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Thursday, June 17, 2010

So Here We Are

Today I sat down with Peter, the therapist that Josh had been seeing before being hospitalized. Peter has been very helpful to ME as I've moved through the past few months trying to deal with something I have no knowledge about.

Bipolar.

Specifically, I need Peter to help me in guiding Josh toward mature responsibility. Not just responsibility surrounding his disorder, but his long standing life issues; his inability to just basically get his shit together and act like a 20 year old.

I made headway this week during a discussion with Josh about his need to contribute in some way to the running of this household. He does basic chores if asked, on occasion without being asked, but he has a sense of entitlement that needs to change.

On the one hand Josh insists on being treated like an adult, because hey! He's 20 years old! But often his behavior is more akin to a 12 year old. I've been encouraging him to get a second job since he sat out a semester of college due to his depression. Well, it's about time for college to start again and he still has one job that offers him less than 20 hours a week. There's a whole lot of time in there that he needs to fill.

After much discussion we agreed that he would clean the house each Friday in lieu of beginning to pay me a nominal amount of 'rent'. His brain is so fuzzy right now though that he asked me to text him each Friday morning to remind him to clean the house.

Peter and I agree that baby steps are in order. The one thing that someone dealing with Bipolar needs to avoid is stress. Stress builds and builds and sends someone with Bipolar into a manic episode.

So tread lightly.

Peter and I talked about the discussions that Josh and I have been having where I feel he is leaning more towards acceptance. Peter feels that I am handling those discussions very well, acknowledging how difficult of a diagnosis it is to accept, and stressing the importance of management as the key.

Peter feels that Josh's questions regarding past delusional episodes, and his recognition that he was likely a bit delusional when talking with his friend one night, are all great indicators that he's really beginning to 'see' the truth.

Josh has been extremely flaky today. We went out to dinner and when we returned he told me he was going to smoke pot.

My stand on pot? Well, I'm not gonna sit here and lie and say I've never smoked pot, or lie and say that when I did smoke it I didn't inhale. Personally, I wish they'd legalize the stuff because then the product that our kids would be smoking would be controlled and safer, there would be tax revenues, and if you think for one second that you can control it's use by keeping it illegal, you're nuts.

Do I want Josh smokin' pot? I honestly can't say because I've read such differing views on the subject of pot and bipolar. I think that's a heavy subject for its own post in the near future.

I can tell you this much. The problem with pot is probably twofold. It affects everyone differently and each medication differently and the quality of pot and what it might be laced with is a concern.

And I'll also tell you this. After Josh smoked tonight, he joined me out on the deck and he became increasingly 'sad'. He said he feels like he's a shitty person, that *I* think he's a shitty person. And while his anxiety level was a little elevated all day, he became more and more anxious as the evening wore on. But the interesting thing is that HE noticed this himself.

His anxiety took MANY forms tonight. He's worried about his thyroid, had me pull up a picture of it on the internet. Then he was concerned that the benadryl he was taking to help him sleep was SO little it would get stuck in his throat because his throat hurts and he thinks his thyroid may be enlarged. And he's almost sure he's all of a sudden allergic to his contact solution because his eyes look weird to him and in fact, last night he got some contact solution on his finger and it burned.

It is almost midnight and he's having a hell of a time getting to sleep. I taught him how to belly breath, because he's SO anxious. I finally said, "Go lay down, put on some soft music and belly breath...just concentrate on your breath."

Sheesh, he's wearin' me out.

The fact of the matter is, and I told Josh this, the last eight weeks have been hell. For both of us, but mostly for his poor brain. It's be inundated with all manner of drugs. Sedatives, sleeping aids, this dose of medicine, NO, this dose, NO this dose. Sheesh, no wonder Josh is a walking buffoon.

"I think you'll feel less foggy in a week or so, once all these chemicals are out of your brain, and then we'll see what happens."

And today, while sitting on the front porch with me, Josh looked at me and said, "Well, what are we gonna do if I get bad again?

"You mean like manic?"

"Yeah"

"Well, I don't know. I talked to Patrick today about the Psychiatrists in his office, and that's an option, but he also said they have a Clinical NP who is very good, a little less expensive and he felt she might be a good fit for you, so you should think about if you'd like to see her, or one of their Psychiatrists sometime soon, so they know you, you are under their care, and then if you become manic, we have someone who can help us out."

Josh and I both are having fasting blood work done next Wednesday, ahead of our Physicals which are scheduled for Monday. I will go in with Josh at the beginning of his appointment and discuss our concerns with the doctor. I told Josh that I want him to listen as I talk to the doctor so he can learn to communicate effectively with the professionals in charge of his care.

"It's going to be very important that YOU learn how to ask questions and even challenge the doctors. If they suggest something you don't understand, ask them to explain. If they propose something that you're not comfortable with, ask them what alternatives are available. YOU really are in charge of ALL the decisions about this, but you have to be able to be an advocate for yourself."

4 comments:

Rootietoot said...

ok I am going to take this one little bit at a time.
There aren't that many 20 yr olds who have their shit together. Bipolar or not. Alot of them are in college, getting stoned or drunk (or both) all the time...don't know what they want to do with their lives. all that. I know, I have 3 of them. They also insist on being treated like adults while throwing their clothes on the floor and demanding free food. One of them still lives in my house. Another one of them is probably bipolar but it's mild (thank You, Lord)and he's doing figuring of his own.
AS for the steady chores, that's a good idea for anyone living at home.
Yes to the baby steps.
I am glad Josh seems to be coming to grips withthe whole thing. It's hard, I know.Painful, too.
Maybe he can try looking at the med issue like this: if he had diabetes, he'd be on meds. Or a kidney transplant, or cerebral palsy...chronic conditions that need medication in order to function normally. That's what he has, a chronic medical condition, it just has a mental manifestation instead of physical and that's hard to wrap your mind around when the whole world says things like "crazy" and "institution" and scary mess like that. But Lorda mercy, the difference the right meds can make...normalcy, without the fog...but it takes TIME to get that worked out. It took me a YEAR to get the right combo, and some of the stuff I tried made it worse, but you have to keep plugging at it, and keep trying.

Rootietoot said...

When I was first diagnosed, I starte going here http://harbor-of-refuge.org/ and got good support. It's not all serious, sometimes it's just other people to chat with. I don't know if Josh would be ready to (you have to be on meds and under the care of a psych, and they do NOT approve of pot as a med) but it might be a place you can go to talk to people. You can tell them Rootietoot sent you. I haven't been in a long time but if you want to go I could meet you there. Look it over and read what they say. They're good people (or were, when I was there)

Anonymous said...

Josh is very lucky to have you!

Unknown said...

I could relate to this post in my life right now. I've tried going off medications and the past couple of weeks, probably six to ten have been hell for me and hell for my mom and my therapist. So I have started back on the medications because I don't want to put anyone through more stuff. I know now I need medications in order to be effective and stable. I hope Josh learns eventually.