Posted by Larry Hoover on August 29, 2003, at 11:06:20
In reply to Re: Sobriety and Mania- related to above post, posted by HenryO on August 28, 2003, at 9:25:19
> Larry, what a post, every comment was wise and helpful. This board is a great service. You put some thought into that, thank you.
Thanks for acknowledging the content. I have considerable experience around addiction and recovery (I'm qualified as an addictions counsellor).
> His response to the meds seems like they help, I'd increase the dose quite a bit. There is a chicken and the egg aspect to this. Which issue has more influence on the other. I don't know if the answer matters.
Stability has to come first, though usually that comes through abstention from the substance(s) of abuse. This case is an obvious exception to the general pattern. Cognitive issues can only be addressed once stability is achieved.
> I've decided I am not equipted to nor ready to try to solve him. I can offer a bed for a while but the instaibility I'm not going to have around me for too long.
That's wise, to assert boundaries. Otherwise, you can get sucked into "giving a little more help", over and over again. Moreover, he has to take responsibility, somehow. Maybe, get him a referral to an inpatient program, even drive him there, but then it's up to him.
> It looks like pure mania, how rare is that? I didn't know if that was really possible.It's common enough.
> I think he uses to stay sane. He eats as much as two men. He's not heavy. And he sleeps like the dead, at least right now. Maybe he's making up for lost time. This is the first good place to crash for a while.
Pure manics do eventually crash. The body has limits the mind can't supercede.
> The program works for a 18 months or so, then this other condition comes in over the top. He feels it comming, starts going to two then three meetings a day.
That pattern should be emphasized to him. If he can feel it coming, he ought not to be relying on more meetings. He should be heading straight for a doctor's office. Recovery is where you find it. He's looking in the wrong place, to solve the mental issues.
> People give up on him like he's insincere.
That's common in AA, IMHO. Psychiatric dysfunction is often attributed to a failure to fully adopt the program, to reservations. I know of one residential program that has a counsellor (nick-named Gestapo Al) who keeps all psych meds under lock and key (that's the good part), but then refuses to give them out as prescribed (via various subterfuges). I had to take one poor guy to the emergency department for an injection of Haldol, because he had been denied his Zyprexa for about a week. He had been advised to increase his efforts in prayer.
> But I'm starting to see this other illness is making it so that thinking is not always in the picture.
He has to heed his own warning signs. A sponsor may help with that, via feedback, but it is his task to change his behaviour. "If you keep on doing what you always did, you'll keep on getting what you always got."
> Indeed several days may go by while he is clean and manic that he doesn't remember.
Once the mania is fully active. He's missed the window of opportunity. He needs to formulate a plan of action when he's not manic, and pledge to put it into effect when he feels the warning signs.
> I've know him on and off since high school, he has always been high voltage.
I hung with a similar dude.
> I worry, maybe even starting to think, the prognosis isn't good. I wish he and I could leave him in some good hospital setting for a long time.That's really a fine idea. If you're in Ontario, I know just the place.
Lar
poster:Larry Hoover
thread:254628
URL: http://www.dr-bob.org/babble/20030828/msgs/255300.html