could use some insight and advice

[liesagain]

I came to the mental health page hoping some of you could give me some insight or advise because today I have no idea what to do

my 17 year old son had a psychotic episode last may spent over a week in the psych unit and was diagnosed with bi polar disorder. At that time I learned he had been smoking pot and that could have triggered the episode........though the diagnosis would have happened eventually ( according to the doctors)

anyhow my husband ( not sons dad) is an addict (cocaine, crack)
and hes had active use, clean then relapse for the last few years...........so hes not wanting to give much imput as he feels he has no "right" and will let me handle it

so my son has been fine taking his medication and told me he knew better than to ever smoke pot again..................but yesterday I found out he is and he has been for MONTHS!!!

so heres the thing, even knowing that it could cause a return psychotic episode he still did it again...............this is to much like the active adddict........using despite the consenquences
so I am scared to death, and frankly I want to put his butt in treatment............

and worse, hes not sorry hes actually down right disrespectful about it today......telling me I cant control if he smokes pot and that all the doctors are crazy hes FINE and pot wont hurt him..............

so what do I do?

On one hand I feel like he needs treatment now while I still have some say before he turns 18

I have already taken the car and hes grounded but I feel like maybe I need to do more like get him treatment...............I know its not as bad as some drugs but he does it KNOWING its horrible for him and his condition............
maybe he needs more than just "punishment" such as losing the car

sorry this is so long and rambling but any advice would be great..........

[nandm]

As a parent I can definately relate to your post.

When I first was getting sober my two oldest children, at the time 14 & 15, started using pot and alcohol. My oldest had a psychotic episode while smoking pot which only got worse when she was prescribed anti-depressants. She started cutting on herself and also became suicidal. It was a very frightening time. Both of them dropped out of school and refused to go. They were bringing drug dealers in my home. Refused any type of treatment or help. It finally came down to my sending them to live with their grandmother and father since I was afraid that if things kept going the way they were I would not be able to stay sober.

Needless to say things got worse for them before they got better. They both experiemented with meth and prostitution. My oldest would not speak to me for a year. I was terrified for them. Finally after almost 2 years my oldest daughter moved back in with me. She is afraid to drink or use drugs because she can still clearly remember how miserable she was during that time and she knows the drugs only made it worse. She no longer cuts on herself and is a happy, productive 23 year old. My other daughter still drinks and I believe smokes pot daily but has gotten her GED and gone through vet tech school. She works as a vet tech and continues to live in the same city as her grandmother.

I don't really have any advice to give you but I just wanted to say that you are not alone. One thing I did learn through all of this was that "their problems may have been of my making but their solutions are of their own making." In other words I can not fix them, I can just be there for them. This was a hard lesson for me to learn and a harder one to apply. I wish you the best with what you are facing right now as I understand how horrible it is to be in that situation.

[shutterbug]

Typically, bipolar disorder first starts showing up with noticible symptoms in late teens or early 20's. With the psychotic episode, this points to Bipolar I. Being bipolar I, means he will struggle with mania and these psychotic episodes throughout his life IF he doesn't get on and STAY on a mood stabalizer like Lithium or something else. A psychiatrist may also want him on an anti-psychotic.

Him using pot....is nothing you can control, IN MY OPINION. I think punishing him may just make him less likely to want to communicate with you at all...and do the opposite of anything you say.

Research shows that around 80 percent of bipolars become addicted to some substance. And is usually discribed as a way for the person to try and self-medicate the illness (without realizing there's any connection).

He's actually VERY lucky to get a diagnosis so early in his life...it means that he can start learning to manage it BEFORE it starts distroying his life. The longer he goes without proper medication maintence from and mood stabalizer and other....the more rebellious he will likely be for the rest of his life about taking meds.

Why? Because those with BPI have manic episodes...and that's like a 'high' all on it's own. Mood stabalizers help lessen any manic or depressive episodes. If he doesn't spend much time experiences the highs of manias....then when on a mood stabliazer he won't be so quick to complain about them making him feel 'flat' or 'numb' like many BP I's do.

This is all my opinion and from what I've researched and experienced as a bipolar II, and from knowing a few bipolar I's also. I am not a doctor. So please see that he starts regular appointments with a psychiatrist for medication manegement....and many will also recommend him seeing a psychologist for regular therapy sessions.

Like I said, I'm not a doctor, but frankly I think the pot had very little, if anything, to do with your son's psychotic episode. But even if it did....him staying away from pot is NOT going to put any kind of end to these and other episodes. In fact, in most people....pot tends to 'chill' the person out....which might actually help keep him from showing more manic symptoms than he has been. (although, apparently pot does energize some...and if that's the case with him then it will only make the bipolar I worse, IMO).

My other suggestion would be to take a look at your family history and his dad's side....for more addiction issues or mental illness issues. With addiction issues....typically comes mental illness issues in family lines. Bipolar disorder is very genetic....and if both the mother and father of a child have bipolar disorder then the child is around 70% likely to also develope the illness. But look closely at the family backgrounds because bipolar II disorder is NOT as easy to recognize as bipolar I. Why? Because we don't have full blown manic episodes or psychotic episodes....instead....our main symptoms come on as deep, deep depressions....and research shows 1 in 5 bipolars end up committing suicide (that data does not seperate bipolar I from bipolar II....but BP I's tend to be more quick to react to thoughts.... very impuslive...which puts them in danger of suicide).

Please take this diagnosis serious. If you start learning about the illness...the more you will be able to see how it has weaved it's way thru you and/or his dad's families....and how he is likely to carry on the gene to any of his kids in the future. That's why education is key.....without him understanding WHY he needs to be on meds....he will have a much harder time going thru life and much more of a risk of suicide or more, worse addiction issues.

My suggestion is to talk to him calmly, with a knowledgable professional present, to explain the illness to him (WITHOUT mention of the pot). This is his illness...and therefore he has the right to be a part of his own treatment of it. And any and all education he can get about it....he will carry on with him...always....even when he doesn't have a mom or dad to try and FORCE him to do the right thing.

p.s. I am not an advocate FOR pot, and don't do it myself, but i am also not against it's use for medical purposes. And i also think, the harder you come down on him about it at age 17....the harder he will use it when he is out on his own and he feels free from any parental restrictions. So.....again....education as to why it could be harmful to him...is key and really all you can do, in my opinion only.

p.s.s. An awsome book to read for insight and great information about bipolar I, is "A Brilliant Madness" by Patty Duke. If you look on Barnes & Noble site....they usually have used copies in near perfect condition for only a $1 or $2.

p.s.s.s. the web site NAMI: National Alliance on Mental Illness offers good information about bipolar disorder and addiction issues.

Jenna

[liesagain]

shutterbug........thank you very much for your reply and the information...........

my son had his first psychotic episode last may..........I posted about it here then too and I believe you replied to me then ( thanks )

back in May he started acting out being obstinent and I just thought Teenage stuff ( I have a 19 year old daughter too) but then he started being really hyper talking alot and sleeping very little
that progressed to him saying really strange things......like he could "tell" what people were feeling or thinking or that he had really high level thinking that others couldnt understand.... hes gifted, and I figured he was saying he was reaslizing his potential...........hes also learning disabled and was diagnosed as ADHD as a child............so I was glad thinking good he is growing up......but in a matter of days it progressed to out and out scary he was saying really strange things and his behaviors became paranoid...........and I decided to take him to the hospital and over a few more hours it got worse and worse.............they admitted him
he was okay with that he said he knew something was wrong

but in a few more hours he became convinced he was losing blood and the food was posion complete paranoia, delusions ( thank goodness he didnt hear voices)
so they put him on Geodon and told me he was having a psychotic break............that he was "a little" young that it generally happens in 19 -22 range but that the pot most likely triggered it sooner.............

he was eventually stabilized on Depakote and has been perfect like it never even happened.

Hes been good about taking the meds and told me hed never smoke pot again etc............than yesterday I found out he was smoking again and now hes saying its fine and is saying the doctors dont know anything he thinks he can smoke pot..........

Tonight I was thinking maybe his depakote levels are off or something and maybe he is self medicating............we will be going to the doctor tomorrow.........

tonight I told him no phone no friends and asked him to look up "scientic" information about bipolar and teens and the drug use connections.......he has been and hes alittle less argumenative right now..........

I'm gonna go seee if I can find the book you recommended
do you know of any books that might be good for him to read? that could help him understand better what hes dealing with ?

thanks again

[shutterbug]

I'm not feeling well right now so this will be fairly short. sorry.

they hyper talking and acting...and little sleep is typical of mania. The brain does go into over-drive and sometimes the person doesn't make sense to outsiders b/c they are connecting ideas that may not typically connect in the most logical ways. And then...like you explained...can progress into paranoia and psychotic forms. (actually, the paranioa is present in both bp I and bp II...it's just more enhanced in bp I's and more likely to cause problems in their daily lives).

"A Brilliant Madness" by Patty Duke would also be a great read for him. It's not too technical...and offers an entire chapter of famous bipolars in history and why we tend to have high intelligence levels and tend to lean toward more creative and artistic careers.

It starts out with Patty talking about her story of being thrust into the television and movie world so early that she lived with her 'agents' for most of her childhood. Then it progresses quickly to her older years and bouts with alcoholism, suicide attempts and explaining bipolar I and how it was seriously affecting her life. The book alternates chapters by her and her psychologist. So every other chapter gives more informational writing about the illness, but in very easy-to read terms.

The book actually made me feel a little proud to be connected to such great, prominent figures in history with the same illness. It made me feel a little 'special' by showing me a few positive aspects of what it can bring out in a person.

There are many other books about bipolar disorder, but most of the others are more clinical and not such easy OR inspiring reads. Patty Duke is a hero in my eyes for writing such an open and honest account of her mental illness and addiction issues....and at a time when both were even LESS understood, talked about or accepted than today.

A new copy....which you may have to ask a local bookstore to order is like $8.95 or something. VERY reasonable. I think it's a MUST read for anyone dealing with bipolar disorder personally or have friends or family suffering from the illness.

Lastly, this is not something that needs to be thought about right now, but i want to just give an introduction in case your son ever has a very severe and devistating manic (or depressive) episode. ECT is a fast and affective treatment for both mania and depression....with 70-80 % of patients benefiting from treatments. (I've had 23 this past year, and was the ONLY thing that REALLY worked to lift me from suicidal depressions....i just wasn't able to do enough maintenance treatments to keep the good benefits working). However, from my readings, it seems to be even most beneficial for severe manic episodes...and sometimes in as little as 1 treatment. And whatever the stigma of it....i'd MUCH rather have an ECT treatment than go to the dentist. The worst part of any of my treatments was having to get the I.V. put in my hand or arm for the anesthesia and other muscle relaxants during the actual procedure.

Anyway...that's not something that is needed right now, but i just wanted to let you know it's out there, effective and a treatment option in major episode situations. And even Patty Duke herself told me to my face about 6 months ago that she's also had the shock treatments and that they often work better than all the meds combined ever have.

----
anyway, i'm glad to hear your son is on a mood stabalizer. I've been on Depakote before and don't recall having any negative issues with it. I was also on Geoden for a brief time, but don't remember anything about it.

Hopefully, the Depakote will continue working for him....but be aware that bipolar disorder....episodes come and go like waves. So he may be fine for months, or even years, and then have it hit him again out of no where. That is also another reason to continue to re-affirm his need to stay on a mood stabalizer for good. Many stop b/c they think they are fine and don't need it any more....but that is never the case with a bipolar. It may be a while, but it WILL return. And if he's a rapid cycler....then it's likely to return sooner rather than later. But that will be something that will just have to be monitored and talked to his docs about.

The age of 17 is a little younger than typical, but i'd have to do some research before believing the pot had much to do with the onset of this right now. If he's started self-medicating....then there was obviously something already going on that led him to using the pot to self-medicate. Which is mainly why i don't think the pot had much to do with it, but as i said, i'd have to see what research is out there to have any truely 'educated' opinion about it.

That's great about him researching the illness and addiction issues for himself. My suggestion would also be to re-assure him that having a mental illness does not mean he is defective in anyway....OR won't be able to lead a good life. His type of bipolar is MUCH easier to manage with meds than mine....so the hardest part is just him staying on the meds and being open to looking at med changes with a pdoc as needed.

That's another reason I think "A Brilliant Madness" is a good choice for him too....b/c it does show that a person isn't doomed because of the diagnosis...and that they actually are more likely to accomplish great things if they really want to and work towards their goals. It's inspirational.

Is he seeing a therapist or psychologist right now?
Would he be open to that?
I think i could help him come to terms with it and understand it...and all through someone outside of his family....so that he will not feel pressured, but rather supported by an outside party sworn to total secrecy from anything he talks about (w/ the rare exceptiong of if the professional fears for his or someone else's safety...and then they can report that for obvious reasons).

Hugs,
Jenna

p.s. i guess i jabbored away anyway. lol. I enjoy helping others start the process of learning. It makes me feel that all my struggles haven't been for nothing. So thanks for allowing me to offer my thoughts and opinions...whatever they're worth. lol

[liesagain]

thank you so much for the info Jenna. I actually just saw your post.........I did take my son to the doctor today and she thinks the issues are related to the biploar rather than substance abuse.........

I have to go for now I'll update more tomorrow again thank you so much you help more than you know!!