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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Kim(for my hubby Brendan) on November 3, 2000, at 10:42:42
Hi Everyone,
I'm writing partly on behalf of myself, but also on behalf of my wonderful husband Brendan.
In 1998 something personally traumatic happened that caused what we think was Brendy's first MAJOR "manic high" episode which resulted in the diagnosis of Bipolar. While some of this certainly made sense with regards to his rapid talking, excessive energy, "high" moods agression (both verbally, physically ie while driving, with others) the part that didn't make much sense was the depression... I can't honestly think of that many times when he was "truly depressed" and neither can he. Brendan ended up in hospital for quite a while, on heavy medication which completely changed the person that he was.. he could barely talk, let alone think or walk... it took him 3/4 of a day to sit and weed a patch of garden bed less than a metre wide. HE HATED IT and so did I. The trouble is he liked(and still does the highs)- (I find this hard to understand but am trying). One of the things that Brendan discovered was that he would get an incredible ability to write "STUFF" all kinds of different things. In a few hours he would write 10-20 pages of info on things he had no prior knowledge or formal learning of.. This he finds very disturbing as he does not know where all this info comes from. One of the most distressing things (for me and his friends anyway) is his obsession with religion and god. The first time Brendy was convinced that he was Jesus or god reborn and started to talk to groups of people, write incredible things. call hundreds of people on the phone... want to talk to the pope...etc... it goes on... my questions are;;;
Have any of you had similar experiences?
Did any of you write pages of your "thoughts" or "things you have been told by a voice"
Brendan refuses to go on medication because of the last episode in hospital... naturally he's frightened and does not want to be on drugs... he feels that he can control this himself...
His latest Manic High only a few days ago sent me into a mad panic and frightened some of our "new friends" off(we've moved state as after what happened before we thought a new start would be good. While that seems to be over (with a minor low now) I am still concerned that this will happen again... I don't want to see him drugged up like he was before... but I want to help him.. we have 2 beautiful children who adore him and I love him dearly.. but I could do with some words of advice.... I don't doubt that when Brendan finds this web site he will want to write to you and ask some questions too...... hope I haven't babbled on too much
yours in advance
Kim
Posted by danf on November 3, 2000, at 11:45:09
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
I feel for you. This is probably going to get a lot worse before it gets better.
What you describe is pretty much classic for Manic depressive disorder or as it is now called, bipolar disorder.
Most people with manic bipolar of this type are very hard to get to take their meds. They are on a "high" kind of like an internal cocaine buzz. The meds take that away.
It also tends to get worse as time goes on without effective treatment.
I would recommend that you get counseling to learn how to deal with this.
There are very few people, if any that can control this on their own.
I know this sounds very down & I am sorry.
The best thing you can do is learn as much as you can about this disease & how to cope with it in a loved one.
Posted by B Day on November 3, 2000, at 13:13:24
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
I'm rather new to bipolar treatment myself so I'm not particularly knowledgeable in this area so take what I say with a grain of salt. I agree with danf that it sounds that your hubby has possibly had a classic manic episode. I have been diagnosed as having a form of bipolarity called Bipolar II Disorder. In this case the manic side is somewhat milder than with Bipolar I which is the classic manic-depression condition. If this is the first time your husband has experienced a manic episode, I couldn't say that he is bipolar based on that alone. I suspect his physician had his reasons.
Regarding depression, I read little of severe mania segregated from depression. I can understand why in light of my own experience as well as that of others. Indeed, it has been burn out from extended episodes of hypomania that has generally triggered depressive phases in me. If one has never experienced a period of severe depression it might seem unimaginable to them. However, if one is having severe, long-lasting manic episode it is very possible for that to be followed by depression. The depression can be just as powerful, destructive and debilitating as the mania. There is always a first time for both mania and depression with bipolars so your husband may never have been depressed...yet.
It sounds that Brendan may be having difficulty accepting that he may have a bipolar disorder as indicated by his doc. Whether such mania as he is experiencing was induced by trauma or body chemistry, it is not "normal" and will need treatment if it continues. Perhaps he will be one of the lucky ones and it will just go away never to return again. Whether it leaves or stays, I would speculate that your Brendan's self-determination and will power alone will not get rid of the condition. If it leaves it will most likely be because he has healed enough for it to do so on its own. If it stays then he's going to need some help.
I've learned that the symptoms, diagnosis and treatment of bipolarity can be quite complicated sometimes. However, there are a wide range of helps and treatments available for it including medications which will not "change" or diminish him. The internet also is rich with good information about Bipolar Disorder, a.k.a, manic-depression. This board is one of them. If you search this site you'll find many threads related to bipolar issues. I would also be happy to email you a list of good web sites concerned with bipolarity. I think you and Brendan will find the folks on this web board to be most helpful as well.
PS: You might mention to your husband that all of us bipolars dig our manic phases...at least until they begin to damage our lives which, untreated, they nearly always do. The mania can be great, but only to a certain and unextreme point.
B
Posted by Emmanuela on November 4, 2000, at 1:09:28
In reply to Re: Can anyone help with some questions please, posted by danf on November 3, 2000, at 11:45:09
Hi Kim - I know how hard and terrible this is for you. Please keep writing here to get the support you need. I know the situation so very well, and my heart goes out to you. Are you getting some therapeutic help for you and your kids? Are you familiar with NAMI? Do write again and let us know what's happening. Please feel free to email me.
Very best,
Emmanuela
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
Posted by Emmanuela on November 6, 2000, at 23:54:49
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
Hi Kim -
I've been thinking about you. How are you doing, and what's happening with Brendan?? Please let me know.
Hugs,
Emmanuela
This is the end of the thread.
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