When do I know if a manic episode is an emergency?

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CNSKris
Regular Member


Date Joined May 2006
Total Posts : 236
   Posted 8/3/2007 5:46 PM (GMT -7)   
My boyfriend is bi-polar, newly diagnosed, but I suspected it for some time (as my daughter is bi-polar).  He is currently experiencing a manic episode: 1 wk severely agitated, irrational and eratic behavior, hyped up, racing thoughts, 3 days little sleep. I am starting to be concerned as to whether or not I need to take him to the hospital as his counselor's office is closed for the weekend. 
 
Does anyone know when one should be sent to the ER?  Don't want to do it as it is upsetting but I don't want this to get out of hand either.  For now I'm trying to keep him as calm and centered as possible.  Any suggestions?
 
Thanks - Kristin
 
  Dx:  Lupus CNS 11/2005; Current - kidney disease, enlarged heart, MVP/regurg, dementia; GERD; vision loss, narcolepsy, rheumatic arthritis, IBS, ovarian cysts, raynauds, EBV/CFS, inflam. liver/spleen. Rx:  Atenolol, Aricept, Flexeril, Motrin  Previous-rashes, hemi-pelagic migraine, sensory loss, amnesia, PTSD/Dep., host of neuro problems, pregnancy compl., False pos. syphilis, fine speck & homogen ANA; IgM; staph/strept infections, colonitis, pancreaitis, gastritis, costochondritis, pericarditis, Hashimoto's, dyspnea, hyper/hypotension, lipedemia, ulcers, pneumonia, anemia, Scleroderma symptoms, vein swelling, etc.  
 
 


Honey Bee
Regular Member


Date Joined Jun 2007
Total Posts : 114
   Posted 8/3/2007 8:50 PM (GMT -7)   
Hi Kristin

I am sorry not to be able to offer advice in this situation but I am sure someone else will. You have posted a very good question here and i would also be very interested to hear what people think and at what 'point' you should be going to the hospital. I find it very difficult to know at either ends of the scale , either manic or depressed. I might be completely wrong here but find it harder being a woman in this scenario as I cannot really 'manhandle' my hubbie to the hospital if he doesn't see the problem or won't go.

I have had a few situations over the years where I think my hubbie should have been hospitalised both with mania and depression and have never really had the courage to do so it would be really good to hear others experiences of how they have known and handled things. I also felt that things could get out of hand very easily and also didn't really have the confidence that even if he went to the hospital he would be properly treated there as I have read so many negative things about people just being sent home again which made things ten times worse.

Honey Bee

CNSKris
Regular Member


Date Joined May 2006
Total Posts : 236
   Posted 8/4/2007 7:52 AM (GMT -7)   

Thanks for the comfort Honeybee.  I guess I will just monitor the situation and use my instincts on this one.  I know with my daughter when to take her to the ER, but like you said it is harder with men.  Especially hard for him to see there is a situation that we may need assistance with.  He does know he is having racing thoughts and feels aggitated, but doesn't get that he is irrational.  He also is afraid to tell me when he gets like this because he thinks I'll leave him or something.  I told him I wasn't leaving my kid over it, so why would I leave you.  He hasn't left me because I get sick from the Lupus.  I guess men feel like they have to be okay all the time.  Sounds strange to me, but I know most of them have this bravado thing going.  Mine is a "man's man" kind of guy so I guess this is hardest for him.

Hope to still hear everyone's thoughts on this.  Maybe we can all benefit.  Thanks again - Kristin


 
  Dx:  Lupus CNS 11/2005; Current - kidney disease, enlarged heart, MVP/regurg, dementia; GERD; vision loss, narcolepsy, rheumatic arthritis, IBS, ovarian cysts, raynauds, EBV/CFS, inflam. liver/spleen. Rx:  Atenolol, Aricept, Flexeril, Motrin  Previous-rashes, hemi-pelagic migraine, sensory loss, amnesia, PTSD/Dep., host of neuro problems, pregnancy compl., False pos. syphilis, fine speck & homogen ANA; IgM; staph/strept infections, colonitis, pancreaitis, gastritis, costochondritis, pericarditis, Hashimoto's, dyspnea, hyper/hypotension, lipedemia, ulcers, pneumonia, anemia, Scleroderma symptoms, vein swelling, etc.  
 
 


_Christina
Veteran Member


Date Joined Feb 2007
Total Posts : 553
   Posted 8/4/2007 10:09 AM (GMT -7)   
When he is a danger to himself or others is the time to get help. Not when he IS, but when you believe that he WILL BE. By the time he has become the danger, it is time to call 911 and get help with getting him to the hospital. This is true for both sides of the scale. The danger can be choices or actions or threats of actions.

One thing is that if you turn yourself in with depression to the ER, saying that you are a threat to yourself, because you turned yourself in, they don’t believe that you are truly a threat to yourself. It is better –if you are serious- to have a trusted person “bring you in”. They will take you more seriously then.

Christina


Christina
 
When you cannot stand, on whom do you lean?

Post Edited (bpc_christina) : 8/4/2007 3:42:12 PM (GMT-6)


CNSKris
Regular Member


Date Joined May 2006
Total Posts : 236
   Posted 8/4/2007 7:14 PM (GMT -7)   

Thanks Christina that will work.  Makes sense.  Guess you get emotional sometimes with the irrational behavior.  Thankfully, it didn't get to that point.  He slept all day today and is calmer now.  Hopefully this bout is over for now.  I'll call the counselor on Monday to see if we need to change medication or if there is another way to comfort him when this happens again.

It is easier with my daughter because she doesn't try to hide it as much.  That and she gets very homicidal or suicidal and I know right away to take her in.  It is tougher when they are doing very odd things but not threatening any one or themselves.  I just can't be there all the time to watch over him and don't want to lose him to the illness.  He just got out of the hospital for being suicidal and I'm a little more emotional about it now.  Tough to keep it in perspective sometimes.

Thank you - Kristin


_Christina
Veteran Member


Date Joined Feb 2007
Total Posts : 553
   Posted 8/5/2007 1:16 PM (GMT -7)   

You're welcome.

The thing is, if you are used to a case that is hospitalized regularly, then it would be more difficult to deal with a case that is right on that "edge". Most cases that I have known did not need hospital inpatient care and did just fine with clinic visits.

When I spoke to my doctor about this (I wanted to go in) he says that insurances don't pay for it unless it is a medical emergency, therefore doctors don't admit people unless they are sure they will get paid.  This makes it more difficult for a person who could benefit from inpatient care, but is not a mortal threat to themselves or others.

Good luck.


Christina
 
When you cannot stand, on whom do you lean?


Honey Bee
Regular Member


Date Joined Jun 2007
Total Posts : 114
   Posted 8/5/2007 5:04 PM (GMT -7)   
Hi Christine

Just wanted to say thank you also for your advice. You are spot on with your reply. I think in our situation there have been several times in the past when we should have gone to hospital but I didn't feel I could press the issue with a very agitated husband and maybe should have called for help. It is difficult to know though like you say when things are so often on 'the edge' and that if you can just get through the next hour or so then the current situation will pass and things will start to calm down etc.

Thanks again.

Honey Bee.
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