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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by garnet71 on February 17, 2009, at 16:46:41
Hmm..Looks like some psych educated people here. Maybe someone could take a look at this situation and offer an opinion? I am going to ask my own PDoc about this next month, although he probably wouldn't have the time to talk about another's case. Many thanks.
Someone very close to me has been caught up in substance abuse most of her life. When she abruptly quit heroin/oxycontin/alchohol (and other things) she had a manic breakdown within a month and a half. She was not getting treatment, she did it alone and when she started a new job, had major other problems, including past criminal activity she was dealing with, car wrecked/no transportation, major financial problems, no health insurance, staying with abusive/unhealthy mother, and more, along with the emergence of life emotions she had never processed while continually high, she had a meltdown.
She was rapid cycling with extreme mania, paranoi and delusions; a bit of hallucinating. She was given a dual diagnosis for substance abuse/bipolar.
My question is, how would anyone know if she truly has bipolar disorder, or if it was just temporary from quitting drugs? Or once you have a "mental breakthrough" (breakdown) - does that mean in ALL cases, the person has a permanent condition?
I heard from the NA people (who are very wise, btw) that everyone who quits abusing hard drugs becomes bipolar. Is this temporary for some people?
I'm concerned she is going to be permenantly on meds and will never get a true diagnosis as someone who has not been on illegal drugs for over a year.
She takes lithium and Wellbutrin; has gained a lot of weight. I'm concerned about her health.
She goes from PDoc to PDoc in training as she is in the Medicaid system. Hope someone out there knows about this.
Thanks,
Garnet
Posted by obsidian on February 17, 2009, at 17:59:36
In reply to Bipolar Diagnosis and Drug Abuse, posted by garnet71 on February 17, 2009, at 16:46:41
I don't know garnet, but I think there is this real overlap area of what is part of me and what is part of the substance abuse
I just stopped smoking for almost two months, and there has been a real recovery period, dealing with agitation and depression and anger, very uncomfortable to say the least
and this is just marijuana
it's been better recently, but I'm on extra klonopin now. I wasn't functioning well. Am I prepared to find out what that was like again without medication? No.I wasn't doing well before the pot smoking though, I was dealing with a tremendous amount of anxiety on a chronic basis and I had a hard time staying afloat
I don't know garnet, alcohol/substance abuse is a bad combination. I think that is where my parents were coming from. They were some seriously crazy people. I've seen crazier, but they were crazy in their own way.
I think stabilization first, some period remaining stable, then trying out less meds slowly, step by step, it's a slippery slope
Posted by seldomseen on February 17, 2009, at 18:19:11
In reply to Bipolar Diagnosis and Drug Abuse, posted by garnet71 on February 17, 2009, at 16:46:41
I read your post over on the other board and on the link to it on the med board. I think in order to make an accurate diagnosis, one would have to know what this person was like prior to the drug abuse. Substance abuse just complicates everything. But I do want to point out that -good for your friend- good for her indeed. I know she must have gone through hell getting off those drugs like that.
So, I guess the question is that if one experiences symptoms of bipolar disorder post drug abuse, should those symptoms be treated and for how long? I think yes they should be treated. Is it a permanent condition requiring lifelong treatment? I just don't know.
The question I would pose would be is she getting better?
She's gained weight, but post heroin, that might be a good thing. Lithium is the only drug for bipolar disorder with documented efficacy against suicide. When monitored, it is a safe dependable drug IMO. I'm not sure I get the wellbutrin - maybe for the dopamine, I don't know.
If she's not getting better or at least more stable, then some adjustments might be in order somewhere.
I would consider the biggest threat to her mental and physical health right now would be going back to the drugs of abuse.
What does she think of the situation?
Seldom.
Posted by Garnet71 on February 17, 2009, at 20:05:34
In reply to Re: Bipolar Diagnosis and Drug Abuse » garnet71, posted by obsidian on February 17, 2009, at 17:59:36
Thanks guys for offering your opinions. Your right though, I guess staying clean should be her priority. It's been over a year now since she's done anything; she is just starting a new job finally....took a while to find one...even the $9 jobs do background checks sometimes. I think she deserves a chance like anyone else.
Unfortunately, she's been substance abusing since she was about 11, so it's hard to tell what she was like before. She doesn't remember mania, except she did tell me she remembered that when she saw buildings, she would have sudden urges to 'jump off them' and other similarities; strange-not suicidal, but she told me she remembers being attracted to those types of thoughts. Maybe she is BP. I was just worried about her going to all those different PDocs, being medicated for the rest of her life w/o anyone knowing whether or not she is permanently affected. When she had her breakdown, I took her to the psych hospital ER 5 times and was upset at the way they treated her.
Thanks for all your help.
Posted by Phillipa on February 18, 2009, at 0:10:11
In reply to Re: Bipolar Diagnosis and Drug Abuse Seldomseen » obsidian, posted by Garnet71 on February 17, 2009, at 20:05:34
What a young age to start drugs. Any chance with the thoughts of jumping off buildings she could have been delusional and schizophrenic and used the drugs to stop voices telling her to do things or was she just high. And didn't know lithium prevented suicide. Phillipa
Posted by Sigismund on February 18, 2009, at 1:22:08
In reply to Bipolar Diagnosis and Drug Abuse, posted by garnet71 on February 17, 2009, at 16:46:41
She sounds like an argument for over-popular and therefore illegal drugs.
>how would anyone know if she truly has bipolar disorder, or if it was just temporary from quitting drugs?No idea.
>I heard from the NA people (who are very wise, btw) that everyone who quits abusing hard drugs becomes bipolar. Is this temporary for some people?Many people are bipolar these days, even babies under 2.
Certainly withdrawal from opiates promotes mood instability (to say the least), but if, as is likely, the opiate use was an attempt to self medicate, it will be difficult to clearly separate the prior and resultant conditions.
Posted by Sigismund on February 18, 2009, at 1:23:42
In reply to Re: Bipolar Diagnosis and Drug Abuse, posted by seldomseen on February 17, 2009, at 18:19:11
>Substance abuse just complicates everything.
Yes
Posted by Dinah on February 18, 2009, at 7:51:04
In reply to Re: Bipolar Diagnosis and Drug Abuse Seldomseen » Garnet71, posted by Phillipa on February 18, 2009, at 0:10:11
My mother always had a phobia about heights because she said she got an urge to jump. She has never been suicidal in her life, and she doesn't hear voices. I think from what I've heard it's not uncommon among people with a fear of heights.
Posted by Kath on February 20, 2009, at 19:13:27
In reply to Bipolar Diagnosis and Drug Abuse, posted by garnet71 on February 17, 2009, at 16:46:41
Reminds me of my son. His diagnosis if 'schizophrenia'. However, it might be 'substance-induced schizophrenia' which might mean he might have becom sch. anyway or that the sch. was caused by drugs, but would go away if he completely stopped for, I think it's at least 6 months. Even his mental health worker said that unless he stopped for 6 mos. it wouldn't be known.
He is on meds & has gone from a size 36" waist to 42" waist. Now weights 230 lbs.
I wanted to post this to let you know that I can relate to your concerns about your friend. In my son's case, he's still doing some drugs, so probably wouldn't be successful going off meds completely. He was on seroquel, risperidone & clomazepam. Is off seroquel & has reduced risp. a bit & the clomaz is just to help him sleep. He's only on .5 mg of it.
I am very sorry - I really don't know how they can KNOW that once off hard drugs a person would be bipolar forever!
It's hard to see those we care about in difficult & scarey situations.
It is truly wonderful that your friend was able to become clean & sober.
((you)) Kath
Posted by Kath on February 20, 2009, at 19:27:19
In reply to Re: Bipolar Diagnosis and Drug Abuse » garnet71, posted by obsidian on February 17, 2009, at 17:59:36
> I think stabilization first, some period remaining stable, then trying out less meds slowly, step by step, it's a slippery slope
To me, that makes sense.
Kath
Posted by garnet71 on February 21, 2009, at 11:01:24
In reply to Re: Bipolar Diagnosis and Drug Abuse Seldomseen » Garnet71, posted by Phillipa on February 18, 2009, at 0:10:11
No Phillipa, I think it's that adrenaline factor--for her (my sis) being an adrenaline junkie. I have some of that in me too, though. She never heard voices or hallucinated, anything like that. Schitzophrenia does run in the family, among other things. I think maybe my family's dopamine levels are messed up. We have an uncle with a learning disability (didn't talk until about 6) and dyslexia; he doesn't appear to have any problems communicating at all know, and he works in machinery and is highly mechanically inclined. We also have a cousin, now 13, who has low-functioning autism.
Autism is such a mystery, and it scares me for our society. I think, just a random thought, that some who are treatment-resistant for depression actually are misdiagnosed. Asperger's is a form of autism that is commonly misdiagnosed. The spectrum of autism is very broad. There are people out there who don't even know they may be in that spectrum.
Posted by garnet71 on February 21, 2009, at 11:03:49
In reply to Re: Bipolar Diagnosis and Drug Abuse » garnet71, posted by obsidian on February 17, 2009, at 17:59:36
Obsidian, I was really glad to hear you quit smoking weed. Congratulations!!! Hang in there-this could be a valuable self discovery period for you. It could last a few years but think of it as rewarding when you consider others' who didn't use drugs may have formed their identity as a child without having supportive parents. It's sort of a case of I wish I knew then what I know now. If you've been a substance abuser all your life, and I don't know if this is your case or not, you get to form your identity using all the knowledge and experience you've collected over the years, rather from trial and error. Reinvention doesn't sound too bad. I'll have to pass that thought along to my sis as well.
Posted by garnet71 on February 21, 2009, at 11:05:48
In reply to Re: Bipolar Diagnosis and Drug Abuse, posted by Sigismund on February 18, 2009, at 1:22:08
Yeah, Sigi, that's probably why they have specialists for dual-diagnoses. So complicated to sort your substance-abuse behavior from behaviors that may or may not be attributed to your personality if clean.
Posted by garnet71 on February 21, 2009, at 11:12:55
In reply to Re: Bipolar Diagnosis and Drug Abuse, posted by Dinah on February 18, 2009, at 7:51:04
Oh no, she's definitely not scared of heights!! No phobias on her part. Interesting what you said about your Mom. I'm scared of heights--no urges to jump like your Mom though. I had always confronted my fears and it's not so bad now (still has kept me from parasailing when I had numerous chances to do so though I do intend to try it someday), but it's terrifying to be around my son say-on a mountain overlook. When he was very young, he was so squirmy, fidgety, and impulsive--around edges of cliffs or whatever he'd just try to run around as if there was no danger at all. The time I took my son to Niagra falls was very scary for me....Also in those very tall buildings that sway when you are at the top....I'll go to the lookouts but am nervous the whole time while up there.
It made me feel as though I was going to pass out if I didn't hold my son tightly away from the edges in such situations. He used to get angry at me when I did this.
Posted by garnet71 on February 21, 2009, at 11:38:25
In reply to Re: Bipolar Diagnosis and Drug Abuse » garnet71, posted by Kath on February 20, 2009, at 19:13:27
Hi Kath,
So sorry to hear about your son. It sounds like he has in it him if he sought mental health help-the desire to straighten out his life. That's very important, to not be in denial. Maybe he is in partial denial and that's why he hasn't come clean yet? Do you think, by chance, he has ADD/ADHD, and he was self-medicating to the point where he got too far into addiction? Over 50% of ADDers fall to substance abuse.
I'm soo lucky my son never got that far. He has smoked weed, abused alchohol, and done some other things like take too many percocets when he got his wisdom teeth pulled (I never even knew people used those to get high!), but he had always drawn a line in front of harder drugs. He insists weed is better than alchohol (an aspect of denial, I think, in him stating this), and I agree with him to a certain extent although I also feel it screws up your brain (but so does alcohol), and I still think he does it on occasion. He knows how strongly I feel against it, though, and it has rubbed off on him. He has friendd who smoke it, and my son, in trying to avoid substances, now stays at home much of the time, avoiding friends who are out 'partying'. He's going to the gym and playing basketball and going to college now. He even coooked me a wonderful spaghetti and meatballs dinner last night.
Oh, and my friend--its my sis. I have hope for her, and I want to pass it along to you (if you need some). My son's sister was into all the hardest drugs--has been clean for 3 years now, has a beautiful daughter and family, very productive and absolutely no mental health issues now. When she quit using, she took an SSRI, but only for a few months; it turned out she never needed it after that. She has a great head on her shoulders, very spirited and emotionally healthy, and even after using hard drugs, damaging her body, she is lucky to have regained her phsyical beauty as well--she looks like a movie star. She did quit when she was still very young-20, but started very young as well-11-12 like my sis.
Thanks so much for sharing about your son. I couldn't imagine how painful that is for you. I think when our children are suffering or are self-destructing, we literally feel their pain and destruction, big time. There is lots of hope, though, Kath. You seem so bright and positive; I hope you keep the faith.
(((((Kath))))))
Posted by Kath on February 21, 2009, at 19:16:09
In reply to Re: Bipolar Diagnosis and Drug Abuse » Kath, posted by garnet71 on February 21, 2009, at 11:38:25
> Hi Kath,
>
> So sorry to hear about your son. It sounds like he has in it him if he sought mental health help-the desire to straighten out his life. That's very important, to not be in denial. Maybe he is in partial denial and that's why he hasn't come clean yet? Do you think, by chance, he has ADD/ADHD, and he was self-medicating to the point where he got too far into addiction? Over 50% of ADDers fall to substance abuse.~ ~ Hi Garnet, Thx for your reply. I think you're right that he's PARTLY in denial. It really 'sucks' because his friends are very important to him & all his friends 'party'. Drugs are very much a part of their life & he is into the music scene - 'mixing' vinyl recores on 2 turntables. It's his passion. And drugs of very much a part of the club scene. :-(
You're right. He has ADD. It probably started with adolescent experimenting & turned out to be 'self-medication' & felt so much better that, yes, it became an addiction. How sad eh. That's shocking about the 50% of ADDers becoming addicted! Yikes.
I am so glad for you that your son is making such wise choices. I can see how you'd want to help him when he asked you to help him with his school stuff, under the circumstances. My son is a really good cook.
Thanks for the story of hope. I'm so glad things turned out so well. Yes - I ALWAYS need hope!
> Thanks so much for sharing about your son. I couldn't imagine how painful that is for you. I think when our children are suffering or are self-destructing, we literally feel their pain and destruction, big time.
Thanks for saying that Garnet. I sure feel like I feel his pain...that's for sure!
>There is lots of hope, though, Kath. You seem so bright and positive; I hope you keep the faith.
>
> (((((Kath))))))
>Thanks for the kind words & the hugs. I'm thinking positive thoughts for your sister.
hugs back-at-ya. How are you doing? You have such a hard 'row to hoe' as someone recently said to me.
Kath
Posted by Phillipa on February 21, 2009, at 20:05:34
In reply to Re: Bipolar Diagnosis and Drug Abuse Seldomseen » Phillipa, posted by garnet71 on February 21, 2009, at 11:01:24
Garnet that's great and great news autism is not caused by vaccinations of childhood as a lot of Mom's I've met will not vaccinate their kids. This I learned in my newsletter. Love Phillipa
Posted by Kath on February 22, 2009, at 15:33:18
In reply to Re: Bipolar Diagnosis and Drug Abuse Seldomseen » garnet71, posted by Phillipa on February 21, 2009, at 20:05:34
> Garnet that's great and great news autism is not caused by vaccinations of childhood as a lot of Mom's I've met will not vaccinate their kids. This I learned in my newsletter. Love Phillipa
~ ~ Hi Phillipa - I don't agree with you on this one. I've heard of WAY too many cases where the child was perfectly normal until receiving shots! It's my understanding that some vaccines have mercury in them. Unless this has now changed.
:-)) Kath
Posted by Phillipa on February 22, 2009, at 21:18:23
In reply to Re: Bipolar Diagnosis and Drug Abuse Seldomseen, posted by Kath on February 22, 2009, at 15:33:18
No more mercury according to nursing newsletter. Love Phillipa
Posted by obsidian on February 22, 2009, at 22:52:25
In reply to Re: Bipolar Diagnosis and Drug Abuse » obsidian, posted by garnet71 on February 21, 2009, at 11:03:49
thanks garnet :-D
I did stop, I think it was just before christmas. That makes it about 2 months now. I did smoke once last week. I'm trying to figure out if it really is something I need to avoid completely.
I had been smoking for about a year pretty regularly. I picked it up after about 9 or 10 years of not smoking. About 9 or 10 years ago I used regularly for about a year. I guess that makes about 2 years total of regular, maybe almost daily use, separated by a lot of years not smoking.
I'm trying to figure out if the smoking really does mess with my mood/increase my anxiety levels to a point that it's harmful.
At the moment I thankfully do not have an overwhelming urge to smoke, and I'm kind of liking the decrease in cloudiness in my head.
thanks again, take care,
sid
Posted by Kath on February 23, 2009, at 11:12:33
In reply to Re: Bipolar Diagnosis and Drug Abuse Seldomseen » Kath, posted by Phillipa on February 22, 2009, at 21:18:23
> No more mercury according to nursing newsletter. Love Phillipa
That's good news. I hope that's the case worldwide.
love, Kath
This is the end of the thread.
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