truth.

It's been eight years since my wife's first episode... we've been married for 22 years now. She's not a throw-away wife.