False accusations

I believe my wife may have BP and/or PPD. She exhibits cyclical mood swings, like BP, lasting about 1-2 weeks. From hypomanic to angry/irritable/sad, and during this down mood also paranoia. Some other symptoms of BP also. The mood swings I can deal with. I've had them myself for 40 years, and dealt with wild swings with my first wife for 20+ years. That's just SSDD for me. So mainly I'm concerned with the paranoia, which I have not dealt with before.

I know the ultimate goal is to get her into treatment, but I don't know how to get from here to there, and need advice on coping/managing it until (if) that happens.

She is convinced she is being lied to and hurls all manner of false accusations that seem to just be the fabrication of her own mind with little relation to reality. Suspicious and untrusting. She is now ready to divorce me because she is so convinced that she is perpetually being lied to about everything. This is her third marriage, and it is obvious to me that this problem is significantly impacting her social life, and has been for maybe a long time.

She knows that she has a suspicious nature, but I don't think she knows how pervasive it is. She is also very opposed to any mental health treatment, particularly medication. I have brought it up a few times, and it didn't go well. I know that I can't force her to get treatment, so I want to know how to handle, manage, and respond to these episodes.

She has agreed to go to marriage counseling, which I am hoping could lead to individual counseling for her (I already have one). I have read that a good way to handle the paranoia and false accusations is to just tell them truth, don't argue about it, and walk away if necessary. I long ago gave up trying to tell her truth to counter her false beliefs, because it just made her angrier. I guess maybe that wasn't the right thing to do? But sometimes the false accusations come so fast and furious I just need to duck and hide to protect my own sanity, and can't deal with responding to all of it. But I don't want a lack of response to be interpreted as me agreeing with the lies (and if I don't respond, she gets even angrier).

I also am trying to start setting boundaries (very lenient ones) to protect my own mental health. Of course she doesn't like that, but I know she's doing her best to comply as I don't believe she has ever had any healthy boundaries put on her since childhood, and those she pretty much just ignored.

All help appreciated! Thanks.

I myself am very opposed to medication. So I can relate to her in that. I've had direct family members on medication and it never seems to help. I mean it helps, but then it creates is own array of problems. To the point where you aren't really sure which version of the person was better.

My suggestion would be to explain to her the difference between a psychologist and a psychiatrist. One can prescribe medication and the other can't. One talks, one medicates. Try to get her to see a psychologist and assure her that medication is a bad idea and that they can't prescribe her any. Try to be on her side as much as possible.