Anyone with bipolar or family member with bipolar--need help

[Ottakee]

I am the payee for my brother who has bipolar. He also likely has gout and has a diagnosis of fibromyolgia and has some anxiety.

 

He is NOT stable at all. He just got switched from Community Mental health to a private doctor. I LIKE the new doctor but he does NOT at all.

 

His current meds are:

Vicodin

Methadone

Sanomas (not sure on spelling)

Xanax

Tradazone

 

 

Again, he is NOT stable. He was on Adderall as well but the new psychiatrist stopped that as he does not have any real symptoms of ADHD but he "liked" it and said it gave him energy.

 

He does NOT want to take a mood stabilizer as he said that they will make him emotionally numb and unable to feel or do anything. He does not want an antipsychotic at all either. He is convinced that meds in those categories will "kill him" by making his kidneys or liver fail or just make him not feel anything anymore.

 

How in the world can we help him?

 

My 16dd has bipolar and is stable on 2 mood stabilizers and an AP but he is sure we are just ruining her.

 

I am having a hard time having empathy for him as he does not want to follow a medically indicated treatment plan. He wants the Adderall back so he will have energy (he is very manic right now but maybe without the high level of energy but the anxiety, racing thoughs, paranoia, etc.)

 

He is convinced that if he gets treatment for the gout he will be just fine. I see that as one piece of the puzzle but that is not going to stablize his moods.

 

Those of you in the midst of this......how can we best help him? Is there any way to convince him that mood stabilizer might help him feel "normal"? I know though that after mania "normal" feels very flat. Fact is, real life is just sorta flat most of the time for most of us.

 

Again, the doctor is trying to follow what I think are standard guidelines and treating the mood disorder FIRST and then if there really is any ADHD, treating that later. He just doesn't like that plan and doens't want to take the mood stabilizers or APs.

 

Feel free to email or pm me if you dont' feel comfortable sharing on the board.

[SailorMom]

:grouphug:

 

I don't know from personal experience, but I used to work in the mental health field. See bolded above. I don't see any treatment for bipolar disorder. I'm not a doctor, obviously. But I don't see any sort of mood stabilizer on the list either. The last thing a manic person needs is Adderall. Have you talked to the doctor yourself and asked about it? I would be concerned that he's an addict.

 

 

Xanax is the only drug there that looks familiar as a bi-polar drug. My SiL is one that, along with Wellbutrin, and a benzodiazapan (sp). I know she is on a few others as well. It's quite a cocktail.

It is pretty normal for bi-polars to not want to take the meds that will help them. Not much you can do, really, except work with his docs....

[OnTheBrink]

I have limited experience. My EX is bipolar and he was on depakote (mood stabilizer) and celexa (I think. He was started out on prozac but was allergic to it so I think they put him on celexa. It was another anti depressant, anyway).

 

EX reported that the depakote did make him numb and decreased his sex drive. Given EX's sex addiction, that was a huge issue for him and he went off the meds pretty fast.

 

Bottom line: you can't help someone who doesn't want help. You're wasting your own time, energy and emotions. You can't force someone to take meds and there's nothing you can do to get him hospitalized unless he becomes a danger to himself or others. So, my advice is to protect yourself emotionally from this, and do all you can to protect your dd from your brother's downward spiral. I'd point out to her that his erratic behavior and thought processes are due to him not being on his bipolar meds.

 

I'm sorry you're going through this. Dealing with BP (as you know!) is very stressful. :grouphug:

[SailorMom]

As I recall, doctors are trying to get away from prescribing Xanax because it only treats the acute symptoms of anxiety and has a high potential for abuse but does nothing to actually control the problem. Wellbutrin, Prozac, Zoloft, antidepressants/antianxiety meds are a better choice. Again, I'm not a doctor and don't mean to second guess one! :)

 

I agree, I think Xanax is a bad idea. There are much better drugs out there now.

[Ottakee]

:grouphug:

 

I don't know from personal experience, but I used to work in the mental health field. See bolded above. I don't see any treatment for bipolar disorder. I'm not a doctor, obviously. But I don't see any sort of mood stabilizer on the list either. The last thing a manic person needs is Adderall. Have you talked to the doctor yourself and asked about it? I would be concerned that he's an addict.

 

 

 

BINGO. The NEW doctor (we have seen her twice) wants to change his meds and put him on a mood stabilizer or AP and go from there. HE doesn't want that. He wants the Adderall----which I agree with the doctor is the LAST thing he needs right now.

 

I do have permission to talk to the doctor and have gone with him to the 2 appointments. She mentioned counseling for addictions or possibly inpatient to stablize meds but he doesn't want to go and he is not bad enough for a 72 hour hold.

 

He sees this not as a mental illness (bipolar) but rather that he had ADHD and fibromyalgia and gout and that his pain is from those so he needs all these meds for pain and sleeping.

 

I honestly think the new doctor has the right idea but you can't force him to take the proper meds. I am afraid she will drop him as a patient because honestly, what good does it do to go and pay her if he won't try the prescribed treatments?

 

We have even tried (the doctor was behind this totally and tried to help) to get him on a very simple sleep/wake schedule (same time every day), very modest exercise program--even walking to the mailbox and back several times a day, etc.

 

It is just so frustrating. When my daughter was unstable, she was 5 and only about 40 pounds so we could handle her and she would take the meds I gave her.........and didn't read on the internet how "bad" the psych meds are for you.

[Veritaserum]

My bipolar dd takes Trileptal (anti-seizure/mood stabilizer), Celexa (anti-depressant), and Vyvanse (ADHD). The Trileptal and Celexa are taken at night. The Vyvanse is taken in the morning.

 

Maybe he would go for something like that?

[shanvan]

Looking at the long list of meds, my concern would be how on earth anyone would be able to even evaluate him currently. All those meds are going to have an effect on his mental health. I would think you'd need to get him off most, if not all, before anyone can decide what are truly biopolar symptoms and which are being caused by side effects and/or addiction.

[Ottakee]

Is he being treated for the gout? He's obviously in denial about the meds and wanting to stay on the ones to which he likes--there's plenty of bad stuff on the Internet about those too!:grouphug:

 

The gout diagnosis is new and we have the dermatologist that says certainly gout and blood test to back it but wants primary to prescribe the meds for it. The primary isn't so sure (he is the doctor I think is a quack out of any of them----but he hands out the vicodyn and methadone, etc). We have an appointment to really go over all of this but that isn't for 4 weeks.

 

You are right about there being plenty of bad stuff on the internet about Xanax and Methadone and the other stuff but he "likes' those so won't listen to how those could be harmful.

[Ottakee]

Looking at the long list of meds, my concern would be how on earth anyone would be able to even evaluate him currently. All those meds are going to have an effect on his mental health. I would think you'd need to get him off most, if not all, before anyone can decide what are truly biopolar symptoms and which are being caused by side effects and/or addiction.

 

Again, I totally agree and I think the psych. would be totally for an inpatient admission to wean off his meds (maybe all but the methadone as I know that is a huge deal to mess with) and see what we have.

 

This is a chicken/egg thing---is there bipolar which is then causing addictions by self medicating or is the addicting meds making him look bipolar? There is some family history of bipolar so that is a real possibility but when you have these meds along with "medical marijuana" and alcohol it is a NASTY combo to figure anything out.

 

Problem is, I don't know how we would ever convince him to go for that as these other meds "help' him and he just needs the Adderall back.

[Ottakee]

The poor guy. He probably walks around like a zombie on all of that.

 

I have nothing to say except I don't really blame him.

 

He says he is a zombie but yet at what point does he need to agree to try to wean some of the meds, try a medically indicated treatment plan? (vs. the one he sorta makes up on his own as he goes--taking what meds he wants when he feels like it--either more or less than prescribed and in various combos, etc)

 

I wish he were 10 and we could just do what needs to be done but as an adult unless he is a danger to himself or others, there isn't anything we can do.

[PollyOR]

I don't have direct experience with this. Isn't Adderall addictive? Was your brother weaned off of it?

[mamajag]

I'm bipolar and had pretty much the same opinion of mood stabilizers and antipsychotics. I hated them. It felt like since they couldn't make me feel good they resorted to making me feel nothing at all. That isn't a good place either, though it makes it easier for family members to deal with you.

 

I kept trying different cocktails on and off, but I was using regular physicians. Finally I went to an actual mental health specialist, and the difference in what she has prescribed is astounding. I feel like me…a little wobbly but me. We're still in the adjustment/addition phase so I'm only on clonazepam (sleep), Wellbutrin (antidepressant), and Lamictal (mood stabilizer). She didn't want to start too much at once so next month we add a couple of other things. Yes, I at times take enough pills to get full, but it helps me be a good mom and wife and that's what matters.

 

Honestly, there isn't really anything you CAN do. A person has to come to terms with being bipolar on their own. Until they accept it and are ready for treatment, there is nothing you can do besides try to talk to him.

[HSMom2One]

 

Bottom line: you can't help someone who doesn't want help. You're wasting your own time, energy and emotions. You can't force someone to take meds and there's nothing you can do to get him hospitalized unless he becomes a danger to himself or others. So, my advice is to protect yourself emotionally from this, and do all you can to protect your dd from your brother's downward spiral. I'd point out to her that his erratic behavior and thought processes are due to him not being on his bipolar meds.

 

I'm sorry you're going through this. Dealing with BP (as you know!) is very stressful. :grouphug:

 

I have been dealing with Bipolar issues in my family for the past 35+ years, and I can't agree with the bolded statement above enough. This is the sad truth, and please believe me when I say that I've been to hell and back in learning it. My late first husband was bipolar and was in and out of the hospital a number of times after a suicide attempt (jumped a bridge) and I have an adult son who has suffered horribly as well and has been hospitalized more times than I can count because of refusing to follow treatment and get stabilization.

 

You really must protect your family and yourself. If a person refuses treatment then you have to draw firm boundaries. I know it pulls at your heartstrings, but in order to keep yourself and your family from going down in flames with your loved one with bipolar disorder, you really must do it. You can be firm and loving, stating that in order to remain in close contact with you they must submit to doctor's orders. Otherwise, you will have very limited contact. High maintenance sufferers of bipolar are completely self absorbed and will suck the life out of the people in their lives without even realizing what they are doing. That is why those that are healthy need to make the decisions, set the boundaries and stand firm.

 

I'd highly recommend that you turn over your payee role to a neutral agent that is not related to your brother. I was my son's payee for a number of years and learned this the hard way. I cannot even begin to tell you how much a relief it was to turn the finances over to someone else. You may not have issues now, but up ahead if your brother resists treatment it can get very ugly. Please, please believe me.

 

I don't want to be all gloom and doom about this, but bipolar is a horrible disease that requires a tenacious position for family members. The repercussions can be a matter of life or death for the person affected as well as all the people around them. It can be emotionally painful beyond description for the entire family, especially those that are closest to the person who is ill. The severity of the disease varies person to person, and some respond to meds well and have stable, productive lives. But by your description, it seems that your brother may be going down a dangerous road and you would be wise to evaluate things carefully now before your situation escalates.

 

I had reached a place where I had nearly lost hope because my ds had been so sick for so long and had been going from bad to worse at a fast rate of speed. But I'd like you to know that even when a person goes through multiple episodes, they may gradually come to grips with what needs to be done. My ds fathered a child when he was ill and although the circumstances weren't ideal, becoming a father caused him to realize that he has to stay on his meds and seek care. He has been stable now for the past five years and is able to spend time with his dd each week. That was his wake up call, and I offer it to you as hope. Your brother may find his own wake up call that causes him to make better decisions about his health. But he must come to that place on his own, without any help from others.

 

Blessings to you and your family as you walk through this. I pray that you find the support that you need and are able to sort through it all and are able to make wise decisions for the sake of your whole family.

 

Lucinda

[shanvan]

He says he is a zombie but yet at what point does he need to agree to try to wean some of the meds, try a medically indicated treatment plan? (vs. the one he sorta makes up on his own as he goes--taking what meds he wants when he feels like it--either more or less than prescribed and in various combos, etc)

 

I wish he were 10 and we could just do what needs to be done but as an adult unless he is a danger to himself or others, there isn't anything we can do.

 

Can you find another doctor and acknowledge that he doesn't care for this new doctor? Express your genuine love for him and hope that together you can find a better solution. Talk about the side effects of his current meds and how there may be a way to help him more than he is being helped with current meds. Assure him that the treatment your Dd is getting is not what you are looking for for him. Try to show him the positive aspects of getting off the current meds. For example, many of his symptoms may disappear completely and he may need far fewer meds in the long run. There may be diet and lifestyle changes he can make that will help, etc. Talk about trying to find the absolute best options that are currently available. Convince him not to settle for less. If you could find some inspirational books or documentaries, movies etc. that would show him what is possible that might help.

 

I would focus my energies on convincing him to get off as many meds as possible. That might be hard with Fibro since it can be very painful. I'd have some alternative ideas for him to deal with and avoid triggers for pain. (I have fibro. I have Vicodin in the cabinet for extreme pain, but my doctor knows I won't abuse it. I hate the way it makes me feel and have taken one pill only 2-3 times in 3 years and always at night so I could sleep despite the pain. The new meds for fibro don't work for me. They make me worse! Mostly I use lifestyle changes, exercise, diet and supplements to manage my fibro.)

 

I've dealt with a similar situation with a relative who has bipolar. You do have a choice. You can continue to do what you are doing. Be there for him. Remind him that there are better ways and alternatives for dealing with his health whenever you have a chance, but don't push (b/c that usually makes them push right back). But, set definite boundaries and don't let his problems encroach on your life too much. Love him, but realize you are not responsible for his poor choices.

 

Or, if things get too out of hand and you cannot stand by and watch, you can cut off contact with him and tell him you love him and will always be there for him if he wants help.

 

Those are just about the only two options. I suppose you could try to limit contact instead of completely cutting off. I agree with the other poster, you can't force him to deal with things differently. You may have to focus on your own life and consciously choose not to think about him--and don't feel guilty.

 

My relatives and I know that our family member is not getting appropriate treatment and I've done everything I can to help her, but she refuses to change doctors. She has mood fluctuations and can be embarrassing at times though her bipolar is not completely out of control. The meds she takes do a little to help, but aren't as effective as other meds. I've learned to love the good parts of her (there are many) and realize that the annoying and inappropriate behaviors are part of a disease. I can do no more. I pray for her and welcome her unless she is just too much for me to deal with at the time. There was a time when she was so out of control that I told her she was not welcome in my home until she was back on her meds. It took a year and a hospital stay, but she did end up seeking proper treatment.

 

It's hard, but you have to learn your limitations and focus on your self and your own family. My neighbor has cut off all contact with his father b/c his dad will not seek treatment of any kind for his bipolar disorder. You are not alone in the frustrations you are feeling.

[shanvan]

I have been dealing with Bipolar issues in my family for the past 35+ years, and I can't agree with the bolded statement above enough. This is the sad truth, and please believe me when I say that I've been to hell and back in learning it. My late first husband was bipolar and was in and out of the hospital a number of times after a suicide attempt (jumped a bridge) and I have an adult son who has suffered horribly as well and has been hospitalized more times than I can count because of refusing to follow treatment and get stabilization.

 

You really must protect your family and yourself. If a person refuses treatment then you have to draw firm boundaries. I know it pulls at your heartstrings, but in order to keep yourself and your family from going down in flames with your loved one with bipolar disorder, you really must do it. You can be firm and loving, stating that in order to remain in close contact with you they must submit to doctor's orders. Otherwise, you will have very limited contact. High maintenance sufferers of bipolar are completely self absorbed and will suck the life out of the people in their lives without even realizing what they are doing. That is why those that are healthy need to make the decisions, set the boundaries and stand firm.

 

I'd highly recommend that you turn over your payee role to a neutral agent that is not related to your brother. I was my son's payee for a number of years and learned this the hard way. I cannot even begin to tell you how much a relief it was to turn the finances over to someone else. You may not have issues now, but up ahead if your brother resists treatment it can get very ugly. Please, please believe me.

 

I don't want to be all gloom and doom about this, but bipolar is a horrible disease that requires a tenacious position for family members. The repercussions can be a matter of life or death for the person affected as well as all the people around them. It can be emotionally painful beyond description for the entire family, especially those that are closest to the person who is ill. The severity of the disease varies person to person, and some respond to meds well and have stable, productive lives. But by your description, it seems that your brother may be going down a dangerous road and you would be wise to evaluate things carefully now before your situation escalates.

 

I had reached a place where I had nearly lost hope because my ds had been so sick for so long and had been going from bad to worse at a fast rate of speed. But I'd like you to know that even when a person goes through multiple episodes, they may gradually come to grips with what needs to be done. My ds fathered a child when he was ill and although the circumstances weren't ideal, becoming a father caused him to realize that he has to stay on his meds and seek care. He has been stable now for the past five years and is able to spend time with his dd each week. That was his wake up call, and I offer it to you as hope. Your brother may find his own wake up call that causes him to make better decisions about his health. But he must come to that place on his own, without any help from others.

 

Blessings to you and your family as you walk through this. I pray that you find the support that you need and are able to sort through it all and are able to make wise decisions for the sake of your whole family.

 

Lucinda

 

Excellent post which mirrors my experiences with mybipolar family member exactly and much better written than the post I recently submitted! Definitely agree with getting out of the payee role.

[KidsHappen]

Xanax is the only drug there that looks familiar as a bi-polar drug. My SiL is one that, along with Wellbutrin, and a benzodiazapan (sp). I know she is on a few others as well. It's quite a cocktail.

It is pretty normal for bi-polars to not want to take the meds that will help them. Not much you can do, really, except work with his docs....

 

Xanax is a benzodiazapine. It is possible to be prescribed two different ones though.

[KidsHappen]

As I recall, doctors are trying to get away from prescribing Xanax because it only treats the acute symptoms of anxiety and has a high potential for abuse but does nothing to actually control the problem. Wellbutrin, Prozac, Zoloft, antidepressants/antianxiety meds are a better choice. Again, I'm not a doctor and don't mean to second guess one! :)

 

A known bi-polar person should never be put on an anti-depressant without first being stablized with a mood stablizer or anti-psychotic.

[KidsHappen]

I don't have enough time to post as much as I could but I did want to quickly mention Lamictal. I know you are familiar with it and already know a lot about it but as a BP person I can tell you that this is my best med. Granted it does have a few issues: first it has to be tirated slowly so it takes awhile to reach a theraputic dose, second of course is you have to hope you aren't allergic to it, third it can be a little fincky but provided you clear all those hurdles, it causes the least side effects of any of the meds I have taken. For me personally, I take it and it keeps me fairly stable most of the time and I don't notice any other effects at all. It is the only one of my meds that I can say this about.

 

I will try to come back later today and discuss the other meds I take and the challanges of dealing with meds in general.

[Wendi]

A known bi-polar person should never be put on an anti-depressant without first being stablized with a mood stablizer or anti-psychotic.

 

That's what I was confused about, too. I remember reading a book about bipolar, and the author really stressed that putting someone on an antidepressant alone for bipolar can make them worse.

 

Wendi

[mamajag]

A known bi-polar person should never be put on an anti-depressant without first being stablized with a mood stablizer or anti-psychotic.

 

Yup, and I have a full-blown manic episode to prove it. My bipolar has been far more difficult to control since that idiot decided I wasn't bipolar just depressed...

[Night Elf]

:grouphug:

 

I don't know from personal experience, but I used to work in the mental health field. See bolded above. I don't see any treatment for bipolar disorder. I'm not a doctor, obviously. But I don't see any sort of mood stabilizer on the list either. The last thing a manic person needs is Adderall. Have you talked to the doctor yourself and asked about it? I would be concerned that he's an addict.

 

My research into Trazedone is that it is not addictive. I specifically looked into that because it was prescribed to my son for insomnia. I just looked online again and I'm not finding anything that says Trazedone is addictive. Could you by chance be confusing it with something else? Can you help me find something online that explains how it is addictive?

[katilac]

I won't quote it all, but I strongly agree with Lucinda's post. ime, the only thing that persuades a meds-resistant person is to hold something they very much want over their heads. This could be financial support, close contact with family, whatever. Once they stabilize, the 'threat' helps keep them from the temptation to go off meds once again - because even when they are thinking more rationally, the temptation is very strong. A loved one once told me (while stabilized) that one reason she resisted so much is that manic phases can feel GREAT for the person going through them. She liked being manic, enjoyed it. This was hard to hear, b/c her manic phases were insanely destructive to everyone around her.

 

My research into Trazedone is that it is not addictive. I specifically looked into that because it was prescribed to my son for insomnia. I just looked online again and I'm not finding anything that says Trazedone is addictive. Could you by chance be confusing it with something else? Can you help me find something online that explains how it is addictive?

 

My doctor did not say that it was addictive, but that it loses effectiveness if you take it all the time.

[bettyandbob]

My mother had guardianship over her sister for the last 10 years of her sister's life. Mostly she just had financial control, making sure my aunt's rent was paid and giving her an allowance. My aunt tried to change doctors or simply did not go. She stayed off meds except when episodes put her in the hospital and she was forced to take meds.

 

You could try to help your brother find another doctor. It seems your brother does not really want treatment. You can't do anything about that.

 

I know you have a pretty full life, but are you familiar with NAMI ( http://www.nami.org ) . They have support groups for family members. My mother went sometimes and these are the kinds of questions that came up and it helped her to see hear what she could do and what she couldn't do and the importance of accepting what she couldn't do.

[HSMom2One]

I won't quote it all, but I strongly agree with Lucinda's post. ime, the only thing that persuades a meds-resistant person is to hold something they very much want over their heads. This could be financial support, close contact with family, whatever. Once they stabilize, the 'threat' helps keep them from the temptation to go off meds once again - because even when they are thinking more rationally, the temptation is very strong. A loved one once told me (while stabilized) that one reason she resisted so much is that manic phases can feel GREAT for the person going through them. She liked being manic, enjoyed it. This was hard to hear, b/c her manic phases were insanely destructive to everyone around her.

 

Absolutely true. My son has told me on numerous occasions that being manic is a highly euphoric experience, one that he's completely enjoyed. As I said before, when you are mentally ill you are completely self absorbed, so you have no concept of how it affects those around you.

 

My mother had guardianship over her sister for the last 10 years of her sister's life. Mostly she just had financial control, making sure my aunt's rent was paid and giving her an allowance. My aunt tried to change doctors or simply did not go. She stayed off meds except when episodes put her in the hospital and she was forced to take meds.

 

You could try to help your brother find another doctor. It seems your brother does not really want treatment. You can't do anything about that.

 

I know you have a pretty full life, but are you familiar with NAMI ( www.nami.org ) . They have support groups for family members. My mother went sometimes and these are the kinds of questions that came up and it helped her to see hear what she could do and what she couldn't do and the importance of accepting what she couldn't do.

 

Glad you mentioned this. I usually do when advocating for a better understanding of mental illness or am reaching out to family members. NAMI has a wonderful program for families called, Family to Family. I highly recommend that the op gets signed up for this as soon as possible. I did it many years ago and STILL to this day find that the information was invaluable. Joining NAMI and attending support meetings while dealing with seasons of stress connected to the loved one's health issues is also very helpful. NAMI is awesome!

 

Blessings,

Lucinda