Question

[Easeful]

I polled my adult step children yesterday to see what meds they have used. Some have a diagnosis of bp, some take meds for depression and anxiety.

One of the girls who is finishing her nursing degree in April, told me that she doesn't believe any of them need to be on an antipsychotic. She has a diagnosis of bp and doesn't take one.

I'm wondering now, the drugs that have caused problems for my son are the risperdol, seroquel and abilify. He's now taking zyprexa and so far so good.

But I'm wondering do the majority of bp's need antipsychotics?

[Draysin]

Not sure why unless there are serious mania issues...and Seroquel is the only drug you mentioned I know anything about. Never took it myself but friend just weaned herself off of it. She took it for psychotic episodes and mania.

I'm tentatively diagnosed with BP. They are not sure what's up as I am also newly sober, possibly experiencing PAWS and have a lot of situational anxiety (divorced, death of several family members, etc). I also have ADHD and cannot take Adderall without sleeping all the time.

Good question...looking forward to the responses you get!

[shutterbug]

1. seems i remember that your son was loosing touch with reality?

2. The one finishing up the nursing degree is wrong. There are a BUNCH of reasons why psychiatrists prescribe anti-psychotics to bipolars and others (who aren't actually suffering from psychosis)....one is known as "augmenting." For some reason, some meds like those you mentioned will help the anti-d's and the mood stabalizers work better. Remember there is a BIG difference between a nurse and a psychiatrist.....and I personally don't even trust most psychiatrists to know what they are doing!

[Easeful]

Originally Posted by shutterbug

2. The one finishing up the nursing degree is wrong. There are a BUNCH of reasons why psychiatrists prescribe anti-psychotics to bipolars and others (who aren't actually suffering from psychosis)....one is known as "augmenting." For some reason, some meds like those you mentioned will help the anti-d's and the mood stabalizers work better. Remember there is a BIG difference between a nurse and a psychiatrist.....and I personally don't even trust most psychiatrists to know what they are doing!

I see I didn't express that very well. I just threw in the nursing bit to indicate that she has a little more than the average bp patient's level of understanding of meds. But what she was speaking from was her own experience that she, her siblings and her son don't need antipsychotics, not that bp's don't need them.

I'm trying to understand. What it's sounding like from the nearly incoherent psych professionals I've been listening to, is that my son had a prolonged bp manic period (a week or so, and that can't really be confirmed) that resulted in the break with reality. Is that possible?

And assuming that I've got that much right and it's not schizophrenia (3 out of 6 say bp, the other 3 say more likely schizophrenia but too early to label) it seems that avoiding the manic highs would be the goal? Maybe I'm oversimplifying.

Thanks for the info on augmentation, that gives me a better understanding.

[barb dwyer]

hell I dunno I'm not a doctor.

this is what I do:

*prayers*

[shutterbug]

sorry if i came across harsh....i'd just woken up and was feeling pretty ill. I should prolly hold off on giving out responses until i've had my morning java! LOL

Barb makes an excellent point in that most of us here are not docs. I personally try to take my own health into my own hands as much as possible and read/research as much as i can about things on my own and that way i have a better idea of things that might be going on with me on a daily basis. I personally don't understand why monthly visits with our psych docs is acceptable....especially considering we only spend a few minutes with them during that monthly visit as it is!

I think the thing to understand with a lot of this mental illness stuff is that nothing is really consistant. By that i mean....I had my first major depressive episode in college and should have been diagnosed with bp then, but wasn't so i didn't stay on any anti'ds or anything (especially since i've always hated pills)....and i lived my life totally fine, just like everyone else for the next 7 years!

So i spent about a year showing signs, symptoms and then suffering greatly from my illness....and then *poof* everything was back to normal and i thought nothing was wrong and hadn't a clue that i'd end up eventually going through the same thing sometime in the future.

I guess i'm saying that because all of those in your family who have been diagnosed with bp may not even know that entirely themselves either, but major episodes come and go.....and so even if medicated properly now...we can think we are good from here on out, but usually that is not the case. With bipolar I, it IS much easier to stay stable longer and without the severe trip-ups that bipolar IIs tend to go thru much more often, but the fact remains that nothing is ever a "for sure thing" with this stuff...unfortunately. So they may not be on anti-psychotics now, or haven't been thus far, but that absolutely does not mean that a time won't come when one is needed in the future.

As for your son....if he had a break in reality, however brief, then an anti-psychotic med is quite apropriate in my opinion. As for your question of a week-long mania....they can easily last that long....and longer. There have even been people on here who have logged on to ask questions about how to get help for loved ones who were totally in complete psychotic mania for long periods of time and refused help because they were sooooo not in reality.

My suggestion would be this....educate yourself and your son as much as possible and continue that education in the understanding that it's the most important thing he can do to ensure his future health and happiness on the basic level. If he's not mentally healthy then everything else isn't going to go according to plans he has for his own future. Right? I'm not trying to scare you, or him, just emphasis the importance of making this a priority in his life...it has to become a basic self-care part of his life that includes daily meds, weekly theapy and monthly pdoc visits (and that's the minimum). But it's really no different than if he had diabitis or anything similar that required regular attention for healthy daily living.

My next suggestion is this....there are many sites like NAMI: National Alliance on Mental Illness-The Nation's Voice on Mental Illness-Formerly National Alliance for the Mentally Ill that offer not only tons of information, but also contracts. They have a specific name, but i can't recall it. Basically, it is a contract that you and your son sit down and fill out together where he makes some decisions about how he wants things to be handled should he loose touch with reality in the future and become in need of hospitalzation again. It's a contract that he basically signs for you and himself giving permission for you to step in should he get to that point again.

There are a ton of resources out there to help you both through this and NAMI is a great place to start.

Also....it would be beneficial if you and/or him find and download a "mood chart" and fill it out according to how his moods seems to be each day. That could DEFINETLY help get him diagnosed quicker and also help with med changes and such. You should also be able to find the mood chart at nami.org and also at www.dbsalliance.org

I don't know if i've answered your specific questions or not, but feel free to ask again if i haven't. And remember....this is all just my own personal opinion and i'm not a doc.

lov and hugs,
Jenna

[newsandi]

(((Jenna))) Thanks for the above info. I have been wanting to get some type of contract for my son to sign so that I can help him if ever needed. I have been on the Nami site but never seen the contract.
Thanks!!!

[Easeful]

>As for your son....if he had a break in reality, however brief, then an anti-psychotic med is quite apropriate in my opinion. As for your question of a week-long mania....they can easily last that long....and longer. There have even been people on here who have logged on to ask questions about how to get help for loved ones who were totally in complete psychotic mania for long periods of time and refused help because they were sooooo not in reality.<

My question wasn't if mania could last a week (I have a bil who can keep a high going for months), I was asking if it was likely that a week could produce psychosis? I get that anything's possible, what I'm looking for is a norm or average or consensus or something.

[Easeful]

>My next suggestion is this....there are many sites like NAMI: National Alliance on Mental Illness-The Nation's Voice on Mental Illness-Formerly National Alliance for the Mentally Ill that offer not only tons of information, but also contracts. They have a specific name, but i can't recall it. Basically, it is a contract that you and your son sit down and fill out together where he makes some decisions about how he wants things to be handled should he loose touch with reality in the future and become in need of hospitalzation again. It's a contract that he basically signs for you and himself giving permission for you to step in should he get to that point again.
<

My h and I attended our first NAMI meeting the same night that we put our son in the hospital. They are a wonderful resource.

As to contracts my son has mentioned a safety contract several times but no one else has talked to me about it. In his description it's an agreement between us that if he feels suicidal or homicidal he will come to us and we will take him to the hospital. Period. No other fixes, no wait and see.

[Easeful]

<I guess i'm saying that because all of those in your family who have been diagnosed with bp may not even know that entirely themselves either, but major episodes come and go.....and so even if medicated properly now...we can think we are good from here on out, but usually that is not the case. With bipolar I, it IS much easier to stay stable longer and without the severe trip-ups that bipolar IIs tend to go thru much more often, but the fact remains that nothing is ever a "for sure thing" with this stuff...unfortunately. So they may not be on anti-psychotics now, or haven't been thus far, but that absolutely does not mean that a time won't come when one is needed in the future.
>
::sigh::

[shutterbug]

Originally Posted by Easeful

My question wasn't if mania could last a week (I have a bil who can keep a high going for months), I was asking if it was likely that a week could produce psychosis? I get that anything's possible, what I'm looking for is a norm or average or consensus or something.

Sorry sweetie, i don't know the answer to that one

[shutterbug]

i guess i'm a little confused. I know all of this is stressful to family, and especially parents, but since you have so much family history of it already and therefore a bit of background in at least having seen some of it before....i'm wondering if there is something more stressing you? I ask because i get the feeling that you are totally overwhelmed by this and that you are feeling like this is all a total catastrophe that has wrecked his life for good?

It's not the end of the world. It could be much worse. There is actually a huge part of me that is thankful for my bipolar disorder. Yes, it is difficult at times, but it makes me who i am and it also has made me more sensative to what others may be going through and it has a huge impact on my art. It's not cancer and it's not AIDS or anything like that....it's just a genetic part of my family circuitry.

Is there something more going on? I mean, I work in a corporate office where i'm talking to and photographing lawyers, CEOs, politicians, millionaires....on a daily basis...and yet when i came back from my 6 weeks of shock treatments (ECT) I didn't hide it. I'm not ashamed of my illness. It makes me who i am. It's actually been a great source of comic relief in the newsroom!! Even my boss joined in the fun the other day with a comment about needing to start recruiting future newsroom staff from the local mental ward!! LOL And my copy editor is great with here comedy...and i've kept a list to include in my future book, with her permission. An example was when i was talking about fearing that i needed a "maintenance" shock treatment because i was starting to go back down hill with my severe depression and she said with a smile, "Yep, It might be time for a jump-start!"

I know it's hard, but try to take things one day at a time and know that this current crisis is temporary and things will even out soon. Take a few deep breaths and know that everything is going to be okay. It just seems like the end of the world right now, but it's not. It's really not.


Jenna

[Easeful]

i guess i'm a little confused. I know all of this is stressful to family, and especially parents, but since you have so much family history of it already and therefore a bit of background in at least having seen some of it before....i'm wondering if there is something more stressing you? I ask because i get the feeling that you are totally overwhelmed by this and that you are feeling like this is all a total catastrophe that has wrecked his life for good?


You are perceptive. I am totally overwhelmed. Nine weeks ago, I was the mother of a 20 year old son who had been living almost completely independently for 2 years, who could have taken on any candidate you've ever seen compete in a presidential debate and held his own in knowledge of U.S. and world affairs, vocabulary and presence on stage. Nine weeks ago I had a son who could have been or done anything. He may still but......

For the last eight weeks I've been the mother of a son who could not follow the directions necessary to heat a can of soup, who wets the bed regularly and who can barely form a coherent sentence.

And the family history? That's not my family, it's my husband's and until we moved here 18 months ago I had no idea what living with bp was like.

[shutterbug]

Easeful....you still around?
How are things going?

Sorry i didn't post sooner. This thread of yours and your response inspired me to compile all the bipolar links i've found and listed among my journals over the years. So....i got side-tracked for a couple days....and then got busy with work....etc.

I still plan to post the links, but i wanted to check on you and see how things are going?

Jenna

[Easeful]

I'm still here. Thanks for asking. My son was discharged last Tues. after 12 days. The three things that seem to have made the biggest difference at the end of his stay: 1) drawing a weekend pdoc who really listened. 2) who changed son's meds after hearing the type of reaction son had previously had to anethesia 3) and changed the anti-d to one that had worked well for half siblings.

Our son was accepted into a 5 week intensive outpatient program at our request. We've been in such a crisis mode for the last 2 months having him f2f with a p-doc 3 times a week for a while is a huge relief.

We're awaiting the results of a MRI that was done yesterday a.m. This follows a cat - scan done in the er 9 weeks ago on which the Dr. noted that if psychosis continues a contrast MRI should be done in 6 weeks. No one's told me what they would be looking for, but I viewed the scan last night and other than some tiny blood clots they look normal to me. note: I'm not a Dr., I just read a lot. ;o)

At this point I'd say our son is about 85% of his "normal" self. It's taking 6 scripts and at about $500/month to have him almost where he was before this started, but it is a huge relief to finally be seeing some progress especially after being told he'd never come back.