[Phoenix]

I have a close friend diagnosed with FTD several years ago though her doctors acknowlege there is no definitive test for FTD except through a post-mortem autopsy. Like a number of diseases, an FTD diagnosis, in advance of an autopsy, is an educated guess. For this reason, it is particularly critical to stay open to possibilities, as similarly presenting conditions can be missed and not treated.

In my friend's case, she presents nothing like an MLCer, but does have a number of the physical and cognitive symptoms outlined at the Association for FTD website: http://www.theaftd.org/understandingftd/diagnosis

Since absolutely no one, including knowledgable scientists and doctors, can know that anyone does or does not have FTD until the brain is looked at after death, it is very important for each person to do his or her own research.

Some highlights from the Association for FTD website that may be helpful are:

FTD is a form of early onset dementia and, like Alzheimer's it is characterized by brain atrophy and gradual loss of brain function.

FTD is primarily a disease of behavior and language dysfunction.

FTD patients exhibit behavioral and personality changes, but retain cardinal features of memory. Some FTD patients may have only language dysfunction and the pattern of language loss may be specific, such as an inability to name a familiar, everyday object.

FTD patients are more likely to display early motor abnormalities, such as difficulty walking, rigidity or tremor (similar to Parkinson disease), or muscle atrophy and weakness.

It is important to understand the distinction between clinical diagnosis of FTD and pathological diagnosis. A clinical diagnosis is carried out by the physician meeting with the patient and family and detailed examinations of changes in cognition, behavior and personality, and neuroimaging studies.

"A pathological diagnosis is determined through autopsy, and requires looking at the brain tissue under a microscope. It is during this examination that physicians can determine the specific type of abnormality present in the brain, and thus the definitive cause of the progressive symptoms experienced during life. A definitive (or an official) diagnosis of FTD can only be made via autopsy.[/u]"

"There are many potential causes that may explain changes in cognition, behavior and motor skills. No single diagnostic test exists to confirm or rule out a diagnosis of FTD. This often results in a long and frustrating process of testing for other disorders with symptoms similar to FTD to rule them out. It is not uncommon for an individual’s diagnosis to change multiple times. Research is still looking for a definitive test for FTD."

I agree with those who have said that what we refer to as MLC is a cluster of symptoms and behaviors that may indicate a variety of issues and conditions that are psychological, physical, emotional and spiritual in nature. There is MUCH we do not know and each person, their genetics, family/personal/medical histories are different, etc.

Personally, I think it's helpful to stay open without forcing any one cause onto anyone. MLC is likely a complicated, multi-layered issue with varying triggers resulting in some similar behaviors, but not necessarily similar outcomes--physical or otherwise. In my own case, I am a third generation LBS, with the interesting medical/genetic part being that the LBS are related through my maternal line, but none of the MLCers are connected biologically. So perhaps there is also a genetic or Family of Origin issue in who we are drawn to, a pattern of choices or lack of self-worth, repeat effort to fix past family issues via our own marriage, or a subconscious "magnetism" to what is familiar to us even when ultimately not in our best interest. My mom vowed not to marry a man who would cheat and abandon, yet somehow she did. I did the same, and could not have married someone who seemed more different in personality and priorities than my father. Yet, 25 years into knowing one another, my H ended up with almost identical behaviors/demeanor/rationale, etc. to my father during his own MLC. While I am in no way blaming the victim, I believe it's imperative to look at ourselves as LBSs as well, and our own history, particularly for me as the mother of a daughter who I hope can break what appears to also be a generational pattern among the women. I can't help her, and she can't help herself, if we are unwilling to look at this from all angles.

For me personally, I also tread carefully about too much dependence on pathologizing MLC as solely a medical issue. It's too simplistic, in my opinion, and may be more about our need as an LBS to avoid looking inward, whether about our own issues and choices, so we don't feel others can "blame" us or point to flaws in ourselves that may have contributed to issues over the course of our marriages. It is less painful, in some ways, to be able to point at a medical condition beyond our control and our spouse's rather than a spouse wanting a different life, not being happy, not wanting to stay married, falling out of love, choosing to betray us. etc. But in the case of my exH, that would also mean a terminal illness which, for me, far outweighs any comfort of absolving I might gain.

In my family's case, none of the MLCers exhibited any brain atrophy, the physcial or degenerative symptoms of FTD, etc. and they lived decades beyond the BD, maintaining second marriages, successful careers, friendships, etc. What they did have in common, is what I've observed in a good number of male MLCers in particular, which is  a history of conflict avoidance, poor communication, avoiding help/therapy, and compartmentalizing which can also contribute to destructive behavior over the long-haul (reaching a tipping or boiling point so to speak). My own exH is 7+ years past BD, a total vanisher--including with his daughter--but otherwise doing very well and still with the OW. It does me and my D no good to focus on him being "unwell." He's chosen a different life for whatever reason and whether is be completely free will and or mental/physical issues, I cannot control or impact that. His health and life are is and my life, and my daughter's, are better served by living them.

Phoenix

[Slow Fade]

what I've observed in a good number of male MLCers in particular, which is  a history of conflict avoidance, poor communication, avoiding help/therapy, and compartmentalizing which can also contribute to destructive behavior over the long-haul (reaching a tipping or boiling point so to speak).

Describes my MLC'r to a "T".

[Velika]

Phoenix, I think what you have written is extremely articulate and important. I hope everyone who visits the site reads it.

I think it is very important to consider the LBS state of trauma when this occurs. I think in this state of shock people are very impressionable and susceptible to other's opinions. This may include both what the MLCer says to the LBS (criticisms of the marriage, criticisms of the LBS) as well as advice from others, which is often based on their personal or professional experience or bias. Just as many object to a general medical diagnosis, I think statements like "your spouse is on a journey" or "most regret it" are oftentimes also too strong for someone who is clinging to hope.

One thing I want to note is that I don't think that a medical cause precludes looking at oneself and the marriage, or is a way to avoid this. I actually suspect that many LBS were even more unhappy than the MLCer on a certain level, especially if there was a typical pattern of increased but suppressed anger and withdrawn behavior, or an emotional or physical affair (or other secretive behavior) the LBS was unaware of.

I think oftentimes we think of "mirror work" as a way of "taking a long, hard look in the mirror" in a self critical or judgmental way. I would like to encourage every LBS to take a compassionate look as well. Initially I blamed myself entirely and took all of my MLCer's criticisms as merited and true. I was willing to overlook extreme emotional abuse thinking I had to prove myself to not be the person he was describing in his attacks.

It took me a long time just to remove myself from the situation and a level of contact and to see with more detachment. So please, if you are new and reading this, I think it is very important to be forgiving of yourself, especially if your former spouse intentionally was leading you to believe everything was okay. Perhaps mirror work can at times be simply, as Phoenix points out, examining whether perhaps you did not choose someone who appreciated you or valued you.

I also want to add — understanding any problems in the marriage does not mean your spouse's way of treating you was justified. If your spouse has treated you without empathy, in an abusive way, or with total emotional detachment, betrayed you, etc. — this has to do with your spouse and not you, whether they are acting this way for neurological, spiritual, or psychological reasons — or a combination of these.

For me, understanding medical symptoms as well as behavioral patterns was a way to observe in a more detached way and also to understand that in many ways this was taking place regardless of me. Not engaging in arguments and maintaining low contact has also been helpful to this end.

[Ready2Transform]

I think oftentimes we think of "mirror work" as a way of "taking a long, hard look in the mirror" in a self critical or judgmental way. I would like to encourage every LBS to take a compassionate look as well. Initially I blamed myself entirely and took all of my MLCer's criticisms as merited and true. I was willing to overlook extreme emotional abuse thinking I had to prove myself to not be the person he was describing in his attacks.

Absolutely I think a lot of times RCR's reference to mirror work as self-reflection gets lost here as we debate and become defensive of our beliefs. She outlines it really well in the articles. The late Louise Hay I believe was the originator of the phrase (please correct me someone if I'm wrong on that!) and also describes it in a very self-loving and nurturing way: http://www.louisehay.com/what-is-mirror-work/ . Definitely something all LBSs, standing or not, can benefit from.

[bvFTD]

Thank you once again, Velika.

I am not proposing everyone's spouse on this site has ftd. I have repeatedly said that you know your relationship and situation best. I asked only that you read up on the disorder and decide for yourself whether the signs and symptoms look sickeningly familiar.

A nurse told me the other day that her husband was definitively diagnosed with late-onset bipolar disorder in 2006 at age 38. We have discussed ftd phenocopy and the possibility that people with underlying psychiatric disorders decompensate at midlife. Who knows? We may have lived with complete @$$holes all this time, but I doubt it.

I came on this site to alert you to a common but underrecognized type of dementia that tends to strike people in midlife. I am very sorry if I upset members here by doing so. I think it is far better to know just what we are dealing with, whatever it is, that causes a beautiful marriages of decades to implode, destroying a great family, followed by so much pain, heartache and destruction of finances, and future dreams.

[bvFTD]

Phoenix:

Your assertion is not quite accurate. Neurologists can definitively diagnose ftd before death. I think what you mean is that they can't determine specific pathology until autopsy: Pick's bodies, TDP, Tau, ALS pathology, PSP, etc. and if they conduct a genetic test they can determine the errant gene such as C9orf.

They can and do diagnose ftd with certainty before death, just not the specific type of ftd. There are many.

[Anjae]

I am not proposing everyone's spouse on this site has ftd.

Yes you are. You blantingly told people that MLC does not exist and what there is, is  frontotemporal dementia in your own words:

HopeEndures:

There is no such thing as a "Midlife Crisis," but members on this site will tell you otherwise.

However, there is a common but under-recognized brain disorder called frontotemporal dementia that tends to strike people in their 40s to 60s that blows up a perfect family and their happy little world that is wrongly called "midlife crisis" or marital breakdown, or misdiagnosed as depression, stress, anxiety, OCD, ADHD, NPD, late-onset bipolar disorder, schizophrenia or even alcoholism/drug-addiction because of the tendency for some people with the disorder to self medicate./b]

First sign is turning away from their true love since empathy, emotions, morals and inhibitions are first destroyed in this type of dementia, not memory!

Read up on this horrific disease then decide whether you should take your spouse to a neurologist.

I find it worrisome that people on this site accept family breakdown, bankruptcy, destruction of credit, foreclosure, disruption and trauma and then try to gracefully guide others through it. Why aren't you balking?

So, please refrain from saying you dind't say what you said. And look at your last paragraph on that post of yours. So disdainful of us,poor idiots.

And this is the title of one of your threads: "Midlife Crisis" is Brain Disease of the Frontal Lobe" http://mlcforum.theherosspouse.com/index.php?topic=9379.msg615687#msg615687

and also this from that same thread:

"Dear Readers:

As most of you have already mentioned, people in "midlife crisis" all tend to follow the same pattern and script. All of our stories are so similar because in many cases what we are actually witnessing and experiencing are SYMPTOMS of a common but under-recognized brain disorder called frontotemporal dementia that tends to strike people in their 40s to 60s. Please read up on the disease. The behavioral variant has a disinhibited type and an apathetic type. People with the language variant seek out doctors when they start stuttering or misnaming objects, but those with the behavioral variant usually believe there is nothing at all wrong with them. The behavioral and language variants are also sometimes the precursor to motor diseases. "

You also told Chriss:

I agree with you. Your husband is unwell. But his new life is not a new beginning. It will be the death of him.

Really? Do you know Chriss's husband? Are you a neurologist and have done tests on him? And even if you were a neurologist, no serious doctor or health professionals talks in such terms. Even because, there are indeed tests for FTD, but FTD is quite tricky and often a diagnose is wrong. So, telling point that point blank is absurd, let alone on the internet.

A nurse told me the other day that her husband was definitively diagnosed with late-onset bipolar disorder in 2006 at age 38.

Bipolar, being a mood disorder, can be diagnosed at any age. 38 is not late-onset bipolar, it is just bipolar. Bipolar can show when one is 70 or older. Same for depression, of which bipolar is a type with two poles - manic and depressive - and schizophrenia.

It is personality disorders that show in adulthood (aside from early 20's)/middle age/when one is an elder.

Do you even read what we write on your threads and on the board? Because I lost count of how many times it has been said that MLC mimic Bipolar, please note, mimics, not is bipolar, and that bipolar can show up at any age.

"No single diagnostic test exists to confirm or rule out a diagnosis of FTD. This often results in a long and frustrating process of testing for other disorders with symptoms similar to FTD to rule them out. It is not uncommon for an individual’s diagnosis to change multiple times. Each time, however, additional information about the patient is incorporated toward a more accurate diagnosis which the physician can use to recommend treatment."

and "Research is still looking for a definitive test for FTD." both from The Association of Fronotemporal Degeneration:  http://www.theaftd.org/understandingftd/diagnosis - I am fairly sure they know what they are talking about.

So, no, there is no definitive test for FTD. Not yet. One day, I am certain there will be. And you can't certainly diagnose anyone with it over the internet.

We may have lived with complete @$$holes all this time, but I doubt it.

On this I agree with you. More, I am certain we haven't. Otherwise none of us would had been surprised with our spouse behaviour. Since we all were, that means they didn't used to be that way.

Don't you think your time will be better spend in a FTD site? Or trying to think about/figure ways of finding a definitive diagnose or even cure for FTD?

We all already know that there is a terrible illness called FTD.

[xyzcf]

Bravo Anjae!

Many members have expressed to both bvFTD and Velika our thoughts and concerns of how this impacts, especially new people who are just trying to find their way through this crisis in their families.

If you do not believe in MLC...that's fine with me but pushing your agenda is not helpful to the many of us who do truly believe in MLC.

I am sure we shall keep fighting about this, because for some reason which I fail to understand, you are determined to put a diagnosis on all our spouses of FTD...you can claim that is not your intent, but as Anjae has documented...your words say otherwise.

[Ready2Transform]

Bipolar, being a mood disorder, can be diagnosed at any age. 38 is not late-onset bipolar, it is just bipolar. Bipolar can show when one is 70 or older. Same for depression, of which bipolar is a type with two poles - manic and depressive - and schizophrenia.

This was the case for my xH. His episodes became less depressive as he got older, and psychosis and mania became more prevalent. Most of what would have been red flags to a professional were easily dismissed earlier because things like hypomanic spending looked like irresponsibility because he was young or just hadn't been taught how to budget. Quitting a lot of things, trying on a myriad of identities, all looked like finding himself. Clearly, he is still looking.

We may have lived with complete @$$holes all this time, but I doubt it.

And I too agree with both bv and Anjae. Our 20+ year relationship was very real and true. We're all flawed humans in some ways, and a disorder does not make the years any less worthy of being cherished. I was young myself, and came from a background of brokenness, so I didn't recognize signs earlier. With the objectivity I gained from healing during my stand and charting out major events in our lives without further being disrupted, it was much easier to see that his bipolar diagnosis was spot-on. A crisis at midlife for sure, and certainly not everyone here is experiencing the same thing I am. But I am satisfied to know my truth, and it gives me closure, even though I am no longer in a position to help him directly. I hope that for all of us, in our own ways. I have found though that it's easier to share my experience and hope it reaches others who resonate with it, than to push. We've all been pushed enough.

[Anjae]

You're welcome, Xyzcf.

It was HS that has it documented.

I think I don't like this "I never said (or did) stuff", especially in certain situations.

That was Mr J did to me. And you can bet I went looking for every single piece of evidence he had said/done what he said he hadn't.
And found it.

Mr J, of course, didn't like it and become mad at me, and most likely bvFTD also didn't like it and will be mad at me. So be it.

Ready2, as you know OldPilot's mother has bipolar and she had a MLC. I think it is imporant for people to understand that having bipolar does not preven one from having MLC.

What will happen is that, once MLC goes away, the bipolar would still be there. But at least there are meds for bipolar/ways of dealing with it.