Diagnosed as Bipolar

[khunpa]

So yesterday my wife and I just found out that her son (24 years old) has been diagnosed with bipolar. He apparently went to a doctor himself and has been on medication for the past 6 months, without telling anybody.

 

Anyway, he is clearly now down mentally and we have therefore told him to come back home and stay with us, until we can all go and talk with a doctor about his illness and medication. Obviously it is not working as it should, as he says he has never missed taking it and has been feeling completely down the past days.

 

Having absolutely no experience with this and both my wife and I really do not know the best way to handle this. If anyone has any experience or advice, it would be very much appreciated. 

 

 

[BobBKK]

There are some good videos on YouTube. Stephen Fry, for instance, has Bipolar. But, forgive me, are you sure it's that?  BiPolar people don't just feel 'down' they feel ecstatic and totally hyper just as much as 'down'. It's 'bi' 'polar' swinging between the two. I had bouts of that in my 30s and 40s. Manic sometimes, rushing around, and insular at others. Read up, get to YouTube and best wishes.

[Heppinger]

Where does he live?

 

[mark5335]

You'll probably receive better informed advise in the Health/Medical Sub-Forum, however, perhaps you should arrange for a 2nd opinion on the diagnosis and the medication. If you're in the Bangkok area, the Manarom Hospital in Bangna is well regarded for mental health issues.

[Crossy]

Let's try this in Medical.

[sanuk711]

Yes he will feel down especially if the doc is giving him to strong a dose of lithium, a Mood stabilizer. He will  typically need mood-stabilizing medication to control manic or hypomanic episodes. Best person to ask is the Cat lady on the medical questions --she does seem right up with most things .

 

 

[Sheryl]

It takes time to get the meds right with bipolar disorder, every case is different and it is no easy task getting it just right. It frequently requires a mix of 2 or more drugs to get the balance right and communication between doctor and patient is critical.

 

It is a VERY big plus that your son recognized his problem and sought medical help and is compliant with his meds. These thing are often not the case.

 

He does need to let his doctor know promptly when the meds don:t seem to be working, or perhaps are working but not enough. Certainly any major depression should be quickly reported, and if it is, the doctor will usually add a med or adjust dosages.

 

That is something Thais often do not do .....too often they feel that speaking up implies criticism of the doctor which is taboo,  meanwhile the doctor goes on prescribing the same thing because as far as s/he knows, it is working.

 

There are a wide range of medications used for this and there is no single mix or dosing that works for all. This too Thais often do not understand, thinking that for problem X there is a single "right" treatment and if it does nto work then nothing can be done and no point in returning to the doctor.. Not at all the case.

 

Should also not wait for scheduled appointments if there is a change for the worse. As it sounds like he has been significantly depressed for at least a few days straight I encourage you to take him back to the doctor now and not wait for the appointment date. That date was for routine follow-up and not meant that he has to wait for it if there is a problem.

[khunpa]

3 hours ago, BobBKK said:

There are some good videos on YouTube. Stephen Fry, for instance, has Bipolar. But, forgive me, are you sure it's that?  BiPolar people don't just feel 'down' they feel ecstatic and totally hyper just as much as 'down'. It's 'bi' 'polar' swinging between the two. I had bouts of that in my 30s and 40s. Manic sometimes, rushing around, and insular at others. Read up, get to YouTube and best wishes.

Unfortunately, I think there is a good chance the doctor got it right.

 

Yesterday, he was crying, saying the whole world was against him. Just can back from meeting him now, where he seemed overly happy and told me of his future plans, which involved becoming the new president of Thailand, after him going to study in USA first and a lot of other totally unrealistic stuff. (I am not kidding) One thing for sure, is that his current medication is not working.

 

Thanks for the Youtube tips, will defiantly check that out.

 

 

Edited May 17, 2020 by khunpa

[khunpa]

58 minutes ago, Heppinger said:

Where does he live?

 

In Chiang Mai. (so do we, but he lives with his girlfriend)

[khunpa]

46 minutes ago, Sheryl said:

It takes time to get the meds right with bipolar disorder, every case is different and it is no easy task getting it just right. It frequently requires a mix of 2 or more drugs to get the balance right and communication between doctor and patient is critical.

 

It is a VERY big plus that your son recognized his problem and sought medical help and is compliant with his meds. These thing are often not the case.

 

He does need to let his doctor know promptly when the meds don:t seem to be working, or perhaps are working but not enough. Certainly any major depression should be quickly reported, and if it is, the doctor will usually add a med or adjust dosages.

 

That is something Thais often do not do .....too often they feel that speaking up implies criticism of the doctor which is taboo,  meanwhile the doctor goes on prescribing the same thing because as far as s/he knows, it is working.

 

There are a wide range of medications used for this and there is no single mix or dosing that works for all. This too Thais often do not understand, thinking that for problem X there is a single "right" treatment and if it does nto work then nothing can be done and no point in returning to the doctor.. Not at all the case.

 

Should also not wait for scheduled appointments if there is a change for the worse. As it sounds like he has been significantly depressed for at least a few days straight I encourage you to take him back to the doctor now and not wait for the appointment date. That date was for routine follow-up and not meant that he has to wait for it if there is a problem.

Thank you so much for this. Yes, his meds are for sure not working. Yesterday, he was very down and today totally the opposite. Can it really change this fast?.

 

Just came home from meeting with him and all I can say is that he is really messed up. I was totally confused after talking with him today. He was overhyped and I just could not make any sense of it all. 

 

My wife gets off work in a couple of hours and then will show her your post and we will have to think about what to do. For sure his meds are totally off. Will keep in close contact with him (he is at my wife's workplace now) and see if he falls back. Think it is a good idea to get him to a doctor ASAP and get his meds adjusted.

 

Yes, it is great that he recognises his problem. But when hyper like today, there is not much common sense in the air. I actually found the down situation easier to handle. I mean, what do you say to a guy who has been crying for 3 days straight and now suddenly has completely unrealistic goals for his life? I for sure went kind of numb. Have a feeling this is not going to be easy, until we find the right medication for him.

Edited May 17, 2020 by khunpa

[BritManToo]

24 minutes ago, khunpa said:

I mean, what do you say to a guy who has been crying for 3 days straight and now suddenly has completely unrealistic goals for his life?

I'd say go home to your girlfriend.

This isn't your child, and isn't really your business. He's an adult with his own partner and own home.

As an old guy you get to pick and choose the problems you deal with in your twilight years.

Edited May 17, 2020 by BritManToo

[Sheryl]

50 minutes ago, khunpa said:

In Chiang Mai. (so do we, but he lives with his girlfriend)

Where is he being treated? There is a govt psych hospital in CM

[khunpa]

1 hour ago, BritManToo said:

I'd say go home to your girlfriend.

This isn't your child, and isn't really your business. He's an adult with his own partner and own home.

As an old guy you get to pick and choose the problems you deal with in your twilight years.

Well, although not my child, I have known him most of his life and he is family to me. 
 

So now that he has serious problems, I will of course not just turn my back on him.

[Lacessit]

2 hours ago, khunpa said:

 

Yes, it is great that he recognises his problem. But when hyper like today, there is not much common sense in the air. I actually found the down situation easier to handle. I mean, what do you say to a guy who has been crying for 3 days straight and now suddenly has completely unrealistic goals for his life? I for sure went kind of numb. Have a feeling this is not going to be easy, until we find the right medication for him.

I have a friend who is bipolar, and as Sheryl says getting the medication balance right is very tricky. It can also change with time, as the effectiveness of a medication wears off.

[BobBKK]

15 hours ago, khunpa said:

Unfortunately, I think there is a good chance the doctor got it right.

 

Yesterday, he was crying, saying the whole world was against him. Just can back from meeting him now, where he seemed overly happy and told me of his future plans, which involved becoming the new president of Thailand, after him going to study in USA first and a lot of other totally unrealistic stuff. (I am not kidding) One thing for sure, is that his current medication is not working.

 

Thanks for the Youtube tips, will defiantly check that out.

 

 

Right looks like the diagnosis was correct. Some good advice on here and a long road ahead unfortunately. I hope the GF is strong as she will have her whole life upside down too and it would be unusual for her to surrender her life to his needs. I feel for her too. Sorry to hear about this and hope you find a solution.  

[1FinickyOne]

On 5/17/2020 at 7:13 PM, khunpa said:

Have a feeling this is not going to be easy

It is not and I have seen enough of this that all I can do is offer my sympathy to you and your wife... when someone is so afflicted it crushes the lives of anyone close... and the ones who are aware, can feel all the worse for ruining everyones life... if he ends up living with you, you will be walking on eggshells. 

 

Find a way to have some space/time in your life for yourself to be happy in... best of luck. 

[Bender Rodriguez]

is he on lithium carbonate ?

 

to flatten out the highs ?

 

is living like a zombie better ?

 

those medications have EFFECTS, not just side effects

 

start by looking them up on google...

 

don't you love that side effect of prozac is SUICIDE attemps ?

[domdom]

Hello

My son is bipolar (his father was and unfortunately he got it through the genes)

I have quite a long experience with this as my son is now 37..

First of all it does not affect his intelligence or nothing but mainly his mood.. he will have and surely has ups and downs.. that means that he goes easily from maniac state to deep depression.

A good follow up from the family helps a lot..

You must know that in maniac phase he can do any stupid things.. he might feel he is the master of the world.. that might reach to compulsive purchases or anything.. You will easily be able to realise in which phase he is.. In maniad phase, difficulties of sleep, talks a lot, laughs very loud, too active, doesn t sit, will clean the full house etc.. etc..

In depressive phase totally the contrary, bad image from himself, tendancy to isolate himself, not answering phone, messages and being alone at home without doing anything. Tendancy to suicide can occur in this phase.. They also have difficulties in controling anger or frustration and can easily blow up if somebody is agressive or angry with them.

Linked to the illness is the tendancy to addictions.. smoke, drinks, games .. also somnambulism etc..

In day to day, very difficult for them to adjust to reality, difficult to respect a budget, tendancy not to pay bills as following up the life s obligations seem difficult for them..

Alltogether also it takes a long time for them to get proper medication and often when medicated they are really down and feel down.. which sometimes leads to them not taking the medication any more as they feel bad..

He needs a very good psychiatric and regular consultations for his all life + medication all life long

Normally bipolar people are very clever and very weak on affective side.. they need a lot of love..

If happy and with normal family life their state can be stabilized.. BUT each affective problem brings them down and increases their state..

Also it is very important for them to have a stable and calm and regular life, go to bed quite early, avoid alcohol as much as possible, have a good quality of sleep and sane life and healthy food and normal weight.. Junk food and overweight interferes in the efficiency of the treatment.

Everybody around them must understand they are sick.. and be open to talk.. and not get upset with them as it won t help but increase the bad image they have of themselves..

NOT tell them "but move, what are you doing always being like this on the sofa" or "be quiet, you make too much noise".. They are sick and it is very difficult for them to control..

I wish you a lot of courage for all this and hope he might be stabilized soon

There are forums and also abroad (I don t know here) associations for the parents and family of bipolar disorder persons

Have a nice day..

 

 

 

 

[GeorgeEboy]

It can take a couple of years before they get the right combination of medications. It is a trial and error. It also depends on which episode is the worst, the manic or the depression? There is also Transcranial magnetic stimulation (TMS) treatment. This works more for the depression episodes. Stay away from the Lithium it has bad side effects. The top ones are listed here. List of Bipolar Medications.

[Brickbat]

I had success with my gf and her mood swings using Amino Acids, L Tryptophan, Gaba and L Tyrosine , all available from iHerbs. Don’t get a one size fits all mix.
I used 1/3 of a capsule for all 3 , mixed in fruit juice on an empty stomach in the morning. 
keep up the Vit B complex too.

[EvetsKram]

It sounds like he is rapid cycling,  more associated with schizo affective disorder than with BAD.  Iid definitely be seeking out other opinion. BAD is too frequently diagnosed by those who really don't have a full picture and want an easy way out.  My advice is keep journals,  seek another opinion, try to keep him safe emotionally,  physically,  financially. Remember this,  BAD is a physical disorder but manifestations are mental.  Know the disease & try be friends with it is a good way to go forward,  classical cases have predictive elements you can work with but th Ed disorder if mismanaged can easily destroy

[Baerboxer]

On 5/17/2020 at 7:43 PM, BritManToo said:

I'd say go home to your girlfriend.

This isn't your child, and isn't really your business. He's an adult with his own partner and own home.

As an old guy you get to pick and choose the problems you deal with in your twilight years.

 

It would be nice to think your post was written as some odd humor or when under the influence.

 

Sadly, I think it rather does reflect your view on life.

[Muzarella]

I just send you a message.

[Sheryl]

8 hours ago, EvetsKram said:

It sounds like he is rapid cycling,  more associated with schizo affective disorder than with BAD. 

 

Schizo affective disorder is a consideration and is indeed sometimes misdiagnosed as BPD. The key difference is that in BPD the mood states are abnormal and extreme,  but there are no outright delusions and certainly no hallucinations. Of course the mood states can distort thinking to an extent -- any depressed person will have an overly pessimistic view of themselves and the world, and in manic phase people with BPD greatly overestimate their own abilities and what is possible, but these are different from the frank delusions that feature in schizo-affective disorder.

[geriatrickid]

Medications can help correct a problem that is organic in  origin. However, they require  experience and patience when selecting the correct dosing. Drug metabolism  has many factors including  health status, age, body weight, and other medications  used. In plain language, I can have  5  24 year old  patients with a similar diagnoses, but all 5 can have  a different medication or dose.  In Thailand, due to the shortage of trained psychiatrists and clinical psychologists, GPs can prescribe treatment and they just do not have the necessary training. Even psychiatrists will caution that dosing is an art that must adapt to the patient's  life cycle changes.  All this to say is that if the drugs do not seem to work, it may just be a question of adjusting the dose or in changing the medication. Patience and emotional support  will get you there. the good news is that the patient is the one seeking assistance. that's quite a step in Thailand where there are taboos. When a patient is that motivated, there is more likely to be a  positive outcome, so do not lose hope. We are all different and some drugs work differently on people. It is not unusual for the first dosing to not be as good as it can be.

 

10 hours ago, Bender Rodriguez said:

is he on lithium carbonate ?

to flatten out the highs ?

is living like a zombie better ?

those medications have EFFECTS, not just side effects

start by looking them up on google...

don't you love that side effect of prozac is SUICIDE attemps ?

It is unfortunate that you have had personal issues, but your sabotage is unnecessary.

There is no "side effect" of prozac related to suicide attempts. On the contrary it is considered uncommon. You are  making a false claim that  is tied to  class action litigation seeking a payout in respect to unsubstantiated allegations of product defect.  Prozac was prescribed to patients who were predisposed to suicide because the drug is an anti depressant.  Sometimes the  drug was not effective when the state of mental illness was too great. It is irresponsible to  spread false information as you have. If a patient is prescribed fluoxetine (prozac) it is a matter between the patient and his/her physician, not someone who misunderstands product monographs and  patient treatment protocols.

[Sheryl]

A misleading, scare-mongering and thoroughly unhelpful post has been removed

[Harveyg]

It seems you are following standard medical care.  Are you or he interested in investigating alternative approaches that seek to look at the cause or at least have no side effects?

[EvetsKram]

16 hours ago, Sheryl said:

 

Schizo affective disorder is a consideration and is indeed sometimes misdiagnosed as BPD. The key difference is that in BPD the mood states are abnormal and extreme,  but there are no outright delusions and certainly no hallucinations. Of course the mood states can distort thinking to an extent -- any depressed person will have an overly pessimistic view of themselves and the world, and in manic phase people with BPD greatly overestimate their own abilities and what is possible, but these are different from the frank delusions that feature in schizo-affective disorder.

You are so wrong in what you say.  BAD is an affective disorder so there are periods of psychosis. Both disorders have psychotic elements.... "can distort thinking to an extent" how many of either have you looked after or been involved with at all? 

[Sheryl]

3 minutes ago, EvetsKram said:

You are so wrong in what you say.  BAD is an affective disorder so there are periods of psychosis. Both disorders have psychotic elements.... "can distort thinking to an extent" how many of either have you looked after or been involved with at all? 

Quite a few.

 

Including a damily member originally misdiagnosed as BPD but actuallt schizi affective.

 

Affective disorders are not psychoses. If actual pyschosis is present then by definition it is not BPD.

[Tagged]

16 hours ago, geriatrickid said:

Medications can help correct a problem that is organic in  origin.

Today you can have a genetic test to see what kind of medication could be useful, and what medication will not be helpful and rather harming more than doing good. Designed medication is now possible, but do not know if its possible in Thailand yet. 

 

I was approached with a medication solution for my problems, but I had experience with substances and different meds from before, as alcohol work different on me than others. So I declined any medication, and turn my life upside down to make what I needed to make to be healthy. And I have made it, but it took a long hard journey to make it, alot of reading, and also learning by doing. I have never been in manic state, just to mention, or had any halluccinations. 

 

However I see one here trying to imply to not use medication in a manic state, and that is dangerous solution. A person in manic state need medication! However bipolar have many different levels and layers, and not one is the same, and official there is 2 bipolar statuses that is serious, and those is called bipolar one and bipolar 2.  

 

However Sheryl is the one with first hand experience, and the best one to seek advise from. 

 

Hope it will turn out well for your step son. It will take a long journey and he have to be willing to do all the work necessery to keep himself balanced. Drugs, alcohol, sugar, etc is things to be avoided just to mention a few things. There is alot valid information to find, and he have to take it serious enough even when he feel he is well, he have to remember where he have been, and what it takes to get up again. Easy to forget you ever have been sick before when a new top is reached. The higher you go, the higher you fall.  

Edited May 28, 2020 by Tagged