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**Woody** · May 29, 2010, 01:18 PM

Hello Schmadrian and welcome

The answer to all your questions is 42

As the third person, I think you are doing the right thing, you are educating yourself and from what you have said, you are there for them. That is marvellous! We would be all so luck if we all had support like this.

If her son is getting experiencing akathisia with the Seroquel XR, he might want to try the regular Seroquel instead if the Seroquel is working to control some of his symptoms. If not, then I would suggest asking for a different medication. It sux enough having to take these medication without having to be tortured by evil side effects.

As an adult (20) the ACT team or what ever release team he was involved with, they might not have included her in the process unless her son had requested that she be.

Not sure where you are in Ontario, but there are organizations in the province that specialize in helping families when a member has a mood disorder. Since there is a drug addiction problem, you might want to contact CAHM. They should be able to get you in touch with the resources in your area.

Sleep Aid; There are many available that do not cause dependence issue. Its a mater of finding the right one for him. It took me and my doctor trying different meds over 2 years before we found the right one for me to be able to sleep regularly at night. Not saying its going to take that long, but nothing with this illness is guarantied success.

Dx: There are 4~5 different variants of BP but we all experience it in different fashions. Probably why it is so hard to get a good Dx and treatment plan. Here is one site that you can do some reading on about the different Dx's

Acceptance; This is something that you just might have to sit and wait it out. Be patient, listen and be relentless.

**gtchamp** · May 29, 2010, 07:21 PM

Hi Schmadrian, I seems like Woody has touched on everything. The only thing I would add is that you mentioned that the mother is putting everything into this, which is only normal. As a caregiver, I have seen mine get exhausted. I don't know about where you live but where I live (Southern Ontario), they have help for the caregiver. A course, support group and a contact person for questions.
Maybe there would be something for the mother around where you live too.

Also, it is my understanding that alot of places have drop in support groups for bipolar people. This may be of interest to the son as he could meet others with the same illness. On the other hand, he could react like I first did and go into denial. That was when I was first diagnosed.

Hope that little bit of info helps. I would call your local mental health chapter to find out info on the above mentioned items, although someone else on the forum might know a better way to find this information.

Good luck

**schmadrian** · May 29, 2010, 07:31 PM

Thanks for your responses so far. (And I'm glad the Master Answer isn't 'Purple'.)

I should explain that *I'm* the one in Canada. My friend is an American. But *I'm* the one looking for help so I can be a better friend to her.

**paul m** · May 29, 2010, 10:32 PM

Hello schmadrian and welcome. Gtchamp and Woody have given you some good advice so I will cover slightly different area, but I agree with them. I also agree that you are to be congratulated for trying to educate your self on this very difficult subject

.

Whether the young person fights the diagnosis or not should make little difference in the treatment. Treatment of bipolar illness is more about treating the symptoms than about treating the illness. There are several reasons for this, the first and foremost is there has only ever been one medication developed primarialy for people with bipolar(lithium). All other meds were first developed to treat some other illness and then added to treated bipolar illness.

Secondly, Bipolar is a very specific illness, I have met very few(if any) two people with bipolar who have the exact same drug regime(dosage, type of meds , time of day taken etc). Nor have I ever met anyone with the exact same symptoms as myself, similiar ones, yes , but not exact same. I think most people with bipolar would find the same.

You mention a few myths, which for accurate treatment of the lad must first be disspelled. I mean no insult by mentioning these, they are common perceptions and unfortunately lead to some mis advice.

1) While addictions may be an issue with some meds used in the treatment of people with bipolar, very few are. At least 3/4 of meds used in treatment have no addictive qualities. However few if any meds will work well if a current addiction is a problem(including seroquel).

2) Unfortunately with bipolar there are no uniform stages that one goes through. I wish there was, it would be a lot easier to deal with.

Now, what can be done to help, well educating yourself is the first step. Second would be preparing the mother to help with good advice when her son is ready to accept it. Unfortunately that may be only a very small window of opportunity. Most people who are reluctant to accept a bipolar dx, refuse when even slightly manic and sometimes even when depressed. This leaves when the person is feeling realitively normal to get him to give permission for the docs to speak to a 3rd party or for educational info to be discussed with him or for that matter even to ask him very important questions, like why he doesn't feel he has bipolar.

The MDAO has a good fact sheet on helping someone with a mood disorder, it may better answer some of your quesions. They also have an easy to read primer on bipolar disorder.

http://www.mooddisorders.on.ca/helping.html

http://www.mooddisorders.on.ca/bipolar.html

Neither fact sheet will answer all of your questions, keep asking them here. It's a very difficult illness understand even when one has the disorder themselves. Looking forward to hearing more from you. Take Care. paul m

AJ · May 29, 2010, 11:07 PM

Welcome to the forums Schmadrian. You've been given some good information here. Feel free to ask questions anytime. We may not know the answers but we can point you in the right direction. I admire your commitment to your friend. It must be especially challenging not living in the same place, different country no less!

**schmadrian** · May 30, 2010, 05:13 AM

Thanks, everyone. I'm heartened by your responses, especially in light of the fact that there must be a history of people such as myself registering, then posting questions, questions the answers for which have already been provided elsewhere. So thanks for your patience...and your indulgence.

To respond to AJ, yes it has been 'challenging'. My role in so many of my friendships over the years as been that of an ad hoc 'Life counsellor'. But in this instance, though I have my own history of mood disorders (almost part-and-parcel of the profile of a writer), I knew once the son had been in care and everything had turned an entirely different corner that my limitations in being able to offer specific advice were very much in effect. I want to help her, and aside from being generally supportive, learning more about bipolar and equipping myself, even if it's just with directions to resources is something I am compelled to do. Isn't that what friends are for?

Throughout the past few months, when there have been incidents with police, with care, with anger, with the neighbours approaching my friend, telling her that with all the son's yelling, they were concerned for her safety, all this, I've been curious as to the best and the worst case scenarios. The best ones I can imagine. But as to the worst...aside from suicide...I'm wondering how families deal with a member of legal age who won't address the situation.
-Is it necessary to let them hit 'rock bottom'? How do you reach that point of cooperation?
-How many times (in general) does a patient his age cycle through on-meds/off-meds before they're on-board with the meds approach? My friend is a single mom, the father is basically non-involved, so there is a lot of stress for her to bear. (Hence my passive involvement)
-And there's the issue of education; he was in college when this unfolded. Out of the blue. He had to drop out (they're trying to sort out both the academic and the financial mess) but wants to go back this September. Anyone have any experience with this?
-He has his delusional states. There was a point where she wondered if it wasn't bipolar he was struggling with, but something else. Is it possible that the diagnosis might need to be dialed-in?
-How often does bipolar end up being a thyroid issue?
-I believe that in any situation where a 'deviation from the norm' is at play, that the body's resiliency must be addressed. As in 'fitness', especially as a means to corral and channel the other vitalities of the person: the mental, the spiritual, the psychic. Are many bipolars able to see things in such a synergistic way once they find the meds combinations and levels that work for them? I guess what I'm asking is 'Is it possible at some point to 'master' this to full functionality?
-My friend is documenting what she's able on a daily basis. For the practitioners involved, to provide feedback and context, but also for her son, to be able to show him what the results of the meds are, when they're working what that looks like, and the converse as well. My question here is: how do bipolars respond to being shown video of themselves when they're at their worst?

Thanks again for your generosity; I'm off to read some threads and linked-to material.

**paul m** · May 30, 2010, 11:30 AM

Hello schmadrian. I know that understanding bipolar disorder is difficult for someone not having the illness, even for myself it's very difficult. To answer your questions.

1) In regards to violence, people with bipolar have no higher incencite rate of violence than the general population. However people with substance abuse problems do have a high rate of problems in that regard.

2) There is no rock bottom with bipolar, people with bipolar have the highest suicide rate of all people with mental illnesses. Waiting for them to hit rock bottom may be futile.

3) There are no number of cycles a person may have before they accept treatment, a person may never accept treatment.

4) Most diagnosis in young people are uncertain, bipolar may the issue, but what type, is it rapid cycling , are their mixed states, bp1, bp2 etc.

5) Addictions and/or heavy drug and alcohol use can cause drastic alterations not readily apparent to a shrink.

6) What is fully functioning. I have friends with bipolar who are senior excutives of large companies, I also have friends with bipolar who will never work again, but enjoy life immensely.

7) Thyroid? not likely , a complication perhaps, but one easy enough to test for.

8) Fitness, proper diet and good health may help, but my son was a ranked Cdn athlete the first time he landed in the hospital at age 21(with bipolar). Believe me he was in good shape and ate properly.

9)Video him? That would be a good way to alienate him. If you showed me the video of my behaviour one of the following would happen. If I was manic, I would still feel my behaviour was justified, if I was depressed it would deepen my depression, if I was in a normal state it would probably make me manic or depressed almost instantly. Please understand. Our minds don't think like a normal persons. We already know what we do, showing us proof is just showing us what we already know.

10) Delusional states may or may not be part of having bipolar, but they are quite common.

One small thing that I would ask. We have bipolar, we are not bipolar. Just like someone has cancer, they are not cancer. It's a small distinction and to say that I'm bipolar does sort of role off of my tonque, but the preferred term is I or they have bipolar.

When a chance for an intervention comes, please use it. All to often families do not discuss the problems during times of peace for fear of upsetting things. Sometimes even leaving brochures lying around for him to read may help. Any mental health group will usually send you some.

In regards to meds. Often meds make us much worse before we get the right ones that make us better. It is sometimes very difficult to convince a person that the 4th or 5th med may work after 3 dismal failures. That and the sometimes horrendous side effects are the probably the biggest reasons for drug non compliance. Take Care. paul m

**schmadrian** · May 30, 2010, 11:50 AM

Thanks so much, Paul. You've provided invaluable insight. Very appreciated.

I'm curious about #8; I believe what I was getting at wasn't so much the idea that being fit, or physically resilient or possessing physical integrity could ward off bipolar...but that something like yoga (as in the case of Sting) can be a powerful approach to addressing it. I have come across no small amount of testimony in yoga articles supporting this notion. Anyone here have any experience with yoga in this regard?

And thanks for the nudge about 'having bipolar' and not 'being bipolar'. Noted and not to be forgotten.

**Woody** · May 30, 2010, 12:51 PM

You probably have this already, but I will mention it just in case. In the US they have NIMH. You might want to check out there site for programs/support.

It is really his journey. And the hardest thing is to sit by and do nothing but wait. For a parent even more because your first instinct is to reach out and make things better. To Fix! Not doing so feels like you are abandoning them. I'm having to do so with my son right now for other reason, but still having to wait. Its excruciating not to mention how it tears your hearth apart.

If you read long enough you can find all the statistics you like and if you read even longer, you can find all the statistics that disprove the first statistics you found.

You would have to check with someone that knows the American laws, but if he is a danger to himself or others (in this case his family) then he they should be able to have him committed for treatment. There are also instances when you can get the courts order him to take his medications. But this is like using an axe to crack an egg.

There is something called the Ulysses agreement. If you Google that term, you will get plenty of example. Basically it is a care, treatment, and personal management agreement. I have seen one Family put this into place and it is quiet powerful tool.

When I was in my teens, I did not realize it at the time, but I was using various forms meditation and self-hypnosis to control some of my symptoms. That was a long time ago and my symptoms are by far more intense now. I am not sure about Sting's story, but I have met one person in town here who claims she has gone meds and symptom free from the use of Reiki. For her it has been a life long journey to well being. Another way is threw CBT or NLP. I do not think that there is anything wrong with Yoga, but my understanding is that Tai Chi is better suited for helping with mood disorders. I always cringe a little when there is talk of alternate medicine or of treatment methods. In the old west they referred to them as snake oil salesmen. Any medication or alternate treatment regime should be closely followed by a professional.

I think it is a good thing that your friend is documenting the ongoing with her son. We are often recommend to keep a log or diary. BUT I also share Paul concern about confronting him with that documentation and the chance of it backfiring on her. BUT on the other hand it could be information of help his doctor in furthering his treatment.

**schmadrian** · May 30, 2010, 03:18 PM

Thanks, Woody.

Apparently the son has not actually acknowledged, accepted that he has bipolar. (Though he is 'thinking about it'.) Is this often a turning point? Getting to this stage?

Clearly, the analogy is rough because of the cognitive elements, but is this akin to someone with diabetes or cancer or alcoholism, that unless they acknowledge and accept and empower themselves with the appropriate 'solutions', that everything is 'on hold'? (Granted, with some of these comparatives, there's a black-and-white, life-or-death element, and I'd imagine it's possible -for the most part- for someone to deny their bipolarity and endure its effects for a lifetime...)

I cringed myself at your reference to cringing at talk of 'alternative methods', but I don't want to muddy the waters here; I'm getting a lot out of what's been offered in terms of insight and advice.

**Atlantis** · May 30, 2010, 03:22 PM

Originally posted by schmadrian View Post

My question here is: how do bipolars respond to being shown video of themselves when they're at their worst?

Personally for me, it would be horrifying

...
During an episode I have huge gaps in my memory, sometimes upto a couple of weeks with only minutes of converstions remembered...

But some of the memories come back even if I don't want them too; one night in particular my daughter had a music recital and I was on the couch and could not move, could not speak, eat or sleep...I remember that...It's the only memory I have for that whole week

Welcome Schmadrian to the Forum and I admire you for trying to help your friend.

**schmadrian** · May 30, 2010, 03:53 PM

Hey, Atlantis; thanks for the welcome.

From on the outside, listening to my friend describe her travails over the past seven months...back then, it seemed that 'depression' was what was ailing her son...I've tried to relate to what it must be like for her to have to 'deal' with him. In terms of him not being able/willing to 'see'.

It seems to me that were this a person with, say Peripheral Arterial Disease, needing an angioplasty of their leg to alleviate the pain, they *could* deny the situation and refuse treatment...until the pain got too pronounced. Then they'd have the work done, and in the case of my mom, feel as if they'd had their life given back to them.

But in the case of someone with bipolar, there's no window of cogency open enough for them to be able to 'see' the logic of their state (and the associated 'cure') to be able to make a sound decision to 'get on board with the program'. Or, in a harsh parallel, 'You can't reason with a mad man.'

I think that this is what is the hardest thing for her to deal with, this notion of him not being able to 'see', and I can only assume that it's the same for many with bipolar.

**Atlantis** · May 30, 2010, 04:16 PM

I don't think I would of accepted the Bipolar diagnosis as easily in my twenties, when I was suffering depression and hypomania. The hypomania felt good, I didn't even realize there was anything wrong with it.

I was diagnosed with bipolar 1 when I was 33 after an emergeny hospitalization during a manic epsiode, and I couldn't deny the diagnosis then.
I couldn't deny that I had almost lost my mind.

What does the son think, what does he say about all this?

**schmadrian** · May 30, 2010, 05:23 PM

From my friend:

"The son also likes the manic high, the clarity (in his mind) of thought. When I've told him of his behavior the day he was hospitalized, he found it to be 'mostly normal'.

He has been diagnosed with bp2"

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