I need help again...

[judyc]

I'm the mom and my daughter is 34 and has a Bipolar Disorder. We are going down the path again of trying to find help. I googled a number of Mental Health places and call CAMH and they told me to get her to call them and set up an appointment for concurrent disorder assessment. I guess things are going ok, we have hope and have a few places to check in with to look for help. I just want to know what I should be doing. How can I help? I ask her and she is very helpful right now but I'm afraid she will go downhill to that dark place again.

[paul m]

Hello Judyc and welcome. In my mind, the most important steps in helping someone with bipolar are: being there for them, learning about the illness and it's treatments, helping the person find help and not being judgmental.

Very few words, one heck of a lot to try and do. You are off to a good start by inquiring about what you can do and I'm sure that you are very caring. You probably are not even judgmental, but I can say as a parent who has a child with bipolar that sometimes he would try the patience and understanding of a saint. I'm sure that my wife has said that about both our son and I a few 1000 times. (I also have bipolar)

Leaning about bipolar is a very long process, partly because there is so much confusing information out there and partly because everyone's illness affects them a little (or a lot) differently. Not to mention that there is a ton of stuff to learn and a lack of people to help guide you through it.

What can you do. If she does't have a psychiatrist, you should get her to ask her family doctor to try and find one for her. If she does have a psychiatrist or even with a family doctor, you should gently try and obtain her permission to sit in on a session or two.

If she doesn't keep a daily mood chart, encourage her to keep one as doctors find them invaluable for helping making accurate assessments.

You didn't mention medication and it's none of my business, but most people with bipolar at some stage need medication. People with bipolar often don't like taking the medication prescribed,often due to the side effects. some medications work better than others for any individual and often a pharmacists can help make suggestions on how to alleviate side effects. If she is taking a prescribed medication and it doesn't control her mood swings then it's time for her to try a different type or a different combo.

Programs like W.R.A.P. , wellness recovery action plan, can be very beneficial if your daughter is stable. WRAP deals a lot with non medical ways of keeping well, such as diet exercise , life style etc.

Helping your daughter identify, avoid or deal with triggers can be helpful. A trigger is something that may start an episode or mood swing. Our son is getting married this summer and weddings are a major source of stress for me. I obviously can't avoid the wedding so I have to figure out how to deal with the stress or it will trigger a mood swing. My wife will be a great help to me in this.

Early indicators. A lot of people with bipolar will get an early indicator of a mood swing, but they can be hard to identify. For me if I start to notice that I am more irritable with my wife lately, chances are my mood is swinging, and that I should take corrective action. My wife can be helpful by pointing out that perhaps I'm not getting as much sleep lately, or that I'm being a couch potato and not exercising as much. Sometimes small changes can trigger an episode and I might not notice.

Of course there is a fine line between my wife being a help to me and her getting on my nerves by asking constantly" are you taking your, meds, did you go for a walk today, are you sure you aren't stressed out etc." I have to be careful when I talk to me son as well otherwise he can shut me out. However making plans for open and caring communication can be very helpful , but it is best done when some one is not in the thralls of a full blown mood swing.(the making of the plans that is)

The MDAO has a good guide to helping someone with a mood disorder. http://www.mooddisorders.ca/guide/gu...-mood-disorder

Finally, ask lots of questions on here, we can't answer everything, but we are friendly. Also please don't hesitate to vent out your frustrations, on here or elsewhere. Dealing with bipolar is always a frustrating thing to do, both for the sufferer and their loved ones. Take Care. paul m

[AJ]

I haven't got anything to add to what Paul has said, I just wanted to welcome you to the forum JudyC.

[MoMoe]

Hi JudyC
Welcome to the forum. I am fairly new here as well, and like AJ, I don't really have much to add but I do have bipolar. Paul your comments were interesting to me as I know that I have not fully come to terms with accepting it so I tend to sort of ignore it. The medication I have been taking (Lamotrigine approximately 3 years now) has never given me any significant side effects and I often wonder if I really even need it. That alone tells me that I do need it. What I have trouble understanding about myself is that although I haven't had any major "downs" in a long time (can't get out of bed for days at a time, feeling suicidal etc.) I have noticed from the to time feeling slightly manic, which is usually when I am my most productive so i don't get concerned. It makes me wonder if my dosage needs to be adjusted. I guess I thought that if I was taking the medication that I should not be experiencing any of these mood swings although i think this medication is used for primarily depressive bipolar (which is what I have trouble with) so perhaps my doc isn't too concerned about my mania behaviour either. I wouldn't say that I never behave out of control when I feel manic but it has never gotten me in to any kind of major trouble or left to face any serious consequences. It is more like the time I decided a year ago to gut and renovate my basement to make a painting studio, which I did night and day over the course of a week and then did about 8 paintings. Then as quick as that, the feeling went away and I basically have not painted or used that room since (but it looks great! lol). What got my attention about Paul's comments is that the symptoms can still appear even while taking the meds. Do you feel that if this is happening, then the medication is not doing it's job? I am just curious about your thoughts. When I was at my worst, my main issue is depression, not mania. However after I was diagnosed and looking back at my life, I see much evidence of mania behaviour that I just attributed to my "normally upbeat personality". I should also add that since my ADHD diagnosis last year, my pdoc and I have discussed the possibility of trying to come off the bipolar meds to see if my behaviour is strictly ADHD rather than bipolar. We won't be even considering this though until I am (if ever) completely finished my masters.

[hellfish]

Hi Judy- I wish you the best with your situation. I don't have bipolar disorder but I do suffer for Major depressive symptoms and OCD. I believe the very best advice I can offer is the following:

(1) Find a good psychiatrist that you feel you can trust
(2) make very regular appointments with the Dr. to monitor the symptoms to make absolutely sure there are no adjoining or addition mental health issues that come up
(3) Find a good therapist that will be willing to coordinate with your psychiatrist

I feel lucky that I live in the Province of Quebec. For all the faults this province has (don't get me started), I can say that without a doubt the mental health services are exceptional. Is this to say that my mental health issues are completely resolved? No not by a long shot but by following the 3 points I have laid out it has made my life much more manageable- especially for my family.

I will say a prayer for you tonight and I hope that your daugher gets the help she needs-

[dave]

Living with bipolar is a hard road. For the person with the diagnosis and for the people that love them.

The highs are hard and the lows can be devestating

For me the 2 most important things are being with people who love and accept me and learning all I can about my diagnosis and what skills will best help me be more well more often

[paul m]

Hello MoeMo. You asked me a couple of questions. First in regards to a long time stable person taking bipolar meds. I have been stable for a number of yrs, but I still have mood swings. Not very often do these mood swings become drastic, but they can if I don't short circuit them. Because I've had bipolar for decades, I know my meds pretty well and so I take the minimum that I can get away with, two mood stabilzers and and anti anxiety med.

When my moods start to swing I start examining my life style, am I sleeping properly, am I exercising properly, am I using CBT to help restrain some of my runaway thoughts. and am I eliminating or dealing with stress in my life in a healthy way. If I answer yes to all of those questions then I will start to increase the amount of certain meds or start taking meds as a PRN (PRN just means take as required). My pdoc knows all about this.

There is nothing wrong with a little extra energy sometimes, I used to use it all of the time, but I found that it got harder and harder to control. Some people may do it just fine but not me.

A lot of people who have bipolar discover that it can be progressive illness. In fact it almost always starts out that way. Usually the depressive symptoms show up first and then ever worsening mania. That means it can get worse and the meds we used to take , may not work as effectively or even at all at some date in the future. This doesn't seem to happen as much to people who have been stable for 5yrs+, but it can happen to anyone. Stress , anxieties, unhappy living conditions, illnesses can all make our bipolar worse and the medications that we take may no longer work.

I've had mood swings since I was a child, but most times it was just put down as me being moody or touchy or hard to get along with or just full of energy. It took many more yrs for these mood swings to become a major problem.

As a side note, virtually all of our meds are metabolized by our body. Our metabolism can change for a variety of reasons. If it slows up, you need fewer meds, if it speeds up, you need more of the same med as it gets eliminated from your body quicker. We should all go for a regular physical with close attention to our thyroid gland, vitamin levels, especially B12 and a host of other things as they can all affect our moods Take Care. paul m

[MoMoe]

Hi Paul M

Thank you for sharing your insight with me. You make a really good point about monitoring mood swings vs lifestyle. That is something I am definitely struggling with at the moment. I have isolated myself quite a bit since I started school last year ( i do my program through distance online so much of my time is spent home alone) I am so frightened of failing and losing everything that my anxiety and mood swings have been slowly taking control lately. I have not been taking good care of myself. Although I have been working hard at getting (somewhat) proper sleep to keep the insomnia at bay, I have been increasingly depending on alcohol and pot to sleep/numb/escape (fill in the blank). It is not out of control (yet) but I am finding it easier and easier to pour up a glass of wine or 3 in the evening. My pot smoking varies anywhere from half a joint before bed to 5 or 6 joints in one day. Sometimes I convince myself that I can study better when Im high. Other times I can't even get through 2 or 3 lines of text without reading it 10 times. It takes a huge effort for me to leave my house for days at a time but I know I should. I have lost a bit of weight (25 lbs in 6 months) since I started taking the ADHD medication and people/family are concerned about me so I avoid going out since most don't know about the ADHD but want to know why I have gotten so thin. I didn't realize how much I had lost until this week when a close friend who hadn't seem me in a few months said my weight frightened her. Eating has become a chore and looking at food literally makes me sick to my stomach. I keep healthy snacks/protein like nuts/yogurt/fruit around so I will have something to go for quick when I feel I can eat something. I think that is the best I can do food wise for now. Ive been going to yoga classes a couple times a week the last month which I like but I am typically not the "outdoorsy/exercise type". As for the CBT, uggh, it is such a pain in the ass but I do understand its value. Only this week I dug out my old CBT workbook from years ago so I can start implementing more good practices in my thought processing. Can you believe I am studying to be a therapist?? These are the reasons why I doubt myself so much.

[judyc]

My daughter is on meds but still gets triggered by stressful situations. She says she doesn't have a psychiatrist so I will encourage her to get one. Her GP regulates her meds right now. She is looking into getting into a concurrent disorder treatment program at CAMH. Her social worker is working with her on making the call and setting up an assessment this week. The crisis that made me look for help from you is now over. It was a misunderstanding with her and her sister and seems to have been resolved. I feel like I'm floating in water just waiting to be bumped by her mood swings and then it makes me worried or upset, panicky. Story of my life. The suggestions you all have made are very helpful and I think the next thing I'll pursue with my daughter is getting a psychiatrist? How do you get a psychiatrist? Maybe encouraging her to blog her mood changes. Is there medication out there that will take away her mood swings? What can I do to stay calm while she is in crisis?

[MoMoe]

Hi Judyc
It sounds like you are doing some great things to help and stay close to your daughter. My mother just found out a couple of days ago about my bipolar (also my ADHD, as well as every bit of medication I take) and she is extremely worried now to say the least. I am in the situation now where I have to sit down and explain to her ( I am 44, she 70+) the reason why I haven't been able to tell her or my sisters is because I don't think they can understand that they represent triggers for me. Even though I love them dearly, I need to keep my distance. I am certainly not implying your family is anything like mine. My point being, whatever the trigger is caused by, I am more aware that I make them feel how you describe being bumped around in water. When I am like that I can tell you that for me, it is very tricky how a well meaning comment or suggestion can translate as being patronizing and even insulting to think they have a simple solution I have not tried. For me, sometimes it is more helpful to just be there without judgement and listen without trying to fix it. Most of us try to fix something as our automatic empathetic reaction to seeing a person in pain. However, I don't always get that at the time. I obviously can not speak for your daughter's experiences but I thought I would offer my perspective for what it is worth. Good luck.

[AJ]

Hi JudyC. Your daughter's GP can refer her to a psychiatrist. A psychiatrist would be the best person for your daughter to get her medication sorted out. Her pharmacist would be a good resource for questions about the medication.

Sometimes it takes some time to get the right combination that works, and is well tolerated.

Hang in there! Don't forget to take care of yourself in all this. What do you find helpful to reduce your stress? Everybody is unique in that regard. I find walking and writing quite helpful. I also find a mini retreat from the world takes the edge of things. I don't answer the phone or pay bills or deal with anything that can wait a few days.

[paul m]

Hello Moemo. In regards to CBT " it is such a pain in the ass but I do understand its value " . I cannot lie, I gotta agree with you, but I loved the way you put it.

In regards to your weight loss and being sick to your stomach. My son went (is going) through a similar thing. Unfortunately his doctor kept saying it was his bipolar and anxieties that were causing the problems and refused to look farther. Eventually he got so bad that he kept passing out and ending up in the hospital dehydrated and really ill(lost weight too). Too make a long story short, several years later they are still trying to piece together his digestion system problems that got far worse than need be because the doctor refused to believe that it was a physical problem and not a mental problem. I'm not saying what your stomach problems are , but don't over look possible physical problems. Take Care. paul m

Hello JudyC. You ask " What can I do to stay calm while she is in crisis?" A very good question. Having spent endless sleeplessness nights worrying about our son I still don't have a good answer. However having an agreement with my son that sez he can call me at any time and I won't be critical at that time has helped. Knowing that he can call me at any time for non judgmental support helps him to call me. Sometimes that makes it worse for me and sometimes I have trouble giving that non judgmental support, but it's either that or he won't call me. That's not to say that I have to agree with everything he sez when he calls, I just don't disagree, argue or criticize when he is have a serious mood swing.

I also have to learn to get sleep when I know our son is having a bad time, because if I can't keep myself healthy then I can't help him. Is it tough , you betcha. I understand perfectly what you are going through and as I said I don't have any great answers. However keep trying to learn about her illness, both from books and from her. You may also want to ck around your area for support groups that allow loved ones to attend. I know the mental health support group in my area does.If you in or near T.O. the MDAO runs many support groups that would welcome you. Just ask if you would like more info. Take Care. paul m

[judyc]

You're so right....

Hi Judyc
It sounds like you are doing some great things to help and stay close to your daughter. My mother just found out a couple of days ago about my bipolar (also my ADHD, as well as every bit of medication I take) and she is extremely worried now to say the least. I am in the situation now where I have to sit down and explain to her ( I am 44, she 70+) the reason why I haven't been able to tell her or my sisters is because I don't think they can understand that they represent triggers for me. Even though I love them dearly, I need to keep my distance. I am certainly not implying your family is anything like mine. My point being, whatever the trigger is caused by, I am more aware that I make them feel how you describe being bumped around in water. When I am like that I can tell you that for me, it is very tricky how a well meaning comment or suggestion can translate as being patronizing and even insulting to think they have a simple solution I have not tried. For me, sometimes it is more helpful to just be there without judgement and listen without trying to fix it. Most of us try to fix something as our automatic empathetic reaction to seeing a person in pain. However, I don't always get that at the time. I obviously can not speak for your daughter's experiences but I thought I would offer my perspective for what it is worth. Good luck.

MoMoe
You're so right about not fixing. My daughter told me very blatantly many years ago, "Stop trying to fix me, I'm not broken, just listen to me." and I heard her but it is still really hard to just listen and not try to help. I know sometimes me just being me on the phone is a trigger for her and she gets really upset and spirals so she I think is trying not to call me every time she's upset because she only gets more upset. I think she is doing really well but I know she wants to be able to finish school, have a career and a family and these are all very difficult for her. All I can do is support and listen and try to suggest a bit here and there but I do work hard on listening to her suggestions and supporting her in her ideas. She is very smart and knows herself very well but we both still need help coping. Thanks for being there.

[judyc]

Do you know of any support groups in the Kingston area?

[MoMoe]

Hi JudyC

I really relate to what you are saying about your daughter getting upset with you on the phone. When I speak to my mother during a mood swing I automatically get my back up because I know the conversation is always the same. She tries to fix or at the very least "normalize" what I am saying by adding that she "felt that way once" but she just "got over it" or other comments that can trigger a downward spiral. Now, having said that, she was not aware of my bipolar or ADHD until just a few days ago but she has always been aware of my depressive episodes and severe anxiety. It was difficult for me to open a dialogue with her about how to talk to me in a helpful way but I always feared that I would have to disclose my other diagnosis so it was easier to avoid talking about it at all. This has certainly not helped to strengthen my relations with my family but it was all I could handle. Now that she and my sisters are aware of my full diagnosis, she has a lot of questions, concerns and I would imagine many opinions on how to "fix me" LOL. I am really overwhelmed at the thought of having to discuss this with my family but on the other hand I am also relieved that I don't have to hide it any longer. I really have to mentally prepare for this conversation and I want to also think long and hard about how I can communicate to them what they can do to be helpful as well as what kind of things are not so helpful without triggering their defensive behaviour - This is difficult because I can get very emotional talking about it and this only makes me appear even more unstable to them. I would really like to be closer and feel supported by them in the way I need but as much as they may not fully understand how to be helpful, I don't make it easy on them by keeping a wall up and being defensive to their remarks. I don't quite know how I am going to find strength to open up and allow myself to be vulnerable to them yet but I am trying to look at this incident of my mother seeing my personal medical documents (it was totally my fault) as a blessing in disguise and perhaps will allow for better communication in the future because of it.

I also think, Paul m - your comment about having an agreement with your son that he can call you any time and you won't be critical at that time is a wonderful thing. I think that is helpful because it sets up a framework for boundaries you can both trust in. I think something like that might be beneficial to suggest to my family when/if I am able to engage in productive conversations with my family. Also, Paul M, if I could jus add one more thing - My comment about CBT was really in jest as I can see you got the humour. I do honestly believe it is very useful therapeutic approach but can be a very difficult thing acknowledge and change maladaptive thinking not to mention maintaining it. It is a life long process for sure.

Thank you both for sharing your insight! It really makes me feel not so alone when hearing other people's stories. Blessings.