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Tuesday, May 3, 2011

A LONG Talk with Josh

I was driving to a client appointment yesterday morning when Josh called.  I sat in the parking lot at my client's office for over an hour talking to him.

He had a lot to say and finally I asked, "Honey, are you a bit manic today?"

"No, I took an adderall because I have a lot to get done today and it makes me like this."

"Well, be careful with those, I've read that they can trigger a manic episode."

He told me that he's staying at his job, but that he's embarrassed because the night he gave his notice he'd had a 'breakdown', complete with tears. 

"Did something happen that upset you?"

"No, nothing at work, but something I was thinking about upset me."

This triggered my memory.  As a Junior in High School Josh worked at a local grocery store as a stock boy.  He had an emotional breakdown, complete with tears, one night there too.  He had been having issues with his Dad and in thinking about that situation, he had a breakdown.

This made me think about some of the other jobs he'd gone through back then.  His first job ever was at Target, stocking shelves.  He was there maybe six months when he quit because he hated it and the people.  Then he worked at the grocery, which he quit and then he worked as a busboy at a local breakfast/lunch restaurant.  He quit that job too.  Then he landed at the video store, and he worked there for over two years.  He was in his element at that job, which is why I think he stayed as long as he did.  But it makes me wonder if Bipolar wasn't present back then to some degree.

Anyway, Josh had been reading and reading about schizophrenia in an OLD, OLD encyclopedia set his Dad had given him.  He seems to be trying very hard to figure out what's wrong with him.

"Well honey, reading that probably isn't helpful, the information is so outdated."

"Yea but Mom, this Bipolar thing seems so fuzzy, I just can't figure out where I fit into all this."

"Well Bipolar IS fuzzy, it manifests itself so differently in each individual person, but a doctor should be able to wade through it all and make an accurate diagnosis."

I told Josh about Jim Phelp's book and the Mood spectrum he describes and that I've felt that Josh falls on the depressive side with a slight underlying mania that feeds his negative thoughts.

"Yes!  Now that sounds like what I'm feeling."

I told him to come by and get my Kindle so he could read the book, that I thought it would be helpful to him.

He talked a lot about how his mind is working and he said he has had a few auditory hallucinations, where he hears music.  "Living in an apartment is great though, if I hear something I just assume it's the neighbors."

He was concerned that those hallucinations are an indicator of schizophrenia.

"Well, a woman I know who has Bipolar told me that she has hallucinations too, but that she KNOWS they're hallucinations.  A schizophrenic often doesn't realize that what they're experiencing isn't real."

"Well that's reassuring.  When I have them, I KNOW they're not real.  I guess I've been thinking that since I have those I MUST be schizophrenic."

"No, and really honey, from the reading I did about it, I really don't think you need to worry about that.  So many of the symptoms between the two conditions are the same, but you HAVE to have significant hallucinations to qualify as a schizophrenic."

"Oh good.  But what about my paranoia."

"Well, do you think people are out to get you?"

"No, not really, it's more like I think people are talking about me and stuff like that."

"What I read about a paranoid schizophrenic is that they SERIOUSLY think people are out to get them, like tapping their phones, poisoning their food, stuff like that.  I think maybe your anxiety is what feeds those thoughts that people are talking about you and stuff.  I really think that anxiety is a big part of your problem actually and I think a good anti-anxiety medication could really help you, in fact, that could be all you need, I don't know."

"I agree, I think I need something for anxiety."

Josh expressed concerns about the costs of all this care.

"Well, I've kept your health insurance in force and I'm glad I've done that.  Yes, this will cost some money, but it will be basic co-pays.  Think about how much more expensive it would be if you didn't address this and wound back up in the hospital."

"True, but I know money is so tight for you right now."

"Honey, please don't worry about that, I don't want you stressed about money.  You concentrate on getting well and working towards being able to handle your own rent and living expenses."

"Well, I've already got $70 saved up for my June rent.  We talked about me giving you $200 this month and that shouldn't be a problem."

Josh stopped by in the afternoon to get my Kindle, use my computer and do some laundry.

I spent a couple of hours with him, but then I had to leave for a late afternoon client appointment.  Before I left I told him, "Honey, I am so proud of you.  I know this is so hard, all of it, and I'm so proud that you are self aware and intelligent enough to process this and want to get help."

The look on his face told me that he appreciated my comment.

"I keep thinking about things like being on medicine and never being able to drink again.  I guess it's hard to accept that there are things I can't do anymore."

I told him about the essay I'd read on acceptance and that the woman who wrote it expressed that very same thing, "but she realized after struggling against this disorder for twenty years, that she could either accept the limitations this presented so that she could stay healthy and have a good life, or she could continue to quit jobs, throw away relationships and travel the country like a vagabond and never really find any satisfaction.  "Josh, it's a choice that every Bipolar person has to make.  You have to CHOSE to accept the limitations so you can stay healthy."

"Yea, I guess so, but that is hard."

"I know it is honey and honestly, there are people who have Bipolar who are able to occasionally drink in reasonable quantities.  They just know that doing so will throw them a little off kilter and they prepare for it and handle it.  They know they can't go on a bender, but they can have a beer or two once in a while.  Other people just can't drink, either because of the Bipolar or the medication they're on.  All this is unknown for you right now and you'll have to figure out as you go along what is possible for you and what actually causes your illness to get worse."

Right now, and really since he moved into his apartment, Josh's mood has stayed in the normal range, possibly leaning alittle more towards mania actually, but the depression has lifted.  I know that the depression can settle back in at anytime though and I don't think in a depressive state, Josh would be able to maintain this desire to get help.  So for me, time is of the essence here.

I'm waiting for Josh to text me his schedule for this week so I can call the doctor and make an appointment.  I will adjust MY schedule to accommodate this.

Sunday, May 1, 2011

Not Even Sure What to Title This Post

Something pretty amazing has happened and while I should be on Cloud 9, I'm kind of surprised that my feelings are what they are.

Let me explain.

Yesterday I was home all day because I was having a Garage Sale.  Friday Josh asked if he could come over Saturday and use the computer to apply for jobs online.

So I was expecting him yesterday, but he never showed up.

About 4 o'clock I began getting worried about him, so I texted him, "I thought you were coming over today."

No response.

By 5 o'clock, I was beginning to get really worried.  My BF tried to relieve my fear by saying, "He probably got off work really late (he worked at 10PM) and didn't get to bed till 4 or so this morning.  He's probably just asleep."

So I tried not to worry.  The BF and I had plans to go out, so we went.  But the entire time I kept checking my phone. 

Josh finally called, he'd just gotten up and seemed a little put out that I wasn't home.  "Well honey, you can go to the house and use the computer."  He said, "OK," but he sounded 'weird' to me.

A few hours later he called me, "Mom, I'm sorry to bother you but I really need to talk to you about something."

"You're not bothering me honey, what'd you need?"

"You know you talked about taking me to that Bipolar doctor?  Well, I think you need to make an appointment for us."

I was completely taken aback by this, and for some reason, at times like this with Josh I try to react very nonchalantly.  I did this when he was manic.  The entire time he was behaving like a 'crazy' person, I tried very hard not to let him KNOW that I thought he was behaving like a 'crazy' person.  It's the strangest thing, I don't understand why I do this, but I do, and for some reason I didn't want Josh to sense my true feelings at this moment when he asked me to take him to a psychiatrist. 

"OK.  Well I researched that doctor that was referred to me and I wasn't very happy with what I found so I didn't look further, but I'll get right on that Monday honey.  I just want to make sure we get in front of the right doctor."
"OK, I love you."

"Love you too honey."

And we hung up.

I turned to my BF and said, "You won't believe this.  Josh asked me to take him to a Bipolar doctor."


"Yea.  God, I wonder what made him decide this."

The BF must be like me, cause his reaction was about as nonchalant as mine, but I think we were both sitting there just thinking about it. 

"I wonder if he began to regret quitting his job, you know, maybe in a different 'mood', he looked back on it and maybe saw that something bigger was at play when he made that decision."

My BF said, "Well, he could talk to them, just explain he's been under a lot of stress with his move and the new job and all and ask if he could stay."

"From what he's said, I think they like him and it sounds like they think he's doing a good job, so maybe they would let him stay."

And we sat there and thought some more about it and I was wishing I'd asked him more about his change of heart.  I was having such mixed emotions.  This came out of thin air.

Then Josh called me back.

"Mom, I think I need to tell you something else, when I went to the house, I didn't look for jobs online, I did some research and when you're looking for a doctor,  you need to find a doctor who can really make a good diagnosis cause I'm beginning to think that maybe I'm not Bipolar, I think I might be schizophrenic."

"Really? Why do you think that, do you hear voices and have hallucinations? I mean, I don't know much about schizophrenia, but I always thought that was one of the big differences between it and Bipolar."

"Just read about it Mom, there are four basic kinds of schizophrenia, and I kinda see myself a little bit in each of them."

"OK, I"ll research that, and I'll make sure that we find a really good doctor honey, but Josh what brought this on, I mean, are you regretting quitting your job?"

"I don't know."

"Well, if you are, I think you could talk to them about that."

"I talked to my manager last night and she said I could stay, and I'm gonna talk to her again tonight, but I don't know."

"OK, I want you to do what's best for you honey, only you know how you're feeling."

We hung up and I was totally wigged out.  "Josh says he thinks he might be schizophrenic and I don't really know much about that disorder except that in reading about Bipolar it seems like schizophrenia is so much worse, so much harder to treat and all."

I got pretty worked up, mostly I was feeling so sad for Josh, that he was going through all this and I was thinking about how he must be struggling so much trying to figure out what is 'wrong' with him.

I began crying thinking of Josh, normal and happy, just a few short years ago.

"Well," my boyfriend said, "this is a start at least."

"Yes, but I guess I'm feeling like that's all it is, just a start.  Tomorrow his mood could change and he'll be back to total denial, or during the process of finding the right medication he could hate the process; the way the medication makes him feel to the point of giving up.  I'm glad he's taking this step, but I guess I'm realizing what a long road lies ahead of him."

Of course, the first thing I did when I got home is research schizophrenia, and I'm not an expert, but I just don't 'see' Josh as schizophrenic.  He never answered me when I asked if he's hearing voices or having hallucinations, so I don't know if he's having those major hallmark type symptoms.  The only other area of schizophrenia where I think he fits is paranoia.  He's never expressed feelings of people being out to get him, but he recently said that he doesn't trust anyone and therefore he doesn't trust what anyone says to him.  This statement was in relation to his job, that his manager said he's doing a good job, but that he doesn't trust anything anyone says anymore.

One of the types of schizophrenia is called catatonic.  In this state people just stare into space, sometimes for hours at a time, not blinking.  But it also describes people with this disorder to be, well, I guess, unemotional.  Incapable of joy or anger.  Josh may see himself here in the sense that he feels no joy with life, but he has no problem expressing his anger, so again, I don't see him in this, and he's never appeared catatonic to me, even for short periods of time.

So, I don't know.  What I did read is that Bipolar and schizophrenia are often misdiagnosed for each other because there are many similar symptoms, but it seems to me in my reading that hearing voices or having hallucinations HAS to be present and ongoing for a month for a diagnosis of schizophrenia to be made.  I'm praying he's wrong because it does sound much harder to treat schizophrenia than Bipolar.

So I'm scared and unsettled.  Nothing new here really, I've been scared and unsettled for over a year now.  It was just over a year ago that Josh was hospitalized.  It has been the longest year of my life.

I have to pass this on too.  I spoke with Josh's brother Friday, telling him that Josh had quit his job and  I expressed how helpless I felt.  We talked about the financial ramifications of all this on me and how impossible it is to talk to Josh about all this stuff.

I got an email from Josh's brother late that night.  He sent me links to a bunch of sites that offer financial assistance and medical support for someone with disabilities, including Bipolar.

"I don't know what we're gonna do with that kid, but maybe you could call some of these places and get some help with all this, for you and for him."

I thought that was sweet of him to take the time to look into this stuff.

Clearly we all want Josh to get 'better'.  We all realize there is no cure, but there is a path forward for him and I'm trying to not project into the future very far and just be glad that Josh has finally put one foot on that path.

On a lighter note, I hope Josh doesn't have schizophrenia because when I spell checked this post, I had spelt it wrong about half the time.  Bipolar is much easier to type.