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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by katia on July 4, 2004, at 15:33:33
Hi everyone,
A friend of mine is experiencing his first true manic episode after a lifetime of depression and drug abuse. He's 33. He's been manic for about two months now and has been fired from his corporate job and kicked out of his house because his roommate called 911 after he felt threatened by him. He was gambling so much and owed money that guys came after him with a dog and he got mangled up and had to call 911. He's aunt felt threatened on a visit and had to leave for her physical safety. He claims he's number 1 at everything and will prove it through fighting and also claims he has had a spiritual awakening. He's gone completely nuts and won't take meds. He was on zyprexa at 20mg for ONE week and it didn't do much for him and the doctor wanted to up it. But he wanted to prove to everyone that he wasn't manic and since 20mg didn't do anything for him, he thought he didn't need help. He's family is close to me and I wish they would involuntarily hospitalize him before any thing even more serious happens to him. Does anyone have experience with this? How do you go about doing it? He's completely opposed to meds and getting help. i called him to see how he was doing and he proposed dinner and seducing me. Needless to say I didn't return that phone call. He won't take the help that everyone is extending to him.How does one hospitalize someone so manic? He's beligerent and won't cooperate.
Please - responses are welcome.
Katia
Posted by rvanson on July 4, 2004, at 19:27:19
In reply to Friend needs hospitalization - what to do?, posted by katia on July 4, 2004, at 15:33:33
> Hi everyone,
> A friend of mine is experiencing his first true manic episode after a lifetime of depression and drug abuse. He's 33. He's been manic for about two months now and has been fired from his corporate job and kicked out of his house because his roommate called 911 after he felt threatened by him. He was gambling so much and owed money that guys came after him with a dog and he got mangled up and had to call 911. He's aunt felt threatened on a visit and had to leave for her physical safety. He claims he's number 1 at everything and will prove it through fighting and also claims he has had a spiritual awakening. He's gone completely nuts and won't take meds. He was on zyprexa at 20mg for ONE week and it didn't do much for him and the doctor wanted to up it. But he wanted to prove to everyone that he wasn't manic and since 20mg didn't do anything for him, he thought he didn't need help. He's family is close to me and I wish they would involuntarily hospitalize him before any thing even more serious happens to him. Does anyone have experience with this? How do you go about doing it? He's completely opposed to meds and getting help. i called him to see how he was doing and he proposed dinner and seducing me. Needless to say I didn't return that phone call. He won't take the help that everyone is extending to him.
>
> How does one hospitalize someone so manic? He's beligerent and won't cooperate.
> Please - responses are welcome.
> KatiaNot sure there is much you can do, He's an adult, after all.
FWIW, if he keeps this behavoir up, the police will probably be called at one point and he will be booked into jail on a Code 5150 for a mandatory 72 hour psych evaluation.
I wish I could be of more help, but I am not sure there is much you can do at this point.
Hopefully someone else here can give you better advice then I can.
Posted by sb417 on July 4, 2004, at 20:06:38
In reply to Friend needs hospitalization - what to do?, posted by katia on July 4, 2004, at 15:33:33
Hi Katia,
I have an elderly relative who has engaged in similar behavior. From this limited experience, it seems that the only way you can force hospitalization on him is if he poses a threat to his own life and/or to the lives of others. From what you say, it sounds as if that has happened. You sound like a caring, concerned person, but since you are not his next of kin, I don't think there is much you can do other than to tell the family what you know. After that, the choice is theirs, and it is probably best for you NOT to become further enmeshed.
Posted by katia on July 4, 2004, at 20:44:37
In reply to Re: Friend needs hospitalization - what to do?, posted by sb417 on July 4, 2004, at 20:06:38
> Hi Katia,
>
> I have an elderly relative who has engaged in similar behavior. From this limited experience, it seems that the only way you can force hospitalization on him is if he poses a threat to his own life and/or to the lives of others. From what you say, it sounds as if that has happened. You sound like a caring, concerned person, but since you are not his next of kin, I don't think there is much you can do other than to tell the family what you know. After that, the choice is theirs, and it is probably best for you NOT to become further enmeshed.Thanks for you response. But HOW do you go about doing this? Do you call the police and have them take him to a psych hospital? Do you call a doctor? How do people get involuntarily committed?
His parents want to help.
Thanks-
Katia
Posted by katia on July 4, 2004, at 20:55:20
In reply to Re: Friend needs hospitalization - what to do?, posted by rvanson on July 4, 2004, at 19:27:19
> > Hi everyone,
> > A friend of mine is experiencing his first true manic episode after a lifetime of depression and drug abuse. He's 33. He's been manic for about two months now and has been fired from his corporate job and kicked out of his house because his roommate called 911 after he felt threatened by him. He was gambling so much and owed money that guys came after him with a dog and he got mangled up and had to call 911. He's aunt felt threatened on a visit and had to leave for her physical safety. He claims he's number 1 at everything and will prove it through fighting and also claims he has had a spiritual awakening. He's gone completely nuts and won't take meds. He was on zyprexa at 20mg for ONE week and it didn't do much for him and the doctor wanted to up it. But he wanted to prove to everyone that he wasn't manic and since 20mg didn't do anything for him, he thought he didn't need help. He's family is close to me and I wish they would involuntarily hospitalize him before any thing even more serious happens to him. Does anyone have experience with this? How do you go about doing it? He's completely opposed to meds and getting help. i called him to see how he was doing and he proposed dinner and seducing me. Needless to say I didn't return that phone call. He won't take the help that everyone is extending to him.
> >
> > How does one hospitalize someone so manic? He's beligerent and won't cooperate.
> > Please - responses are welcome.
> > Katia
>
> Not sure there is much you can do, He's an adult, after all.
>
> FWIW, if he keeps this behavoir up, the police will probably be called at one point and he will be booked into jail on a Code 5150 for a mandatory 72 hour psych evaluation.
>
> I wish I could be of more help, but I am not sure there is much you can do at this point.
>
> Hopefully someone else here can give you better advice then I can.What does FWIW mean? And do you know where the page is on this website that tells what these appreviations are?
Katia
Posted by Glydin on July 4, 2004, at 23:11:08
In reply to Friend needs hospitalization - what to do?, posted by katia on July 4, 2004, at 15:33:33
FWIW stands for: For what it's worth.
Sorry for your friend's difficulties. As a friend of his, there isn't much you can do but urge him to get help. Someone being involuntarily committed involves a number of legal and medical steps and is generally handled through an ER setting.
Posted by Dr. Bob on July 6, 2004, at 0:15:08
In reply to Re: Friend needs hospitalization - what to do? » rvanson, posted by katia on July 4, 2004, at 20:55:20
> do you know where the page is on this website that tells what these appreviations are?
It's in one of the folders at Psycho-Babble Tips:
http://health.groups.yahoo.com/group/psycho-babble-tips/links/Miscellaneous_001009377572
Bob
Posted by katia on July 6, 2004, at 3:05:13
In reply to Re: appreviations, posted by Dr. Bob on July 6, 2004, at 0:15:08
> > do you know where the page is on this website that tells what these appreviations are?
>
> It's in one of the folders at Psycho-Babble Tips:
>
> http://health.groups.yahoo.com/group/psycho-babble-tips/links/Miscellaneous_001009377572
>
> BobYes, I actually looked there prior to this posting. Please click on that link for yourself and see where it leads you. It didn't really lead me anywhere. Maybe I'm doing something wrong.
thanks-
Katia
Posted by Dr. Bob on July 6, 2004, at 18:24:06
In reply to Re: appreviations » Dr. Bob, posted by katia on July 6, 2004, at 3:05:13
> > http://health.groups.yahoo.com/group/psycho-babble-tips/links/Miscellaneous_001009377572
>
> Yes, I actually looked there prior to this posting. Please click on that link for yourself and see where it leads you. It didn't really lead me anywhere. Maybe I'm doing something wrong.It led me to a page with 3 links. What do you get when you click on it?
Bob
Posted by katia on July 7, 2004, at 2:53:38
In reply to Re: appreviations, posted by Dr. Bob on July 6, 2004, at 18:24:06
> > > http://health.groups.yahoo.com/group/psycho-babble-tips/links/Miscellaneous_001009377572
> >
> > Yes, I actually looked there prior to this posting. Please click on that link for yourself and see where it leads you. It didn't really lead me anywhere. Maybe I'm doing something wrong.
>
> It led me to a page with 3 links. What do you get when you click on it?
>
> Bob> > > http://health.groups.yahoo.com/group/psycho-babble-tips/links/Miscellaneous_001009377572
> >
> > Yes, I actually looked there prior to this posting. Please click on that link for yourself and see where it leads you. It didn't really lead me anywhere. Maybe I'm doing something wrong.
>
> It led me to a page with 3 links. What do you get when you click on it?
>
> Bob
It led me here: http://health.groups.yahoo.com/group/psycho-babble-tips/links/Miscellaneous_001009377572I then clicked on "What abbreviations on prescriptions mean"
Posted by SalArmy4me on May 31, 2001
http://www.dr-bob.org/babble/20010530/msgs/64967.htmland then to here: http://www.dr-bob.org/babble/20010530/msgs/64967.html
It's no big deal. I don't have to know.
thanks anyway.
katia
Posted by gardenergirl on July 7, 2004, at 7:53:02
In reply to Re: Friend needs hospitalization - what to do? » rvanson, posted by katia on July 4, 2004, at 20:55:20
Posted by Dr. Bob on July 7, 2004, at 18:41:22
In reply to Re: appreviations » Dr. Bob, posted by katia on July 7, 2004, at 2:53:38
> I then clicked on "What abbreviations on prescriptions mean"
> Posted by SalArmy4me on May 31, 2001
> http://www.dr-bob.org/babble/20010530/msgs/64967.htmlAh, I see, the link in that post doesn't work anymore. I'll delete that post from PBT.
But FWIW isn't an abbreviation used on prescriptions, so the tip for you would've been "Abbreviations used in posts"...
Bob
Posted by Caper on July 8, 2004, at 6:33:46
In reply to Friend needs hospitalization - what to do?, posted by katia on July 4, 2004, at 15:33:33
Hi Katia,
I have a little personal experience with involuntary psych hospital admissions. The way it works where I live is: the standard for involuntary admission is that you are a danger to yourself or others, or that you lack the ability to care for yourself. (I'm in the U.S., so if you're not most of this won't apply and sorry in advance.)
In this state, to start the commitment process, you go to a magistrate and swear out an affidavit, giving your reasons for your concerns about your friend or relative. It doesn't seem to take much for the magistrate to sign off on what's called an Emergency Custody Order (ECO). Then what happens is (and this is the part that's so hard when you're trying to get help for someone), well what happens in my state is they send police. The person is then handcuffed and possibly shackled at the legs as well, put in the back of a police car and driven to a hospital, where he waits for a mental health person to evaluate him. On an ECO they're only allowed to hold him for a few hours, unless the mental health person decides he meets the criteria for involuntary admission.
If that happens, next comes a TDO, temporary detention order. That means he's held up to 72 hours in a psych hospital, and before that time is up he'll have a hearing with a judge. The judge listens to the patient's side, and the treating doctor(s) side and the nurses and staff evaluations too. Then the judge usually takes the staff recommendation and that decides if the patient can leave.
If the person is not considered well enough to leave, the judge usually offers a "choice" of committing oneself "voluntarily" for a certain number of days, or being committed involuntary for a longer time. (You can imagine what option most people take.)
I've experienced involuntary commitment from both sides. A relative of mine was completely out of control, banging his head against the wall until it bled, telling us exactly where he was going to go get a gun and kill himself, etc. But, when we got the ECO, he was calm and cooperative and basically talked his way right out of it. So then he was home in a few hours and very angry about the whole thing. (Plus a little smug that he talked his way out of it- lied about his suicidal gestures, impulses, etc., and knew he'd gotten away with it.) Your friend sounds like he might not be able to fool them though, if you got him ECO'd. I say that because mania's harder to hide, plus manics don't think they are manic so they don't even try to hide it.
My other experiences were my own. I'll try not to go into the details too much, but it seemed to me that I got TDO'd twice because I already had a psych history dating back to 1995. My relative had none. Neither time I was TDO'd was I suicidal, but I was emotional and I suppose they were just being cautious.
So, to sum up- it's not pleasant for the person who is being committed, but if a person does not need to be there, the docs figure it out pretty fast and then he(or she) gets released. If the person truly _does_ need to be there, then at least you know he is safe and being taken care of.
I'm not sure what else to add really. My TDO's were by doctors, so my family and friends didn't have to deal with my anger about it later since it was not any of them who instigated it.
My relative? He got over it fairly quickly. My theory is he got over it so quickly because he knew everything we said to the magistrate was true and that he _was_ out of control and suicidal at the time.
The only other thing I can think of to say is follow your instincts but try to remember you can't control this. You do what you can and what you think is best and that's all you can do. I know it's easier said than done, when you care for someone, but.....you're already doing more than most people would do I think. Mental illness is hard to face up to.
As far as getting the process started, I'd call the local magistrate and if you can't reach him or her, call the Emergency Room and they'll direct you. I'm not sure if you have to be related to him to be the one to go the magistrate. I'd guess no, but that it would help if you had a family member of his as well.
I hope this helps a little and that it's not too late to be of any help, since you posted this several days ago I see.
Best of luck to you in figuring out this dilemma.
Caper
> Hi everyone,
> A friend of mine is experiencing his first true manic episode after a lifetime of depression and drug abuse. He's 33. He's been manic for about two months now and has been fired from his corporate job and kicked out of his house because his roommate called 911 after he felt threatened by him. He was gambling so much and owed money that guys came after him with a dog and he got mangled up and had to call 911. He's aunt felt threatened on a visit and had to leave for her physical safety. He claims he's number 1 at everything and will prove it through fighting and also claims he has had a spiritual awakening. He's gone completely nuts and won't take meds. He was on zyprexa at 20mg for ONE week and it didn't do much for him and the doctor wanted to up it. But he wanted to prove to everyone that he wasn't manic and since 20mg didn't do anything for him, he thought he didn't need help. He's family is close to me and I wish they would involuntarily hospitalize him before any thing even more serious happens to him. Does anyone have experience with this? How do you go about doing it? He's completely opposed to meds and getting help. i called him to see how he was doing and he proposed dinner and seducing me. Needless to say I didn't return that phone call. He won't take the help that everyone is extending to him.
>
> How does one hospitalize someone so manic? He's beligerent and won't cooperate.
> Please - responses are welcome.
> Katia
Posted by katia on July 8, 2004, at 16:58:39
In reply to my experience with involuntary commitment » katia, posted by Caper on July 8, 2004, at 6:33:46
Hi Caper,
Thanks for such a lengthy and informative post. I am in Cal. so I passed this info along to his family. They can do what they want with it.
BTW, he's just gotten worse...
take care,
katia
Posted by Caper on July 9, 2004, at 18:45:57
In reply to Re: my experience with involuntary commitment » Caper, posted by katia on July 8, 2004, at 16:58:39
> Hi Caper,
> Thanks for such a lengthy and informative post. I am in Cal. so I passed this info along to his family. They can do what they want with it.
> BTW, he's just gotten worse...
> take care,
> katia
Hi katia,You're welcome for the info. I just re-read my post and I'm thinking "wow, I really rambled!" But every word was the truth and I hope it helped.
I'm about to ramble again a bit, because I know how hard it is to have to have someone committed (or try to). The guilt and doubt was bad for me, even though I knew deep down I was doing the right thing.
I'm so sorry to hear he's gotten worse. But there's HOPE, truly. In one of my hospitalizations there was a guy who just suddenly became paranoid and psychotic. He'd never had any previous psych history. But suddenly he wouldn't eat for fear of being poisoned, had delusions his family was wanting to kill him, that the army was coming to break him out of the hospital...I could go on and on. So his family had him TDO'd. The good news is that once he realized that taking his meds was the only way he'd get out of the hospital, he did. I think he thought he was just humoring everyone and that there was nothing wrong with him. But, wow, the rapid improvement in him was so awesome to observe. It amazed me.
I don't know how he's doing now of course, but just wanted to make the point that sometimes a TDO is the only option to help someone.
Let me know how it turns out if you feel like doing so. I'll be pulling for all of you involved in this.
Best wishes,
Caper
Posted by katia on July 9, 2004, at 21:37:19
In reply to trying to give you a bit of hope.... » katia, posted by Caper on July 9, 2004, at 18:45:57
Hi Caper,
I passed your info along to his cousin and she says once she read that, she knew that he didn't need to be committed. He wasn't that bad.But you read my previous post chronicaling his misphaps to say the least. She is in great denial about a lot of mental disorders, including mine. She said "he's still functioning, he's not that bad, he's just doing too many drugs". he's doing the drugs to self-medicate and he's been fired from his job, kicked out of his house, mauled by a dog, and losing friends by the second. Functioning? I don't think so. But that's his family/cousin. I don't really want to get more involved. Good luck to them all.
thanks anyway for your help.
Katia
Posted by Caper on July 9, 2004, at 23:39:48
In reply to Re: trying to give you a bit of hope.... » Caper, posted by katia on July 9, 2004, at 21:37:19
I regret that my info was used by the cousin as an excuse to not try to get your friend help. :-(
But Katia, in my opinion you're right in trying to let it go. You sound like an extremely caring person, but you've done all you can and more than most people would have. The rest is up to them. All there is to do now is hope for the best.
Take care of yourself,
Caper
> Hi Caper,
> I passed your info along to his cousin and she says once she read that, she knew that he didn't need to be committed. He wasn't that bad.
>
> But you read my previous post chronicaling his misphaps to say the least. She is in great denial about a lot of mental disorders, including mine. She said "he's still functioning, he's not that bad, he's just doing too many drugs". he's doing the drugs to self-medicate and he's been fired from his job, kicked out of his house, mauled by a dog, and losing friends by the second. Functioning? I don't think so. But that's his family/cousin. I don't really want to get more involved. Good luck to them all.
> thanks anyway for your help.
> Katia
Posted by katia on July 10, 2004, at 0:42:25
In reply to sorry! » katia, posted by Caper on July 9, 2004, at 23:39:48
This is the end of the thread.
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