Niece's 3rd psychiatric. hospitalization

[gottaloveem]

my niece is currently in the hospital on the psychiatric. floor due to a manic bi-polar episode. I told my brother and sister-in-law that I would take it to the "pros" and see if any of you have any advice.

A little background, my niece is 23 years old, she always has been a difficult child, but always held down a job. About two years ago, she tried a hit of acid and went into her 1st manic episode. This is when she was diagnosed Bi-polar for the 1st time. Not sure if the drugs had anything to do with it, what do you think?

She was given medication to even her out, went home and ended up back about two weeks later. Once again they evened her out, she went home and was supposed to follow up with Dr. visits and continue to take her medications. She did neither. She didn't like Seroquel because it made her gain weight. Not being medicated for over a year, (she moved out on her own) caused her to end up in a manic state again. She was very talkative, excited and happy, and perhaps when she first was admitted a touch delusional. Her roommate was very worried about her, so my sister-in-law bribed my niece into coming home and go see a Dr. My niece did agree and knew she needed to be admitted.

She was not cooperating for the first week so my brother had to go to court and get a court order to be her conservator and to force her to take her medications. She agreed to take her medications finally, so now they are working on evening her out. She had a horrible day yesterday, (they doubled her lithium) as they are trying to adjust the level in her blood.

They have her on heavy doses of Depakote, Lithium and today she agreed to add Seroquel. These drugs and doses will likely change as she is released. Not sure what the long term treatment plan will be.

She is sounding a bit calmer slower, but not herself yet. She wants to get out so bad, yet at the same time, knows she needs to be there.

Just wondering what some of you thought, since I know plenty of you have dealt with Bi-polar disorder for a long time.

Thanks in advance for any help.

Lia

 

[DammitJanet]

First question in your post...do I think taking a hit of acid could have been something to tip her over into bipolar...YES! It is a definite one hit wonder that can send your brain chemicals flying. Actually one of my favorite drugs. LOL.

I am not surprised at the cocktail they have her on but am somewhat saddened by it because it is one that I am pretty sure she wont continue on because of side effects. Once she feels "well" and decides she doesnt need the medications anymore, she will Difficult Child them and all will fall apart because she wont like the side effects from them. Thats the bad part of bipolar. I really wish they would try the more weight neutral stuff especially with female patients. Pull her down on the mania with the seroquel, fine, but go for maybe lamictal. Sigh.

LOL...I need a medical degree.

I think she needs to get very educated very fast on what she has. If she can do that, maybe she would be more willing to be partner in her care. Learning what she has, the why's, how's, what medications do and treat...maybe it will help her feel in control.

 

[gottaloveem]

Thanks Janet.

She has progressed a little as far as cooperation of the medications. When she 1st got there (in true difficult child fashion) she said she would only take medical marijuana

I am very worried about her keeping up with the treatment plan once she gets out. She does hate the side effects which is why she quit taking them in the 1st place.

Lia

 

[smallworld]

Hi Lia, I'm so sorry your niece is having sucha difficult time. It can't be easy on her or the rest of your family.

A couple of thoughts:

I hope she is getting intensive counseling so she will begin to accept her diagnosis and need for treatment. medications and counseling should go hand-in-hand for the successful treatment of bipolar disorder.

It would be helpful if she makes contact with a psychiatrist who will work with her to carefully minimize the side effects while maximizing the benefits of the medications. As an example, I take Amitriptyline (a tricylic AD), which helps my migraines, IBS, insomnia and stress, but causes weight gain. I was very upset about that side effect, and when my doctor didn't listen to me, I finally switched to a doctor who would take my concerns seriously. The new doctor added Topamax to control the weight gain. A creative psychiatrist should be able to work with your niece to choose medications that are weight neutral or add medications that suppress appetite so she will be medication-compliant.

My thoughts are with your family in this difficult time. Hugs.

 

[DammitJanet]

LOL Lia...a girl who Cory would get along with! I notice they are the same age...lmao. He claims his usage is for pain relief and mood issues. Oddly enough, I do think it does help his bipolar better than lithium and depakote did. Now I cant say if it would any of the others because he hasnt tried any others.

 

[susiestar]

I am sorry she is so ill. It is sad that she needs to be inpatient, but at least she knows she needs the help.

My aunt of the many marriages (now on #9!) married a guy she had known for decades. Her family really liked him, heck, her dad tried to get her to marry him 15 years earlier! At first things were great. Then he went to a Union meeting one night.

Someone spiked his drink at the meeting. Some of the guys were really angry because he spoke his piece and the higher ups felt it was true. So they put something in his drink.

When he came home he could barely stand, slurred his words, HIT my aunt with a closed fist! and kicked his cat and 3 of their dogs. My aunt called her son and he brought 2 BIG friends with him to settle the guy down. They got him to the ER and he tested positive on a drug screen for meth and acid. His job required monthly drug testing and his had been done the day before. He was very much against drugs so the chances he took it willingly were just about zero.

He was diagnosis'd bipolar after that and was NEVER the same. He was downright scary and his health went down the potty.

So YES, one dose could do this! Sadly, it could even do this with-o a history of psychiatric problems.

The medication stopping is such a huge problem with bipolar patients. It is part of the reason that patients with bipolar have a very high mortality rate. Hopefully the medications can be managed so as to NOT have such bad side effects.

Be sure to have your bro ask about weight neutral medications and about alternative therapies like massage and biofeedback to help her with relaxing and learning to calm herself down. Maybe you could do some research on the alternative ways to help.

I will keep the whole family in my prayers. I hope this is a one time temporary thing for her.

 

[TerryJ2]

Yes, one hit could do it.
I know several people who were later diagnosis'd with-schizophrenia and bipolar, all had it in their families, and all exhbited symptoms when they did drugs. Up to that point it was iffy, but the drugs sent them over the edge immediately.
They are all at different points in their lives, but one thing I would agree with is Smallworld's comment about intensive counseling to get your neice to accept her diagnosis. Otherwise, she'll be right back where she started.
What a loving, concerned aunt you are!
Best of luck.

 

[gottaloveem]

Thank you all very much, I will call my sister in law later tonight and share the info and advice.

Lia

 

[TerryJ2]

How's she doing?

 

[gottaloveem]

She's still there

Kinda oppositional still about the seroquel. She attends some of the groups but not all. It's like her difficult difficult child self is coming out on top of everything else.

She isn't as manic or perhaps not at all. It is harder to talk to her now because she isn't so up and happy. Now she is sad and tearful and wants to get out. She told me she doesn't feel safe there. The nurses tell my bro. and sister in law she is trying to be manipulative.

I think she really is still fighting this Bi-Polar diagnoses and still isn't convinced she needs the medications.

Kinda tough right now, because this whole recovery would have gone faster if she was more agreeable from the beginning.

I have a feeling this will be a rough road for my bro and family. I am so proud of my sister in law though, she has a pretty healthy way to look at this, and even a bit detached. She realizes it is my nieces battle. You'd think she has read conduct disorders before. She does bring my niece special requests to the hospital when asked for, but if she is busy, she has no problem with telling her no. The nurses did say not to bring her special requests at all, (organic apple juice for example ) because it makes her more demanding.

I do hope she can come home soon, and I hope she will be compliant with her treatment plan. Hopefully if she has learned anything, it is to keep up with her medications and dr. appts.

Thanks so much for asking.

Lia