Husband's new diagnosis
 

My husband completed a neuropsychological exam a couple of months ago and had poor results from the memory test. He scored about 10%. I didn't like the psychologist that tested him so I don't want to work with him. I'm not sure what this all means. My marriage has been very difficult, to say the least, and I don't know what to do next. Is memory loss always from TBI? How is he coping? It seems as if he is confused a lot.

First off welcome to NeuroTalk. Sounds like there are a couple of dynamics at work here.

Regarding the neuropsychological exam, most of the time these are delivered by a clinical neuropsychologist using some subset of standardized tests for memory as well as other cognative functions. If he scored in the 10th percentile this is compared with baseline scores from people with a similar age, education and so forth. The fact that you didn’t like this psychologist is to a certain extent irrelevant, assuming she or he followed accepted protocol. The neuropsychologist’s role at this point would be to recommend therapy treatments, which would likely include work with a speech and/or occupational therapists; the neuropsychologist isn’t normally the one that does the follow up therapy.

Per your question “is memory loss always from TBI”, there can be other causes of memory deficits, but since you have posted here I will assume your husband has had some form of TBI? TBI can cause memory problems, as I know from personal experience. The fact that he is “confused a lot” is also consistent with TBI patients.

Regarding your “marriage has been difficult” comment, is this related to your husband’s TBI? If so, please consider that many TBI patients make tremendous progress. My wife was my best ally and helped push me to continue my progress. If the difficulties existed before, then only you can answer what your role in his recovery should be.

If you provide more background on when the injury happened, the severity of his TBI, and treatments to date, forum members will be better able to share related experiences and suggestions.

Best to you both.

takinxanax,

Again, Welcome to NT. I have memory functions measured in the 5 to 12% range, too. As lightrail said, there is more to this diagnosis than a simple number. You husband may have confusion for a number of reasons that may have little to do with his memory function.

For many of us, our symptoms have remained at a limited level for years. This does not need to be a death sentence to living a full life. You both need to learn the many work-arounds and accommodations for living with memory and cognitive limitations.

Tell us more about his injury, his diagnosis, his treatments and his current living environment/work/family. Improvement in function is helped when the whole family is involved.

It will help if you read the Vitamins.... thread. It has good information and some links to online resources such as the YouTube "You Look Great" video series.

Please feel free to ask or tell us anything. We are a very supportive community.

My best to you both.

Thank you Lightrail and Mark for your answers! Before we were married, 20 years ago, I was unaware of his problems but did question him about his spelling..asking if he had dyslexia and he said no. Over the years I've had trouble communicating with him. I thought he was being a jerk on purpose and we ended up in marriage counseling 2 years ago. The counselor immediately said he should have a neuropshchological test. The final results were the memory issues, and a learning disability. A couple of things the tester, Ralph, said that scared me were: "The only reason you can he can do his job is that he has been doing it for so long and has it memorized" and "He doesn't understand the meaning of things". My husband seems to have some kind of auditory processing problem because he often does not answer the question like he heard it right. But that didn't really show up in the test. I have found out he had two significan head injuries as a kid and one severe car accident in his 20's. He was also a serious alcoholic with 5 DWI's and 3 times through treatment but he has been sober for 25 years.
His life is very simplified and routine. He defers to me a lot. He lacks empathy and laughs at inappropriate things. His social life consists of work and his AA group and many of his male friends have fallen by the wayside. He stays at work as late as possible and everything we have planned in our life together has fallen apart: children, a business, a cabin, etc. He can't seem to see things through. He hasn't accepted that he has issues because he told Ralph he can fix our marriage problems himself. We don't have much family and I am isolated with him and can't take another weekend couped up. I think he needs a lot of help and I'm not qualified or patient and don't know if I even love him anymore. It's a lot!

takinxanax,

First, I hope you are not using xanax to help you deal with this struggle. But I digress.

On the communication struggle, he may struggle to process too many concepts in a sentence. This can be immediate memory related. It is better to ask questions with a single issue. For example, Can you go to the store and get me some flour and baking powder? This has three concepts. Instead, Can you go to the store for me ? he replies "yes" You follow up, I have a list of things for you to get. You give him a written list.

If he has to make too many decisions to answer the question or complete the task, he may overload and freeze up.

His lack of empathy is called 'flat affect.' It is not uncommon. It takes work to learn to express emotion when it does not flow naturally. The laughing at inappropriate times is called emotional lability. That part of the brain gets its wires crossed. I bet this happens most during stressful situations. It is very easy for the PCS brain to get its wires crossed during stressful situations.

His ability to work is due to it being an 'over-learned skill.' It has been memorized into so many different locations in the brain that he has access to those memories even without having to think. This is like a well trodden path through the woods. The ground has been so compacted for so many years that nothing grows there to hide the trail.

An example: I moved to Idaho in July 2000 and suffered my life changing concussion in Jan 2001. I had already memorized all of the main streets in 2 counties and was quite able to find my way about town by January 2001.

After the concussion, I lost all that memory. It was not amnesia. I just could not remember the order and placement of the streets. I could fly back to San Jose for work and know the streets there like the back of my hand. I still can. San Jose streets were an over-learned skill. The Idaho streets were not learned well enough.

He can still over-learn things but it will take repetition upon repetition.

He may have a verbal processing dysfunction. I have a verbal processing dysfunction. I can usually understand complex words but I can rarely recall them to use them as I speak. But, if someone is speaking in very complex sentences, I get lost very easily. So, it will be important to understand how his mind works so you can communicate in ways he will understand.

A family counselor taught us a simple skill. One person makes a comment and the listener has to repeat back what they heard. If you can get him to work with you on this, you may be able to learn how to better communicate. Most of the burden will likely fall on you since you have more adaptive skills. His adaptive skills are likely very limited.

btw, Congratulations on being married for 20 years, especially to someone with his history. I know what my wife and kids put up with before we understood what was going on in my brain. My injuries date back to childhood (1965) with many head injuries since then causing further struggles.

Please tell us more but help us by putting a double paragraph space every 5 lines. Some of us struggle to follow to the next line in long paragraphs.

So, I assume you two are in your late 40's or 50's. There are changes to an injured brain that start to manifest in the 40's. Think of it as menopause for the brain. Prior struggles tend to get magnified.

There are plenty of other symptoms you likely have not told us about. This is normal. Between the members here, we have seen it all.

My best to you.

Thank you for you transparency and explanations. I’m not a doctor or psychologist, but with the concussions happening many years ago he probably has made cognitive and emotional adjustments over those many years that may be difficult to break or change.

In AA (I am a well-qualified AA member also) step 1 is acceptance. Like recovery from alcohol or pretty much anything, the desire to change has to be there. After my TBI I didn’t want to do the prescribed therapies, but I did them because I realized my brain was injured and I wanted to get better. At this point it sounds as if he hasn’t gotten to where he sees the need to change. Indeed, with his history of alcoholism and the brain injuries he may not have the capacity to see the need to change.

Have you considered counseling for yourself? I sense some conflict in your story, and it may helpful for you to talk through that conflict with a professional. Or a free option I might suggest is to try al-anon, where you can talk through your feelings with others that can share their non-judgemental support. Even though he has been sober for 25 years it sounds like he is struggling with acceptance of his other deficits that are impacting your relationship. You sound like a caring but frustrated spouse and you deserve to live a happy life.

I wish you the best.

:hug:

I do go to Al Anon and have for several years. I think your opinion that his old injuries will be hard to change now is right on. He has not accepted that he has problems. I am conflicted because I don't want to get divorced but I can't go on like this. I also worry and care about his future which seems kind of bleak. I have a lot of support and do take care of myself.
He has other issues besides the TBI; dyslexia, alcohol, low self-esteem. I do hope he gets some kind of help. Thank you for your well thought out and written response it has helped me tremendously and best of luck to you.

Have you tried finding a Brain Injury Support Group ? Your state BIAA affiliate will likely have a list. Some have good support systems for caregivers and family.

Mark, all I can say is wow!! You are an expert and hit the nail on the head (what a terrible pun!) This is very detailed and has quite specific ways to deal with him. I am going to print that last post and refer to it.

The problem I am having now is that he hasn't accepted he has problems and still holds his ground and that I am burned out. I have considered being kind of a caregiver support person in his life since we share a beautiful home and cabin and our lives are totally intertwined. I fear for him if I leave because he will be lost and revert to compensating which only get him in deeper doo-doo.

I need to be totally honest here and please be understanding. I know this is very personal but I don't know who else to talk to! I have dated an old friend on the side that I really care for.

I have this crazy idea that I can enjoy and deserve my new friend while I try to help my husband and also work on possibly getting out of this marriage which has worn me down to a confused and hopeless 56 year old woman.

I also feel angry that he wasn't honest with me (husband) and that nobody in his family was honest either. Actually, they covered up the real person and were cheerleaders; cheering him on and encouraging and rewarding and praising him. My mom told me that at our wedding rehearsal dinner a woman from husband's hometown came up to her and said "takinxanax" will take care of him! She thought that was a weird comment, but now we know why she said it.

You might say you can't advise me on the personal issues-but I would accept your views as yours and not take it as advice.

What is the best thing I can do for him given this situation? He seems like he is spiraling downward-depression and hopelessness. Some of this is because I am being honest that I'm not sure I want to stay.

Yes I do take Xanax! It is monitored by my doctor and I am grateful for it. I also have a glass of wine at night to knock me out. But, I do a lot of other things to cope.

Again, Mark, you are amazing with your information and for taking time to share it. Ever soo grateful. Please keep writing if you have more to share and maybe I will change my moniker to "offxanax".

More on husband
 

Mark here are some more symptoms:

Unrealistic anxiety about money. He claims that any expense over $1,000.00 sends him into a panic. Doesn't make eye contact with the person to whom he's speaking-makes eye contact with me or someone else. No personal time structure-makes coffee at night, falls asleep with doors unlocked and computer on his lap, loses track of time during projects. No future hopes and/or dreams. Refers to our friends like I've never met them or don't know them. Defers to me about almost everything. Seems to prefer simple, ritualistic existence. A lot of trouble reading, terrible spelling that is getting worse.

I did try a brain injury support group and suggested he go and that I would go with him....just got a blank look back from him!!

He does have a lot of good qualities and actually some genius skills. He is likable and funny. He really needs to be pushed and helped so his life doesn't get worse. If he loses his job...I fear it will all be downhill from there.

I went back to school a few years ago and got my Master's in Technical Writing and am on the upswing career-wise. I had a sneaking suspicion I would need it.

taking,

First, you have to take care of yourself. Your health is most important. I suggest you get a full hormonal work-up by someone who specializes in bio-identical hormones. Here is a referral link https://www.womensinternational.com/..._referral.html Getting good hormonal balance will be life changing. Most gyno's use a shotgun approach when women need a sharpshooter's aim. My wife's life changed drastically. I got my bride back and she got her joy for life back.

This and other nutritional improvement will help you get free from the Xanax. Research shows that benzos like Xanax cause early mild dementia. You should consider the vitamins in the Vitamins thread. Your benzoed brain needs to be considered injured. L-Tryptophan may also help with the anxiety. B vitamins as listed in the Vitamins thread will be a big boost to your tolerance of stress. btw, Did your gyno prescribe the Xanax. This is common.

It sounds like you were a target of your hubby's family. Family often looks for the person who can continue to care for and even enable the weak family member. You will likely need them to get on your team, almost like an intervention. They need to know you are exhausted as his caregiver and you need their support to get him to participate in these struggles. If you were to leave him, all he would have is them.

If he has a high intelligence, you may also be running into a geek personality combined with the addictive tendencies. We geeks are tough to live with. But, we can do better with proper support. You just need help to get him motivated to take on some of this responsibility. Don't allude to leaving. It may backfire. Express how tired and lonely you are.

It would help if you could put together a signature with his condition, any meds, and other specifics so I and others can readily recall your situation. Use the User CP button in the upper left. You can reduce the font size with a bit of experimenting so it does not take up too much space. I use font size 1.

More later. My brain is fried.

My best to you.

Mark, thanks for more input. I overlooked that this was on page 2. True I should try to wean off the Xanax. I will definitely take that into consideration and it's my family doc that prescribes it. I have had my horomones checked and I am in menopause-I am quite healthy and look a lot younger than I am!
I am going to look at a townhome for myself today because I can't do this here anymore!!!!! I've tried so hard to be nice to him, support him, offer help etc. and all I get is defensiveness and confused responses. Our car insurance company called him at work last week to "review" our policy because he had 2 serious accidents this winter. I think we are going to be cancelled because "he" actually has 5 DWI's on his record and went 9 years without a license.
The stress is from trying to deal with him, all of it. I am too softhearted and wanted to help him but I am done for sure as of today. I think his family was relieved to marry him off and not deal with him anymore. I saw a lawer last week and gave him (husband) warning today. I can handle whatever comes my way and just want him out of my life.
Thanks for reminding me about my own health! So true! I am going to need you for more moral support as I go through this and move out. I am 56 and my real name is Danielle. Please write me back when I need support.

Update
 

Hi Mark and others, I want to update you on my situation with my husband's brain problems (sorry, sounds insensitive). I've calmed down about the situation, probably more acceptance. He has chosen to do nothing even though it was recommended he see a speech and language disability specialist. Where does that leave me? Coping with my codependence issues for now. I find him to be uninteresting and unattractive yet feel more sorry for him than myself, so I need to focus on myself first. Still taking the Xanax though-even with a little red wine at night. I'm sleeping better.

Hi Danielle.

I'm not sure I can help answer the question of where this leaves you, but I can offer some empathy and support, based on my experience as a TBI survivor and as an AA member.

It sounds as if his emotional and cognitive problems go back years. While he has addressed his alcoholism, he doesn't appear to be willing to take that First Step and address his other issues. The neuropsychological evaluation clearly must have identified opportunities where he could benefit from speech pathology and/or other therapies, yet he doesn’t see the potential benefit from following through with those recommendations.

It sounds to me that you have been more than patient, understanding, and supportive. It also strikes me that you haven’t received any of that back. His personal philosophy sounds like “I’m not much but I’m all I ever think about”. Your statement about now finding him uninteresting and unattractive probably comes from his lack of empathy and his unwillingness to move forward with improving his life.

I think you are correct that you need to focus on yourself. I understand that you feel sorry for him, but at some point it would seem he would need to take some action to improve, so that his life isn’t relegated to being an object of pity.

At 56 you are still young (like me; remember, 50 is the new 30) and you deserve to live a happy life. The very best to you regardless of what path that journey follows.

:hug:

Thanks lightrail
 

I am suffering so much that your words mean so much; you are like a beacon of hope. Like I've said, I've tried everything and he hasn't done anything. I just have to hope God figures something out for me. I am now having panic attacks because I feel so trapped. I decided I have to force myself not to think about any of this because I freak out! I just wish someone/somebody or something would be aware and take some of the load off me. I've quit doing all the relationship work and now he just sits quietly in my presence and doesn't speak much. If he does, it's about him.
You are probably right his problems probably go way back and I know I can't feel sorry for him anymore.
I feel for you and your horrible accident! We've only had lightrail here in Mpls for less than 10 years and I can see how it would be easy to get up close and personal with a rail car. I'm glad you are doing well or good enough. Thanks and please keep writing. I need support so badly.

Thank you.

Here are some things that I found useful for feelings of anxiety.

Yoga. I never thought of myself as a new age/Eastern philosophy kind of guy, but I have found yoga practice very beneficial for relieving anxiety and stress.

Mindfulness meditation. Same comment as above about the new age/Eastern philosophy stuff but this does work. Several good books are available and I found a non-credit continuing education class at a local community college.

Massage therapy. Great stress reliever.

Regarding my accident, I have found personal growth after the accident. I recommend:

http://www.amazon.com/What-Doesnt-Ki...sn%27t+kill+us

I lose my temper and then I feel so horrible because he's innocent. Family reunion today...hopin I can let someone in his family know I need some HELP.
I will take your suggestions...thanks for the book idea. I'll let you know.
Know anything about the book the 36 hour day?

Hi Danielle, no I hadn't heard of the 36 hour book until you mentioned it. The review in Amazon suggests it's primarily written for families of Alzheimer’s patients but includes a section on how to cope with an impaired person's false ideas, suspicion, anger, and other mood problems, so some of this may be helpful.

From reading your past posts though, it seems to me the issue is he doesn’t want to make any changes even though the NPA suggested speech or other therapy would be helpful. The other is your continuing relationship considering your feelings about his disinterest in self-improvement.

You seem conflicted with feelings of anger, then acceptance, then sympathy towards him, then the panic attacks around this conflict. Hopefully the family reunion helped with your insight. You mentioned the Xanax was prescribed by your family doctor; it may be time to consult with a psychologist or psychiatrist to help you work through the conflicting feelings. AA and Al-Anon are great programs but sometimes an objective professional may have more insight.

Whatever your next steps are I wish you the best possible outcome, however that manifests itself.

:hug:

I am very conflicted because he is a "nice" person and tries! I am making plans though. I saw a marriage mediator on Monday. The reunion didn't help at all. 35 people there. He did some strange things though! I can tell you if you want to know. Ha ha. I know I will have to move one eventually. I have seen a psychologist and it's interesting because unless you walk in my shoes you don't get the full-on experience. She (psychologist) said ""well, you've been living with this so why is it different now that it has a name?"
Actually it just validates my confusion.

I know he will be very abandoned if I go. He has nobody close to him. Kind of sad. He is seeing his family doctor in a couple of weeks (whom I've tipped off) so maybe something will come of that. I just wish someone else could carry some of the load. I just wish there was another person here interacting with him so I didn't feel like his mother goose all the time. It's not romantic or fun.

Over the past 25 years, he has likely been deteriorating slowly until recently. You did not notice the slow changes, frog in the pot concept, but now, as he is hitting his middle age, his disability starts to deteriorate at a faster rate.

Hopefully, the family doctor can explain this to him. If he can accept it, he may be willing to start counseling and therapy. The point for him to understand is that as he ages, he needs to get way ahead of the train of aging. With or without you, he needs to understand aging and the dysfunctional brain.

My father died from 40 years of Central Sleep Apnea where he slowly starved his brain of oxygen. Central Sleep Apnea is a disorder where the brain/brain stem does not properly regulate breathing until the blood oxygen level gets too low.

As he noticed his struggles, he developed work-arounds so he could continue at his career and hobbies. He finally had to retire early at 58 because he could no longer process the duties of being a rocket engineer. His work-arounds and other skills he developed allowed him to live a full life for 15 more years and stay active up to 3 months before his passing.

His noticeable struggles started when he was about 40.

When my mother finally understood his personality problems were due to slowly increasing dementia, she became more tolerant of his quirks. I can easily understand his oddities. I observed them with my father.

The important issue right now is for someone to break through his ignorance of his own limitations and how those are impacting his life and those around him. Sort of an intervention.

Nobody can force him to understand. He needs to come to understanding on his own. Sometimes, a person gets in a auto accident that leads to getting accessed. His neuropsych assessment should have helped to break though but it sounds like the NP was not any help.

Can you get his NPA report to his doctor so his doctor can address these issues ? It may help.

My best to you.

His neuropsych report was 21 pages. Should I give the revealing ones to the doctor behind his back?

2 days ago he was proclaiming the changes he was going to make, like go to a language therapist, but I think he will just forget it. He also yelled at me to "go get a 40 hour a week job" because we just got the bill for our car insurance, which doubled to $1,100.00 for 6 months because of his 2 accidents over the winter. I work 2 part time jobs now.

Interesting history about your father-but kind of sad. I got John to wear his gear for a while, now he's back to falling asleep without it.

Now that I have educated myself about John's condition which is short recall memory and short working memory (both around 15%) I see clearly why he is the say he is and why our life is like this...confusing. I am not panicking anymore, it was a shock. But I do wonder about my future with him. We don't communicate very well, I am lonely and we have no upward mobility. Plus he likes things "his way". He doesn't get what's going on with us. What's next?

My immediate and short term memory functions are in the same ranges. It explains some things but does not stop me from being able to live a life. A question for you is simple. How much of his behavior is just Him vs how much of his behavior is due to his injury ?

You say you had dreams but were these dreams your dreams that he just went along with ? Or did he have his own dreams for the future. There is a difference in how people define dreams. He may have 'it would be great if ........... happened in our future' whereas you dream with a higher motivation to accomplish that dream with failure to work toward that dream as being a major problem. His can be almost "Wow, if we win the lottery, I want a mountain cabin, ......, ......., and so on"

I had a lot of dreams early in our marriage. We achieved the kids but stopped at 3 because of my wife's choice. I am one of 6 kids. Big families are wonderful. I love riding motorcycles in the dirt. My wife is fearful of me getting hurt so that ended. I had dreams of doing things as a family like I did as a child, camping, water skiing, etc. My kids wanted to play baseball and do other scheduled activities that limited free time.

Do I miss not doing these things ? Yes. Did it end my life ? No. I still have a few dreams but doubt they will ever come to pass.

So, you both may have a different view of the importance of dreams and working toward them. Sounds more like a marriage midlife crisis that his brain injury since it sounds like the brain injury has a long history. Add a bit of rigid thinking or stubbornness and you have your current situation.

Just my observations. I have no idea where to go from here.

It is a tough situation. I recognize that and sympathize with you.

My best to you.

I think you are absolutely right! And nobody has been able to explain it to me like you. We started out with the same dreams but had different versions and expectations. I just get so fearful when the neurologist said the "only way he is doing his job is that he has memorized it". To me, that means, if he loses it, we are screwed unless I pick up the pieces. And John and I can't talk about the situation. He refuses to talk about it with me. I keep wondering if he needs medication?

So many things are unclear and I can't get good answers. It's very hard to be a spouse to someone like this! I left for an hour and went rollerblading by myself and when I came back and walked in the door he fired off 6 questions within 1 minute. He clings to me like I'm his seeing eye dog and its driving me nuts. I don't mean to sound cruel, but I'm so unhappy and trying to sort it out. And I accept some of it was my own doing and choice when I married him but I didn't see the reality at the time.

First, his memorized skills are better defined as 'over-learned' skills. These are often skills that utilize multiple neurological processes. Cognitive memory, sensory memory, muscle memory all combine to create a very robust memory system. Each system supports the other.

Think of how smelling a specific scent can cause you to recall a time that you had forgotten that involved that scent. You would struggle to recall that memory without the addition of smell to direct your brain to the place where that memory is stored.

Your husband has these multiple paths to memories developed to an extreme level. His long history on his job has created hundreds of memory paths to these needed tasks.

The only suggestion I have is to find a way to leverage him to participate in counseling. The counseling should be presented as a way to learn more about his condition and ways to continue on with life. He seriously needs to understand the need to learn work-arounds to accomplishing Activities of Daily Living (ADL's) There should be plenty of counselors to help with this as it is used with Alzheimer's Disease, stroke and other patients.

It is like he needs an intervention. As he ages, his skills will deteriorate. Your ability to help him will also deteriorate. Your ability to tolerate the stress of his neediness will also deteriorate.

What ability do you have to live separately from an economic sense ? Are you both dependent on your combined income ? These are questions for you to answer with the help of a counselor you trust.

I understand your struggle. My wife needs my income to survive. If my income was lost, she could not pick up the pieces with the resources she has after our nest egg was lost in the crash of real estate prices.

I hope you can find a good counselor to help you sort through this.

My best to you.

Thank you for explaining how he is functioning, that helps so much. I could live on my own and am highly considering it. He has a doctor appointment tomorrow (July11) and I've contacted him and gave him the report and also talked to a care coordinator at the clinic about counseling for me.

I have started doing more things on my own. I'm not sure how he feels about it because he can't speak about it. I feel bad about leaving him sitting alone in his office, but I don't know what else to do at this point if he doesn't get help.

It's very sad. What a sad life he has. Nobody helped him when he was younger and needed it. Now all he has is his job and AA. People aren't really interested in him because he's not a good conversationalist.

I'll let you know how he comes out at the clinic tomorrow. I think it's very possible he will get through it without any referrals etc. he's good at that!!

Our relationship has deteriorated drastically over the last couple of weeks. John just barely acknowledges he has a problem and isn't doing anything to get help-like you highly suggest. He is very argumentative and always has to be right. If I rattle of more than one sentence he admits he gets lost.
His medical doctor talked with him and concluded as long as he is going to work he was okay. That came from John. He said he has checked with everyone and "nobody will help him". Truthfully, he probably doesn't request help, he probably says I'm too hard on him and acts like he's fine.

So I have my own new counselor, one that works with TBI and learning disabled people. She plotted his working memory score on a graph and said he was "borderline". Meaning, borderline in needing services. I am going to keep going to her for myself. This feels like a nightmare. He is almost impossible to "connect" with, yet I keep making the mistake of telling him he's hard to connect with. We argue constantly. I've asked for a divorce just to save my sanity and tonite he left for the weekend. I am relieved yet feel alone and scared. But I cannot continue on the way things have been so I will pull myself together. When I am couped up with him alone so much I get lost thinking I can fix things when I cannot it is just constant frustration and making me crazy.
What kind of help does he need? Whom do I call, what do I do? Just end it so I don't have a stroke of heart attack out of frustration?

It appears he does not want any help. Rigidity of thought (stubborn thinking) is a common symptom.

You can not help or change him. He is on a trajectory that he must choose to change.

You may have developed some stubborn mechanisms as well as both defensive and 'stand your ground' mechanisms. But, I'm not trained in counseling so you might mention this to your counselor.

I finally got my answer! He has Asperger's. Seeing a new woman that works with TBI, learning disabilities etc. She said, "sounds like Aspergers". We talked more and she gave me some information and voila! Fits like a glove. I'm not thrilled about it but it sure helps to know.