Request for my Friend Aaron and his son Joshua

[WRideout]

I have worked with many individuals who have bipolar, and it is a truly frightening disease. The good news is that the treatment nowadays is very effective. The patient will need much education, encouragement and assistance to stay on a medication regimen.

Wayne

[Thundarstick]

Yes and yes! My wife and I have been actively encouraging Aaron about how treatable this is, but how important it is for Joshua to understand the importance of, and need for the medication. Both parents have been going to visit every day (about a100 mile round trip), and have been educating themselves. I'm hoping that this treatment center does some family education and I'm assuming they would. I'm praying that Joshua is receptive to the fact he needs continuing medication and counseling. Mental health issues can be so frightening, but I'm praying for the best.

[Wayne Smith]

The bump he will need to get over is that he feels better because of his medication, not in spite of it.

I have a client who I diagnosed bipolar many years ago. She had an absolutely successful suicide plan if her MD did not find a successful treatment plan. He did. She has her MS Physical Therapy, Black Belt in Judo, and worked throughout this process. She told me that she stopped teaching Judo because her body hurt too much and wondered how long she could continue PT for the same reason. I encouraged her to go back to school and get her MA Counseling - after some trepidation she did. She is now in her post MA internship and stable, obviously.

She told me she was considering going off her medication! I asked her how she planned to manage, and told me if she has symptoms she would start her meds again. I told her it was a very bad idea. She asked Why? I told her "Because you used the word "if"."

She laughed and said it was the best intervention she ever heard.

My point is that if anyone should have fully realized this fact it should have been her. This hopeful delusion never completely goes away. It has to be constantly combated.

[WRideout]

People who have bipolar go through a progression from depressed, to stable, to hypomanic, then manic. For those who tend to stay at the "high" end, the desired state is hypomania. At that stage the patient exhibits all the behavior expected from bipolar disorder. He or she will begin to feel amazingly good, then believe they have powers and abilities they have never had before. In this energized state they can stay awake for days, and even work all that time. Eventually they become manic, at which point it scares even them. Then they crash.

In my experience, bipolar people who don't take their medication do so because they truly intend to reach hypomania, and stay there. They will seek it out as if it were a street drug, and can't believe it would harm them. Initially, close supervision will be required to make sure that they are actually taking their medication as prescribed. The corollary is that the patient will have to spend some time getting used to the idea that feeling "normal" is actually okay, even without the euphoria of hypomania.

Wayne

[Wayne Smith]

It's a little more complex than that, Wayne. You left out the mixed episode - the energy of the mania and the mood of the depression - most describe it as an absolutely miserable agitation. If a bipolar is going to successfully suicide it will be in a mixed episode, in the mania they don't want to and in the depression they don't have the energy or willpower to go through with it.

Also realize that every bipolar is different - they need to learn their symptom progression and process. It will be different for each one. In my practice probably half of my cliental are bipolar or schizophrenic or both. No two are alike - so each one getting to know themselves is a cornerstone of treatment. I recommend that each client get a large calendar and write for each day one of four words - "normal", "mania", "depressed", or "mixed". Some may have to write two words. The idea is that they can get to know their progression over time and begin to predict their own progression into the future. Why plan a vacation when you know you will be mixed or depressed?

Also there is a misconception in the understanding of the bipolar. Most people, even professionals, will say that the bipolar person cannot handle stress. This is not true. What they cannot handle is surprise. Not even a positive surprise. They should have the most predictable life possible.

[Thundarstick]

Joshua is in complete denial, and it looks like they are going to keep him into next week. Aaron and his wife have not been counseled at all, and are trying to educate themselves. I suppose there is no way to make an adult child take medicine they don't think they need. I'm afraid this isn't the end, but just the beginning.

[GhostHawk]

I hate to say this. And I am not saying he is not bipolar.

But is there any chance he is possessed?

[wv109323]

Prayers sent for a complete result.

[Wayne Smith]

I hate to say this. And I am not saying he is not bipolar.

But is there any chance he is possessed?

Not impossible but if he calmed down under medication that strongly suggests not. If medicine works it is not likely to be possession.

[WRideout]

It's a little more complex than that, Wayne. You left out the mixed episode - the energy of the mania and the mood of the depression - most describe it as an absolutely miserable agitation. If a bipolar is going to successfully suicide it will be in a mixed episode, in the mania they don't want to and in the depression they don't have the energy or willpower to go through with it.

Also realize that every bipolar is different - they need to learn their symptom progression and process. It will be different for each one. In my practice probably half of my cliental are bipolar or schizophrenic or both. No two are alike - so each one getting to know themselves is a cornerstone of treatment. I recommend that each client get a large calendar and write for each day one of four words - "normal", "mania", "depressed", or "mixed". Some may have to write two words. The idea is that they can get to know their progression over time and begin to predict their own progression into the future. Why plan a vacation when you know you will be mixed or depressed?

Also there is a misconception in the understanding of the bipolar. Most people, even professionals, will say that the bipolar person cannot handle stress. This is not true. What they cannot handle is surprise. Not even a positive surprise. They should have the most predictable life possible.

Thanks for the clarification, Wayne.

Wayne

[Thundarstick]

Joshua came home yesterday. Aaron and his mother are thrilled about the positive change in their son. It's hard to realize that just under two weeks ago the absolute turmoil this family was in, and the praises going up today. I stopped by this morning, and Joshua is truly back, with a positive outlook, and thankful that his malady could be and is being treated. He seems to have a very positive outlook on his future and is continuing counseling. Raise up a praise, and for continued positive outcome. Thank all, GOD is good!

[Pine Baron]

Thank God for answered prayer. All Glory to our Lord and Savior. Amen.

[WRideout]

Through Christ, all things are possible. Praise God for a good outcome.

Wayne