Is it possible...

[trinityroyal]

...to be addicted to the feeling of being off your medications?

My difficult child has been having a terrible time staying medication-compliant, especially over the last several weeks, which coincides with his spring-hypomania. Looking back over the years, it has always been very difficult for him to stay on the straight and narrow with his medications, but especially at this time of year. He also has what husband and I have termed "re-entry", when he restarts his medications after going off them. This includes rapid-cycling between high elevation and dysthemia, followed by a crash of hours or days, depending on how long he's dropped off the medications.

He's always been a sensation seeker, had terrible food reactions which would give him drug-high type symptoms, and he would actively seek out those foods. For a long time, before we got his medications sorted, we used to have to keep those items under lock and key (as in a heavy chain and padlock on a fridge that was locked in another room) if we kept them in the house at all.

He's never tried street drugs and can't stand the smell or taste of alcohol in any form, but he's always had that jones, for lack of a better word.

So, I'm just putting it out there. Is my difficult child an addict, with his substance being his own unregulated mood swings?

What do you all think?

 

[InsaneCdn]

Interesting question... and I don't have an answer.
But I do know that for many people (my difficult child included), until we got the right combo of medications, any one medication was almost worse than not being on medications. It took the interplay between medications to make ALL of it work.

 

[trinityroyal]

Good point, IC. difficult child was on the wrong medications for many years, as his diagnoses were sorted out. The medications he's on now, after years working with a really strong team (therapist, Autism Spectrum Disorders (ASD) expert, forensic psychologist--some of the best in the country) really work well for difficult child. They get tweaked a bit just to keep him on an even keel.

What I'm observing though, is that difficult child doesn't seem to like the even keel. He seems to want the chaos, the spikes and troughs, the disregulation, the wire-snapping edge as he gets closer and closer to full-on mania.

My big fear is, the last time difficult child became that disregulated, he also ended up in jail and then on a year of house arrest (which was more hell for me than for him!) He's no longer a minor, so jail is a much more serious affair for him, and with his social, processing and other deficits, difficult child would not survive adult jail for 5 minutes. The police and court kept him out of juvenile hall because they didn't think he'd survive for 5 minutes either. Even during his (brief) time in lockup, they kept him isolated for his own safety.

 

[compassion]

I walk a similar path with my daughter. She is a fantastic lithium responder but loves the sensations un medicated. We have chosen to get out of the role of medication police, thus much of the time she is un/under medicated. It is frustrating because she engages is high risk activities and less able to negoiate or "reason" with her when she is like this. The unregulated mood swings seem to be more compelling for her than any artificial substance. Still, I see baby steps of improvement and my guess is she is taking medications part of the time, so baby steps towards self awareness. I always try to stay hopeful.

 

[flutterby]

Hypomania can become addicting for bipolar patients and is 1) one of the leading causes of not complying with medications, and 2) the high rate of substance abuse in the bipolar population (to mimic hypomania).

There is an author who is also a psychiatric professor at a well known school who is also bipolar who writes about this stuff. I will try to remember her name - or find a book of hers that I have.

 

[flutterby]

http://en.wikipedia.org/wiki/Kay_Redfield_Jamison

 

[trinityroyal]

Thanks compassion and Flutter. I will definitely get that book and read it.

I have been seeing signs of something off in difficult child's behaviour even more than usual lately, and this might explain it. If he's getting high from his own physiology then this might be an even tougher row to hoe than I thought.

Funny. I can talk about detachment to other people until I'm blue in the face. I'm pretty good at detaching from most things. But with difficult child, letting him fly on his own has always been too scary to contemplate. I think more for husband than me, but for me as well. Maybe these are my first baby steps on the road to letting difficult child live his own life, for good or ill. I'm terrified.

 

[BusynMember]

I would like to share what I learned when I was in a p-hospital for ten weeks, back in the day when you could actually stay until you were well on your way to improvement. Because at least half my time there was spent while I was no longer at my very worst, I would talk to the other patients and socialize big time, asking questions which most patients were very willing to answer. It puzzled me that many people with bipolar would end up back in the hospital once a year and then spend the rest of the year stable, so I asked the patients about that. This was in summer.

The patients basically said that around spring/summer they would get so manic that their medications could no longer hold down their mania and they felt like they didn't need their medications anymore so they'd start going to bars, drinking, picking up men and eventually stopping medications altogether until they spiraled and ended up in the hospital. It was not bad behavior. It was due to the time of year and mania. Literally 3 days to a week after being back on the Lithium, which was the only choice then, they'd be talking and interacting normally, just like a person who was not mentally ill. It was a quick transformation once back on medications.

I remember one patient leaving. As she lifted her luggage, she looked at the nurses and laughed and good-naturedly said, "Bye! See y'all next year!"

I guess this is common when the sun is out a lot and the weather is nice. Of course, these patients had full blown psychotic mania, but in my opinion it's the same concept. Maybe not. thought I'd share though Mania feels great to the person experiencing it, not so much to the caretakers who have to keep the person in control. I can see people getting addicted to mania. Depression? You can't talk me into thinking anyone enjoys that horrible feeling.

 

[trinityroyal]

Thanks MWM. That is very helpful.

I've noticed that difficult child's hypomania kicks up a notch every spring, and that does seem to be when he's most likely to lose it every year. His various runs-in with the law have always been near the end of the school year, which fits as well.

Lots to think about. Thank you all so much for your input. I think I've been staring out my own window for too long, and it's great to get other people's perspective.

 

[DammitJanet]

Trinity, I think it would depend a whole lot on how a person's mania exhibits to them too. My mania is not fun. Probably because I am too physically unfit to enjoy it...lol. I once told a doctor that it is miserable to want to do things and have fun or even feel like you want to climb the walls but you are stuck sitting in one place! Put a mental picture in your mind of a fat person with either a walker or a cane with barely any teeth...yelling "I'll get you for that!" LOL. Yeah. I most certainly cant go bar hopping or anything like that because I would look foolish.

The worse thing I do when I hit a bout of hypomania is ebay shopping and I went foolish with that last month. Really stupid too because everything was too small. I am going to have to just buy her clothes new this time...sigh.

However, I dont like being manic or hypomanic because I exhibit more in an angry way. I get more irritable and uncomfortable in my skin. I cant sleep and I start losing it in that way. I dont like it.

 

[trinityroyal]

Thanks Janet, that's helpful as well.

difficult child's spring hypomania tends to be of the amped up and happy kind. His mood is really elevated. If I didn't know difficult child I would think he'd been taking Ecstasy when he's hypomanic. He loves everyone, everyone loves him, his energy is endless, his behaviour is wildly inappropriate, if a pretty girl strikes his fancy he's just as likely to grab her by the chest as say hello...you get the idea. In other words, trouble-on-a-stick. And he really seems to like the feeling of being in that state, and doesn't seem to understand (or care about) the consequences.

*Lots to think about, lots of reading and research to do.