Posted by JohnL on November 4, 2000, at 4:28:36
In reply to Can anyone help with some questions please, posted by Kim(for my hubby Brendan) on November 3, 2000, at 10:42:42
Kim,
This is kind of long. Two things though: 1)Read the book "An Unquiet Mind"; 2)Work with a doctor to start Brandon on a mere 300mg of Lithium per day. For more indepth comments, please read on...
I sure feel for you. Though mental illness is a very distressing burden for the sufferer, it is equally distressing for the sufferer's loved ones, though in different ways. This is amplified I think even more when you want to help yet feel helpless. The best place to at least start the process of recovery, for both the sufferer and the loved ones, is to begin therapy.
With any kind of manic or psychotic condition (sounds like it could be a blend of both), psychotherapy is likely to be futile. Pharmacological intervention is the only real hope. I have not ever heard of a case where someone could control their manic or psychotic emotions in any significant way. Maybe a little, but not enough to make any noticeable difference. It's not a controllable thing, any more than diabetes or near-sightedness. We can't contol these things with willpower.
It's not uncommon for sufferers to enjoy the manic high. The sad reality is that it doesn't last. It comes and goes in cycles. There is always a cliff at the end of each episode. It's not uncommon for someone to resist or refuse therapy. Especially if they've had a negative experience to certain drugs, as in Brendan's case. At some point in his life he will face reality and begin treatment. Sadly this usually doesn't occur until the person has really gone overboard. Kind of like an alcoholic. They often don't submit to treatment until they are drastically out of control. It often has to get real real bad before they give in. Until the person is willing to submit to treatment, there's not much loved ones can do to help. If clearly dangerous, out of control, suicidal, or whatever, you can call 911. Other than that, options are few.
You might remind Brandon that whatever drugs he was given were probably the wrong ones. The correct ones will allow him to function normally without feeling doped. Encourage him to try other drugs, perhaps in just very small quantities at first. You might be able to steer him into treatment with 'incrementalism', that is, small little steps instead some huge decision. That would at least be better than no treatment at all.
For example, if you could convince him to take just one 300mg Lithium capsule, he would see for himself that it is very mild and has hardly any, if any, side effects. He might have diarrhea for a couple days, maybe, and might a little thirstier than usual, but that's about it. It will soon be as mild as candy. Make sure, and encourage him, to take another 300mg with each day. After a while this will all seem more acceptable to him, especially when he sees that he's not feeling doped. Then maybe after a couple weeks or a month or whatever, start 2 300mg pills a day. At this point he'll notice side effects of increased thirst and increased urination frequency. But he won't feel drugged. Eventually work up to 4. Then maybe 5. Probably somewhere in the range of 3 to 6 pills a day his condition will improve dramatically. If you kind of sneak him into the whole process little by little, it might be an effective strategy. Certainly even just 300mg would be better than nothing at all. Have to start somewhere, right? Just take little tiny steps to overcome his resistance. You might be able to meet with the doctor yourself in private before doing this, so the two of you can collaborate a plan together. Obviously it's not as good a plan as diving right into full treatment, but it's a start. And at this time, a start is better than nothing. From my own experience, I think this kind of sneaky incrementalism could be a very good strategy to get someone who is resistance to therapy into therepy. I hate to be sneaky like that, and the doctor might not like the idea, but hey, it could work real well in this particular case. There's no harm in 300mg of Lithium. It's just a salt processed from the earth. It's not even really a drug. Just a natural mineral.
I wonder what drugs he was given? I would be curious to know that.
The drug of choice would most likely be Lithium. Others might include Depakote or Tegretol (mood stabilizers), or maybe Risperdal or Zyprexa (antipsychotics with mood stabilizing properties). Maybe in the hospital they just gave him tranquilizers? That would certainly dope the person, but not fix the problem.
There's a book called "An Unquiet Mind" you might want to read. The author is a doctor and a severe manic-depressant. It's her life story and the struggles and cycles she went through. In your case I think it's a must read. In the end, she tailors her Lithium treatment so that it doesn't completely get rid of the highs, because she likes them, and doesn't completely get rid of the lows, because she has learned to deal with them. She has found a middle ground she is comfortable with, where she can still enjoy the highs a little bit without getting out of control. It's worth reading to gain some insight and options.
Best to you,
John
poster:JohnL
thread:48106
URL: http://www.dr-bob.org/babble/20001102/msgs/48172.html