Medication Overload

While the changes in Josh on medication are amazing, he seems to have days when he's not at his best.  His mood at times remind me of 'back then'; back then when he wasn't on meds and he'd be full of negativity and everything *I* do is 'wrong'.  To hear him tell it, when he's in one of those moods, I'm the biggest idiot to ever walk; I don't even know how to park my car correctly.  He is NO FUN to be around when he's like this and I steel myself as I take hit after hit.

I've been worried about these mood shifts, wondering what is causing them.  Is his medication just not dialed in correctly yet?  Is he derailing the process by occasionally drinking?  Is it situational? (He's not yet found a job, so he gets lonely and bored).

He saw his doctor last week, and before his visit he expressed that he wasn't sure what the purpose of the visit was, what he should say to his doctor.

"Well, you need to be honest with him and tell him how you are feeling on these medications.  You're worried about your weight gain (12 pounds since he began his meds just a few months ago), so tell him that, and tell him how long that one med is making you sleep.  He can make adjustments if he knows what you're experiencing.  I think you should tell him that your moods have been shifting a little bit too."

"Mom, everybody has mood swings, so I'm not telling him about THAT."

"Well, your mood swings probably aren't 'normal' mood swings, they're based on your disorder.  You may not SEE them, but I do."

"Well, I'm not telling him that."

Fine!

The doctor added an anti-depressant to Josh's pill regime.

"Why did he add that?"

"Cause I'm depressed?"

"Oh."

The new medication is one that does not have weight gain as a side effect and the doctor feels it might actually help suppress Josh's appetite.  Josh says he feels better with this new med; more focused and more energetic.

As I talked to Josh about all this, I could tell he had done a good job of communicating with his doctor, but he said he feels so anxious when he has to meet with his doctor and therapist.

"You should probably take one of your anti-anxiety pills before your visits." (he takes these only as needed)

"Yea, I think you're right, I think it might help.  I just get so self-conscious when I have to talk to them."

His doctor wants to see him again this Friday to re-check the new med and Josh sees his therapist tomorrow.

Josh needs to find a job; I think things would begin to get 'better' for him if he were working and could finally normalize his schedule.  He wants so badly to work.  He had a job interview last week, but the job was only part time (28 hrs a week) and it's on the other side of town.  We discussed whether he should take this job or not.  Josh feels so badly about the fact that I am supporting him.

"Well honey, I think it's really important that you get the right job.  Whether you take this job or not is your decision, but I don't want you to take it if it's not a situation that's going to really work for you long term.  I'd rather keep paying your bills another month or two if that means you get the right situation in the end."

I gave him several ideas about other places to apply for work, several of them are low end clerical type jobs, but I think a job like that (40 hours in a low key office environment) would be a good jumping off point for him.  It's so hard for someone like Josh (no skills, no college degree) to find a job when so many people are out there looking.

We went to a movie this weekend and afterwards we were sitting at home talking and he said, "I feel so bad for you Mom, you've been through so much with me."

"Well, if you really feel that way, then keep doing what you're doing; seeing your doctor and taking your meds, because I know it's the only way you're going to be able to have a better life."

"Dr H asked me if I believe I'm Bipolar and I told him no."

"What did he say to that?"

"He just scribbled in my chart."

Yea, I just bet he scribbled in Josh's chart...probably a note to this therapist to help Josh with the issue of acceptance.

I cannot imagine what it must feel like to Josh to not 'believe' in his diagnosis, and yet, be treating it.  And because he's in this headspace, I worry that he'll eventually give up the fight and stop his meds.

I have an awful lot of respect for him that he IS doing this though.  I know that right now, his life pretty much sucks, and yet, he's hanging in there.

He has been spending quite a bit of time with his 'good' friends who are home from college for the summer.  I dread when they all go back to school the middle of August because that will put Josh further in isolation.  It would be nice if he has work by then to occupy some his time.

Josh's general demeanor isn't the only improvement I see since he began meds.  He regularly cleans his apartment and that is a gigantic step.  He has always lived like a sloth, but I've told him that my hairdresser, whose husband has bipolar, has told me that her husband MUST HAVE a neat organized home and work environment or she notices it causes him mood problems.  Josh has been keeping his apartment very neat and tidy which amazes me.

As a mother, this journey has been so difficult, and yet, I have had to learn that this isn't MY journey.  Because Josh is in treatment, I feel a huge relief, but I know that anything is possible and I try very hard to just be there for Josh in appropriate ways.  I can only offer guidance and advice, but he gets to make all the decisions.  Right now, for the most part, I see him making mostly good decisions and so I'm able to relax a bit with all of this.

It's very hard to know what is possible 'if only'.  If only he'll stay in treatment.  If only he'd get a job.  But it doesn't escape my notice that NONE of this is in MY control.