Options slim for living with moody, ill alcoholic

My other half and I moved to the Las Vegas Valley 10 years ago. He was diagnosed with AIDS and is taking meds and doing great on them -- undetectable and his numbers are awesome. Here's my thing: His attitude slowly but surely is going through the roof even though he should be happy about his T-cell numbers and great checkups.

I know that taking all those meds is affecting his thinking and attitude. There is no talking to this man about anything without him saying and causing arguments, then saying the other person is starting it. All he talks about is himself, his "woe is me," and everything has to be about him. To most people, he is nice as pie. To me, not. He is an alcoholic. He did more or less stop due to legal issues, but now that is resolved he is drinking again and I know he goes off and drinks but never says anything or admits it. I won't leave him because of his illness, but I'm at a point where his attitude is pushing me away. -- S.D., Las Vegas

The most important thing I gleaned from your letter, S.D., is that you won't leave him. You won't leave him, specifically, because he is ill. Now, I have no criticism whatsoever regarding your decision not to leave him. I do, however, have an opinion. To wit: If leaving is not an option, then your choices are reduced to 1) learn to live with being pushed away, or 2) hope his attitude changes and he stops pushing you away, or 3) see what you can do to change his attitude.

Am I missing anything here?

I don't like Choice No. 2 very much because it's passive. Helpless. It has "resentment" written all over it. Choice No. 1 is actually viable. I've seen people do it lots of times. "Married singles," it's called. Two people decide they don't like each other, but, for various reasons, they elect never to divorce. They then proceed to foster separate lives under one roof. Sometimes they go as far as separate bedrooms. Some of these couples even have an overtly agreed upon or de facto "Don't Ask, Don't Tell" policy regarding seeing other people. With No. 1, you would surrender all expectations. Your mate could then push you away. Or not push you away. It wouldn't matter.

Now, just because I said Choice No. 1 was viable does not mean I said it is preferable. Frankly, I don't "get" these sorts of arrangements at all. I'm just saying that tons of couples choose this arrangement -- some for years or even a lifetime. Some, at the end of their lives, believe deeply that it was a moral good -- in itself -- to not have divorced. For some people, the beginning and the end of the work of marriage is long-suffering endurance. That's the only requirement: Never give up. That is, it doesn't matter what happens or what becomes of you in marriage. As long as you don't divorce, then you have been successful.

Which brings us to Choice No. 3. You can try to affect change.

In 1997, Dr. Peter D. Kramer wrote the book "Should You Leave?" Terrific book! Kramer examines marital scenarios in which people often consider divorce. Yet, Kramer argues, none of the scenarios rightly calls for divorce. And, frankly, divorce in these cases would not alter, remediate or change much about what is going on. In each case, he encourages the couple to dig deeper. Hang in there. Work more diligently to put on the table what is really going on.

One of the marital scenarios examined has to do with mood disorder. I remembered this chapter when I read your letter. You describe ready signs and symptoms of a husband with an undiagnosed mood disorder: a life-threatening illness, the social implications of the illness, irritability, isolating and the obvious -- he's an alcoholic. I've yet to meet an addict/alcoholic who wasn't, in part, trying to medicate painful moods, depression, etc.

So, you could hog-tie him, take him to the doctor, barge in with him, and say: "Doc, this guy has become one moody, awful human to live with. He's practicing his addiction again. I think he needs to be evaluated for a mood disorder and possibly medicated."

Then again, your man might refuse to examine his behavior, the causes, or even to care what you think. I'm saying Choice No. 3 depends upon his participation, and it could therefore fail. Leaving us with Choice No. 1.

Or, you'd have to reconsider whether you would ever leave.

Steven Kalas is a behavioral health consultant and counselor at Las Vegas Psychiatry and the author of "Human Matters: Wise and Witty Counsel on Relationships, Parenting, Grief and Doing the Right Thing" (Stephens Press). His columns also appear on Sundays in the Las Vegas Review-Journal. Contact him at 227-4165 or skalas@reviewjournal.com.