And I Just Keep Learning........

Originally posted on my private blog on June 16, 2010

Yesterday I went with Josh to his Nurses Appointment at the Mental Health Center. The nurse took Josh back and wouldn't let me go back with him. But when he came out, she asked to speak to me.

She said that Josh is unwilling to continue therapy there, has been resistant to talking to ANY of them and because of that he is considered to be no longer under their care, therefore she can't provide a prescription for him.

"That's fine," I said, "that's his decision, but he's chosen to stop his medication and I was hoping that you could at least prescribe enough medicine for him to carefully step off the meds."

"Well, I'm willing to give you a one month prescription, but really, he doesn't need to step off of this. He's on a fairly low dosage, so if he discontinues it, there will be no withdrawal symptoms."

Then she preceded to tell me that Josh needs addiction counseling. "He's going to get nowhere until he stops using pot, and I explained that to him, explained why pot interferes with his disorder. This is a very difficult situation for you, I know that, what are you doing to take care of yourself?"

"Well, I have a lot of support from friends and family and I attend a Bipolar Support Group, I'm doing ok, but yes, it's a very frustrating position to be in."

"Yes it is and I'm glad you're getting support, but you should consider seeing a therapist for yourself to help you with all this. The lines between helping and enabling get very blurry when you're in the middle of something like this."

Duh.

Josh and I spent the rest of the day and evening together. We talked a lot. And for the first time I felt like I'd made a few small victories. He began asking me more questions about his behavior, specifically what things he'd said in the past that seemed delusional.

"Well, you told me that you and I could get along together better if I'd open my bedroom window. That my office window was open and that we could live peacefully here together if I'd just open my bedroom window too."

"Yeah, but I know what I meant by that."

"What did you mean then? In what context does a statement like that make ANY sense?"

He started to talk, but stopped and stared off into space. Then his face fell and he said, "None huh?"

Then later he said that when his friend Jon was over the night before, Jon told him that he didn't seem like himself, so he was thinking about what he had been talking about at the time, "I think maybe I was a little delusional Mom."

And the look on his face? Well, it was heartbreaking, because he looked so defeated.

"Josh, I know it must be so hard to realize that you've said things like that that make no sense, but to YOU, in a certain frame of mind, at the time, they made PERFECT sense. That's why I wanted you to read that book, "Welcome to the Jungle". She says, "Hey, it's horrible to find out you have this disorder, that you have something that can't be cured and that you have to live with for the rest of your life; that totally sucks," but the book is very empowering Josh cause she shows you that yes, it sucks, but it's manageable, you can live a normal life if you manage it properly with medication and good lifestyle choices, cause the alternative, to do nothing, will destroy your life."

"But how Mom, how can something like this destroy your life?"

"Well, it affects all aspects of your life. Like Jon last night, he knows about your disorder, so you can explain to him that your nonsense talk is related to that, but what if you were talking to a girl you just met at school and said something nutty, chances are good she's not gonna want to continue talking to you. And what if, as part of your job, you had to give a presentation to the Board of Directors, and in the middle of it you finish a sentence by saying, "so it's plain to see that if we dip our tampons in our coffee, it sweetens it." The point is that without treatment, Bipolar can affect every aspect of your life negatively, and it doesn't have to be that way. Millions of people who have Bipolar live perfectly normal lives. Yes, they have to manage it everyday, but there are tons of people walking around with this and you'd never even know they have it because they manage it properly."

I could just tell that he was really thinking about all this in a different way then he has in the past. You can tell he wants to stay in denial, that's a really warm comfy blanket, but he's beginning to at least pull back the covers and consider that there might be something to all this.
And then this morning when I got up I found him still awake in his room. He stopped his meds last night, and as a result he hadn't slept. He had taken a dose of pediatric benadryl, but it hadn't helped. He has been borderline manic the last two days, since he missed a night of sleep. He's not hyper talking, but his thoughts are jumbled, he struggles to stay on track in conversation. So another night of missed sleep and I fear we're off to the races.

I tried to explain to him yesterday that what SHOULD have happened is that he be under the care of a Psychiatrist when he stopped his meds, then the doctor could prescribe a sleep aid. But since he's refused to stay in care, he's in the position of having no one to help him with all this.

We also talked about 'what if', something he wasn't willing to talk about before. I told him that when he stops his meds it's possible he'll be fine, but it's also possible that he'll struggle with sleep and become manic. "You say you don't want to be hospitalized again EVER, but the first thing they do is give you sedatives to bring you down. If you become manic again, WHAT do you want me to do?"

"Nothing!"

"But honey, you can't just go on like that, in that state! A manic episode can last MONTHS, I barely made it through that one day with you like that! I suppose if you were under the care of a psychiatrist, he might be able to prescribe something that we could have on hand to assist in bringing you down, but you're not under the care of ANYONE. Honey, you kind of put me in a bad position here. You don't want to go to the hospital, but I have no real tools here to help you in a situation like that."

Nothing was really settled yesterday. I still have no idea what I'll do if he becomes manic again, I suppose I'd have to call the police and have him hospitalized against his will, but man, I hate the thought of having to do that.

Since he missed another nights sleep last night, I imagine the next day or two are going to be interesting.

So, I'm learning. I'm learning how to find the right words and the right moments to impact Josh's thinking.

Please keep Josh in your prayers. I'm almost sure the roller coaster is cresting the hill again.