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serafena
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Date Joined May 2007
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   Posted 10/1/2007 9:35 AM (GMT -7)   
Hi everyone. I'm transporting this posting from another thread for Dasa: Please respond to it here.
Thanks, serafena
----------------------------------------

I'm new here. I've been reading some of your posts and I'm so impressed with you Sukay as to how you are able to be aware of your bp behaviors and can ward them off on your own alot. It is also absolutely wonderful how all of you are so supportive of one another.

My husband has been to a pychiatrist and so far diagnosed with anxiety. He now just takes cymbalta for depression, klonopin for depression and insomnia and requip for restless legs. We asked the psychiatrist to try him on an ADD med but he wants him to go for testing with a psychologist in another county before he will prescribe it.

He has taken Strattera which helped him alot but kept him nauseated. He was on Zyprexa briefly and he liked it but it was sooooo expensive we couldn't afford it and it made him food binge. These were prescribed by his regular MD before he started seeing the psychiatrist. He was on valium for many years and went through a terrible withdrawal when the doctor wouldn't continue to write them and the new psychiatrist switched him to klonopin.

I read Loving Someone with Bipolar Disorder and really feel like he shows most of the behaviors of bipolar. The ADD and/or bipolar behaviors are so bad for him that it makes him very disfunctional and he is serious jeopardy of losing his current job.

I would like to know how those of you with bipolar disorder learned the skills of how to get control. He has become more aware of it by listening to me tell him what I've read. But he won't read for himself. When we go to a drs appt he is often throws off a true diagnosis by not telling the whole story of his problems because he doesn't want to look bad. I try to keep him on the right track. He also goes off in another direction when talking and forgets what the original topic was.

He has episodes of panic attacks, insomnia, gets really hyper, often goes out and shops too much and spends money on things that we already have or that he can't find or because he gets excited about something he sees but we can't afford, extremely disorganized, can't or won't complete projects and lays in bed alot during the day. He can't or won't keep up with time and lets days tick off without staying aware of time restraints. He is always late for appointments or doesn't show up and makes excuses later. He procrastinates to the extreme even with things that is fun for him. He has battled depression and says that he wrestles with his thoughts alot. He often talks constantly and brags that he doesn't meet a stranger. He wants everyone to like him so much that he will give away things to friends and those he just met and needs constant compliments from me. He wants me to bring him things, find things for him and is constantly wanting attention from me unless he is engrossed in talking to someone else. He constantly complains of illness or his latest boo boo.

He is also alot of fun at times and a very funny person. Also a loving, kind person most of the time. He use to be verbally abusive but has stopped for the most part when I stood up to him and told him that he had to quit or I wasn't going to continue living with him if he didn't. He is also very smart and creative but his potential is getting dwarfed by these behaviors.

After reading that book, it scared me that he is going to need constant help in managing bp but after reading your posts here, I am having more hope. Actaully seeing that you guys are doing your best to stay aware and coping positively is huge. And so encouraging to me. I am about at my wit's end with our situation!!

What is the best way for him to learn how to help himself and also for us a couple. We have been married over 20 years and don't have children. We have been trying run a business at home together which is very trying and not working too well.

Any help sure would be appreciated........ :-) Thanks.....Dasa
Serafena
Co-Moderator, Bipolar Forum

Ask me about my Bipolar Disorder!


serafena
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Date Joined May 2007
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   Posted 10/1/2007 9:56 AM (GMT -7)   
So, hi again Dasa.

I have a couple of responses. First, if you don't believe the psychiatrist is correctly diagnosing your husband, you need to talk to the pdoc about that. You've written down a list of behaviors here. I'd make a similar list next time your husband has an appointment and go with him. Don't show him the list before hand, and share the list with the doctor. Try not to exaggerate or get too emotional when writing this list, and try to be as specific and cut and dried as possible. You don't want your husband to feel ambushed. If you can, list a few specific dates/specific examples of behaviors you are most concerned about so that when your husband tries to deny them you can share the facts with him. You don't want to be accusatory, just to be well-equipped. Your goal is to bring the correct info to the doctor if your husband is unreliable. You want your husband to get the correct diagnosis and the correct meds.

If the doctor is hurried and tries to rush you out of the office, don't let him. Be aggressive and keep asking your questions. You have a right to know about why he's diagnosing your husband as he is. And if he refuses to be accomodating or listen to your questions, it's time for a new doctor. Be sure to ask him about Bipolar II. It's a diagnosis of bipolar which is only recently being used with any regularity, and maybe this doctor isn't considering it. If he truly feels that your husband is depressed and not bipolar, then great, but make the doc explain WHY that's his diagnosis. Maybe your husband really isn't Bipolar and for all your sakes, I hope he isn't. It's a tough road, but we all learn to live with it.

As to getting to know his own triggers, that takes practice and close observation. He's going to have to get his disorder under control a bit before he'll be able to understand what makes him worse. A few things are more or less universal though: Sleep, alcohol or drug use, excessive stress. Make sure he's getting enough sleep, avoids alcohol or drugs, and excessive stress. (Seems obvious, doesn't it?) When you figure out how to avoid stress, tell me, okay?

Take a look at The Bipolar Disorder Survival Guide: What You and Your Family Need to Know By David Jay Miklowitz. It discusses how to identify one's own triggers.

Good luck.
Serafena
Co-Moderator, Bipolar Forum

Ask me about my Bipolar Disorder!


Dasa
Regular Member


Date Joined Sep 2007
Total Posts : 37
   Posted 10/1/2007 11:06 AM (GMT -7)   
Thank you Serafena,

The pdoc sent him to this psychiatrist originally because he wouldn't prescribe his valium. And he said he wasn't comfortable prescribing an ADD med. Hubby's pdoc before that had him on valium.

His pyschiatrist got a little huffy with me when I asked why he wouldn't try him on an ADD med. At first he said "because I don't want to". I said well, I just wonder what your reason was.....? and then said because it is speed and he would need the other clinic to diagnose ADD. I guess he is concerned about prescribing controlled substances on his own and he also said that there have been those whose with a bad heart whose heart stopped when taking speed. Dh has had his heart checked out thoroughly and it is fine.

The first time we went, I showed the psy a WebMD test that dh took which he scored extremely high for ADD. He wanted to keep my print out. I have been disappointed that he wasn't able to help dh more. He sure got his depression some better but he is still having all of these other behaviors that are wrecking our lives. The psy doesn't talk to dh long except for the first time, writes the scripts and dh is out the door.

I will get that survival guide and thank you for the information! Is is possible for dh to learn these skills without medication?

Do you think that we should go to another psychiatrist or go to that pyschologist that he suggested?

I thought a pychiatrist could diagnose ADD and bipolar. But it's obvious that he won't. I don't know how trained pyschologists are in these disorders.

Thank YOU for your help!!

Dasa

olivia of course
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Date Joined Jul 2006
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   Posted 10/1/2007 12:11 PM (GMT -7)   
Dasa,

I wanted to welcome you to the HW family and the Bipolar Forum.
Olivia
Co-Moderator, Bipolar
 
Dx:  Bipolar I, Anxiety-Panic Disorder
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Dasa
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Date Joined Sep 2007
Total Posts : 37
   Posted 10/1/2007 2:14 PM (GMT -7)   
Thank you Olivia!!  :-)

djdaz_1985
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Date Joined Jan 2006
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   Posted 10/2/2007 2:44 AM (GMT -7)   

Hi there,

I am no expert in BiPolar disorder but I thought I would throw in a useful piece of information. I am a psychology student, in training to be a clinical psychologist. We do get taught about BiPolar disorder, Depression etc... so a psychologist may be able to help you. The only thing is that (In the UK) a psychologist cannot prescribe any meds unless he has done an extra course. That is the job of the psychiatrist. But you might find it useful to get a 2nd opinion from a psychologist and take it from there.

I hope this helps

Darren 


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Honey Bee
Regular Member


Date Joined Jun 2007
Total Posts : 114
   Posted 10/2/2007 5:23 AM (GMT -7)   
Hi Dasa

I have just read your post with interest. I have been with my BP hubbie for 21 years but he has only been 'properly' diagnosed with BP 1 for the past two and a half although he has definately been suffering with this disorder since he was 13 years old.

Also I am in a very similiar situation to you in that we own our own business and work from home so we are together 24/7. We also don't have kids which is a decision we made final earlier this year due to the worry about the effect my hubbie's condition would have on him and raising them and also the big chance that we would pass the disorder on which we did not want to do. Working together can be great as I am sure you know but does present its own set of challenges. The one I struggle with the most that I find when my hubbie is 'ill' (and by that I mean both being very low and very elevated) then I find that his 'mood' in these states totally encompasses me as well. In fact I have found that the older we get the more I am having to accept the role as 'carer' for him at times which is hard to come to terms with when you are both adults.

Regarding your husband's diagnosis, it certainly sounds like he is exhibiting some of the behaviours of BP but you do really need to find someone who is willing to investigate him thoroughly and give you a proper diagnosis. It is also possible that he could be suffering from more than 1 illness. My hubbie also has Borderline Personality Disorder and some of the things you mention ring true with this. However, a lof these illnesses have common 'behaviours' so again it is difficult to tell.

I would strongly suggest a psychiatrist over a psychologist. My hubbie did visit a psychologist went we first discovered about BP but she straight away suggested a visit to his GP who then recommended him to a psychiatrist. From what I know and our own experience these are really the only people who can give you an accurate diagnosis and also prescribe suitable medication. If you are not happy with your current one can you go to another for a second opinion? I know this is not always easy but it is too important to you and your husband not to get to the bottom of his condition. Also it is CRITICAL to the diagnosis that whoever you see as a 100% accurate picture of ALL your husbands behaviour, however embarrasing or horrifying it may appear to him (or you) they will almost certainly have heard it all before and not bat an eyelid! I would keep a diary yourself of his mood on a daily basis, both descriptive and also give it a rating from 0 - 10, 0 being very depressed, 10 being very elevated for example and go to the doc with him and give them a copy (with your hubbies approval of course). I think you doing the diary in this way may give the doc a more even/honest opinion as your husband may find it hard to do this depending on how he is feeling on any one day it can be hard to see things clearly.

If it is BP then I can honestly say IMO you are going to have a long and arduous journey ahead of you (I am sure after 20 years you already know this :-)) In our experience even with diagnosis for us in the past 2 years I would say our situation has got worse actually if anything. We unfortunately now feel more worn down by the BP as having spent 2.5 years trying several different meds (and yet another new one starting tomorrow) I feel that we are even farther away from finding something that works. I think when you first get a proper diagnosis your spirits lift as you think you have finally found the 'answer' to all of the years of torment but then feel even more dismayed when you realise just how difficult it is to treat. I don't really think you ever get 'in control' you just have periods where things are better than others.

How do we cope? Not very well this year I am afraid, BUT all of the things you will have read on this forum can help such as: Gaining as much knowledge as possible about the disorder, doing your own research on any meds your doc prescribes, being vigilant of the symptoms going into depression and elevation and developing strategies to discuss them honestly with each other and cope with them. Agreeing on practical things to do with spending money such as not making a purchase over x amount without thinking about it for a day or two first. Trying not to let the BP rule both your lives. There are many more but these were the few that came to mind.

Anyway, hope this helps and that you know you are by no means alone in what you are going through.

Honey Bee

Post Edited (Honey Bee) : 10/2/2007 6:25:54 AM (GMT-6)


serafena
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Date Joined May 2007
Total Posts : 3715
   Posted 10/2/2007 5:55 AM (GMT -7)   
One other thing I thought of last night, Dasa, and I said, I'm no doctor, but I have heard that the ADD meds such as Ritalin don't function the same in adults as they do in kids. They are stimulants, and if your husband is manic, I cannot imagine why he would want speed. That would be disastrous. Same thing with Valium. If he's depressed, a doctor probably would prescribe an anti-depressant -- as they did, not something that would just knock him out (a depressant). I would guess Valium would be the opposite of what he needs.

Just to give you some idea of how BP meds work: most docs try to give something to stabilize your mood (lithium, lamictal, etc.) They often give you something else to calm your current mood (an anti-depressant if you're depressed, an anti-psychotic if you're manic). Then they also give you one more thing to help you with anxiety or sleep. It can take a long time to get these meds figured out. Everyone's chemistry is different, obviously, and the meds are tricky. It's hard to say how they're going to work from one person to another so it's a bit of trial and error. The meds also have to be adjusted fairly frequently. As your moods change you have to get new meds, or have your dosages adjusted. Medication maintenance is half the work of BP. :-)

I think both Honey Bee and DjDaz have the right idea. A second opinion is definitely in order for you guys.
Serafena
Co-Moderator, Bipolar Forum

Ask me about my Bipolar Disorder!

Post Edited (serafena) : 10/2/2007 6:58:24 AM (GMT-6)


Dasa
Regular Member


Date Joined Sep 2007
Total Posts : 37
   Posted 10/2/2007 8:34 AM (GMT -7)   

Thank you Honey Bee for responding and giving me such good first hand information.  You really are living this just as I am.  Yes, I feel so overwhelmed by his ups and downs and overspending and more as you know.  I use to be so productive and organized.  Now, I feel alot of fear and seem to stay numb over how he just lives his life in general even more so since we have started working together at home. 

It is a type of business where his input is essential so it isn't a good situation at all.  He stays in bed so much and wants to work from his bed alot and wants me to bring him the things that he wants.  I try not to enable him so he will get up and do what he needs to do unless he truly is really sick but it is such a struggle and he pulls the energy and motivation out of me daily just trying to live with him much less run this business with him.  He thinks that it is ok to just get back to a customer when he feels like it.  I often have to wake him up to take a customer call and he lets them know that he is still in the bed because he didn't sleep well the night before.  But it is often the only way I can get him to get up and get on with his day.  Then he gets up and often takes off for shopping and out to eat by himself if I won't go. 

I really dread getting new meds because we have been down that road alot already so I know what you mean about the side affects can often be as damaging as whatever the disorder is.  Yes, he could have more than one disorder going on because I really see ADD because he gets distracted and loses things constantly and has trouble listening during a conversation.  Also, the BPD is possible because he had a very traumatic childhood, one that involved losing his alcoholic parents while still a teenager.  But this pyschiatrist doesn't counsel with him to find out, he just asks if he is having any problems and writes another script.  Maybe I should be more adamant about trying to get the information out during an appointment but the doctor often stops me from talking by changing the subject at the first opening to something else like giving dh samples or something.  And dh talks alot so it is hard to get a word in between them.  This psy is a friendly type guy most of the time and keeps dh talking but about things that don't matter.   

I have heard that psychiatrists only give medications and that pychologists determine or diagnose what the disorders are and then tells the psychiatrist so I felt like you guys know better than anyone which way to go.  I don't have a problem going to someone else for a second opinion and dh will do just about anything I want to do.  I read where the bp folks here often go to the hospital.  That is something we haven't done in any of dh's symptoms of depression or manic or maybe hypomania type episodes.  Should we be calling the doctor every time he has a new mood or won't get out of bed?  He is very dysfunctional alot. That mood chart is an excellent idea, I will start it today. 

When dh overspends, it's not like he wipes out the bank account but he will go into a store like Walmart or Walgreens Drugstore and spend $200 or $300 on stuff that we already have or just junk we don't need (or gifts for other people for no occassion!!).  And he wants to spend an unlimited time just browsing up and down the isles for entertainment, like a kid in a toy store.  He wants to make big purchases like RVs and vehicles, etc. with no regard to our budget or income limitations.   

Thanks Serafena about the information on the how tricky the meds are.  Maybe that's why the psy won't give dh an ADD med is because he isn't sure if he has bp and he is afraid of how it will react on him.   But I wish he would be more forthcoming on what he thinks is going on with dh.  He said once that he had to do this in a scientific way as far as what meds and dosages he would give.  Also what you are saying sounds like he will need to constantly go back to the doctor for new medication every time he turns around.  We don't have health insurance, I don't know how we are going to do that.....

I have thought about just writing the psy a letter with all of dh's behaviors about a week before his next appt, not an emotional one, just the behaviors explained so that he will have to know more when he talks to him next time.

What do are the bp patients go to the ER for?  Is is when they are in a mania stage or a depression stage and can't cope any longer?  What can the ER medical staff do if they are already under medications from another doctor?

Thank you all for helping me understand this.  I really appreciate your help.   

      

 

    


serafena
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Date Joined May 2007
Total Posts : 3715
   Posted 10/2/2007 11:41 AM (GMT -7)   
I'm not sure where you are Dasa, so I'm not sure about the psychologist/psychiatrist division. Are you in Canada? I know things work slightly differently there. As far as my experience goes in the US, psychiatrists can do it all: they're the big guys. Diagnose, prescribe meds, therapy, hospitals, testing... you name it. Psychologists do everything BUT prescribe medicine -- so they do testing, they do therapy, they work in clinics, etc. They just don't prescribe meds. I can't say for sure, but my guess is your psychiatrist isn't sending your husband to a psychologist in another county just because he's a psychologist, rather, I'd guess he's sending him to a specialist -- a center or diagnostic team who work with a specific condition like ADD.

I also think you're running into a common problem with self-diagnosis: many of these illnesses have very similar causes and symptoms. Is his problem ADD, BPD, depression, anxiety, bipolar, all of the above? All of them can claim childhood trauma as a common background symptom. All of them involve sleeplessness, antisocial behavior, inability to concentrate. Only a professional's going to be able to tell you. And your doc's right, you do have to go about it somewhat scientifically, because the meds can cause really adverse reactions. You're messing with your brain chemicals. For example, if you believe someone is depressed and you give them certain kinds of anti-depressants, it can trigger a severe manic episode: paranoia, hallucinations, the whole works. That's really dangerous. You'd need a doctor to help you figure out what kind of meds are going to work best.

Don't get me wrong. I don't have all doctors on a pedestal. Not at all. I know they make mistakes and many of them are too overworked and impatient to do a good job, but they know a h**l of a lot more than I do about this stuff.

I'm so sorry to be the bearer of bad news, but no, a single drug is probably not going to "fix" your husband. He may get lucky, like I did, and find one that works pretty well the first time out. But I have a GREAT psychiatrist. I asked around, I talked to therapists and other professionals and I asked, "who's the best"? And I went to her. But I have insurance. That makes a big difference. Still, even when I'm relatively stable, I have to go see her every 6 to 12 weeks for a check up and medicine evaluation.

I'm not trying to be discouraging, but you seem to want the truth. This is what it takes to be stable on meds. I know there are others out there who have tried and managed to go periods without medication by watching their diet, taking dietary supplements and getting exercise, but you would have to be very vigilant about that approach, I think.

Finally, I may be wrong, but as far as I know, BP patients mostly go to the hospital only when they are a danger to themselves and they are taken there by loved ones.

I hope this is helpful and not too discouraging. There are programs to help the uninsured with drug costs. I don't know about them off hand, but I can help you find out if you like.
Serafena
Co-Moderator, Bipolar Forum

Ask me about my Bipolar Disorder!


Dasa
Regular Member


Date Joined Sep 2007
Total Posts : 37
   Posted 10/2/2007 1:54 PM (GMT -7)   
Thanks Serafena, we are in the USA. Dh is on 3 meds now and sometimes they work but not always. He goes every 6 months too and we can do that right now but if it started getting to where he had to do it every week or two, that was a scary thought. You are right, I do want to know the truth regardless of how discouraging. His dysfunctional life is the most discouraging of all so I just want him to get diagnosed for what is really going on. I just thought maybe we were missing the mark by not calling the doctor when he can't sleep even when he takes the meds and then lays in bed all day and also the spending/shopping trips that he does every few days. If the psychiatrist knew this maybe he would learn more about dh's behaviors and come to a better diagnosis as we go along. Dh takes his meds reguarly so that's not his problem.

Since you say that the pychologist can diagnose maybe we should go ahead and go get him tested instead of starting over with someone else. The website for the clinic where she works is for specializes in addiction treatment....?? But maybe that is just something else that they do there.

Thanks for the offer to help find a source of drug costs. I might ask you one day if we get in a bind. There are a couple of places here that I need to check into also.

Thanks Again.......You have been a big help!!

serafena
Veteran Member


Date Joined May 2007
Total Posts : 3715
   Posted 10/2/2007 7:02 PM (GMT -7)   
Yeah. Why not? Go ahead and see the psychologist. At least she'll have a different perspective, and perhaps a better bedside manner, than the other doctor. Maybe she'll be more patient and really try to find out what's troubling your husband.
Serafena
Co-Moderator, Bipolar Forum

Ask me about my Bipolar Disorder!

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