Hi,

Thank you for the clear description.

After reading the problem thoroughly, it seems your wife probably could be suffering with bipolar disorder with psychotic features.

Bipolar disorder is a combination of recurrent attack mania and depression. Manic features are aggressive and abusive behaviour, decrease sleep, growing grudge on people whom she don't like and taking revenge with bad words while arguing, over thinking on any incident. While depressive features are when she was sitting quietly not talking nor interested in daily activities, anxiety, recalling those previous incidents in her life, reduced sleep, etc. It also seems she has some psychotic features like talking to self, moving objects in her eyes, smiling to self.

However as schizophrenia (a psychotic disorder) patient may present with similar features it is important that we differentiate schizophrenia from bipolar disorder with psychosis. This needs a detailed evaluation of the patient through a proper history and mental state examination. This can be done only at a psychiatrist office. After the initial evaluation she can be put on a combination of a mood stabilizer (lithium or valproate) and an antipsychotic (like olanzapine, risperidone, qutiapine, etc.)

So please consult a psychiatrist at the earliest for proper diagnosis of the case and then start drugs immediately. In the meantime watch her closely. It would be best to have a family member stay with her as and when possible.

Hope I have answered your query. If you have any further questions I will be happy to help.
If you do not have any clarifications, you can close the discussion and rate the answer and please write a review.

Wish your wife a speedy recovery

Regards
Dr Sourav Ganguly

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