Saturday Josh and I ran errands. One of our errands was to go to the library. There was a book there I'd been advised to read. "Depression is a Choice" by A.B. Curtiss. The author believes that depression and mania can be treated without the aid of medications. The premise being that we 'learn' to follow a path of depression and that we can 'learn', or reprogram ourselves, away from depression and mania.
I have barely begun reading that book. That's not the book I want to talk about today. While looking through that section of the library, I picked up another book, "Hurry Down Sunshine" by Michael Greenberg.
Michael's daughter, Sally, suffered a manic episode at the age of fifteen. This is the story of their experiences. It was a 'difficult' read because so much of what this father experienced, mirrors what I experienced during Josh's mania and hospitalization. I could relate to his feelings of fear and sorrow.
Once his daughter came home (she was hospitalized MUCH longer than Josh was), Michael became almost obsessed with monitoring his daughter, and her reaction was just like Josh's was when *I* was obsessively monitoring him; "Do you think I'm insane? Is that it?"
Her mania, the things she said, so reminded me of the things Josh said during his manic phase, and then after, once medication had kicked in, she seemed to be trying so hard to figure out what happened, what did all this MEAN. I remember Josh expressing those same thoughts, along with shame and remorse and the realization that they could no longer trust their mind.
It was disheartening to me to read the Epilogue, to realize that, even though Sally was stabilized on medication and doing well, Bipolar continued to impact her life.
This book is very well written, and if I actually had writing skills, I could have written a very similar book based on my experiences with this disorder. The glaring differences to me, between Sally and Josh, are that Sally was a minor when she suffered her first full blown mania. Josh was already a legal adult, and that changes things a bit. First of all, when symptoms begin at a young age, the prognosis isn't as good regarding treatment, and because Josh was a legal adult, I had no real power to force treatment. The last real difference seems to be in the experiences with the mental health environment.
Sally was hospitalized longer and it seems, her family was much more active in the process than I was allowed to be. Even though Josh had signed releases allowing for an exchange of information about his condition, I was NEVER able to get much information while he was hospitalized, nor was I allowed to visit. Josh was not even close to stable with his medications when he came home and *I* was given no after care education at all.
Because Josh was given a dual diagnosis of Bipolar II AND drug dependency (pot usage), his after care focused heavily on the drug dependency and I believe this caused him to bail on the outpatient program. He didn't stay in treatment long enough to see any benefits from anything being done for him. Sally had no underlying drug use, and Sally had not been suicidal as Josh had been.
Reading this book brought back all that turmoil for me, it's a very accurate portrayal of the myriad aspects of a Bipolar diagnosis. Michael captures all those feelings of being 'lost' and 'out of control' so well. When you're first faced with this situation, you're like a newborn baby; the lights are too bright, the air is cold on your skin, you are so much out of your element and the overwhelming feeling is one of, "put me back in there to float in blissful oblivion!" You just so badly want things to return to normal.
But normal isn't easy to come by with this disorder. For the patient or for the family members.
I suppose, from my vantage point, I view this book as a cautionary tale for anyone struggling through the maze of Bipolar. You can do everything 'right'; you can find something resembling 'normal', but you can still get derailed.
It sounds like Sally has been able to fashion her life in a way that works for her. I only hope Josh is able to do the same.
Showing posts with label IOP. Show all posts
Showing posts with label IOP. Show all posts
Monday, June 27, 2011
Thursday, June 17, 2010
Mr. Toad's Wild Ride
Originally posted to my Private Blog on May 12, 2010
That's what life with Josh is like at the moment, a very wild ride.
Yesterday when he got home from IOP he was angry. He had met with the psychiatrist and the doctor had doubled his medication. He was taking 100mg, now he is to take 200mg. The doctor told Josh that he will probably increase it one more time in the near future to 300mg.
"Mom, I don't wanna take this medicine AT ALL, I certainly don't want to be taking MORE of it!!!"
He complained about the group therapy at IOP, how useless he found it to be. I told him to ask for individual therapy (which he can do there, with a 24 hour request).
"Tell Rob that you think that's what you NEED right now, ask him for individual therapy for the next two weeks. We're paying for you to get the help you need there, just let them know what you feel will help you."
Josh was very dejected, sick of living in this world, unable to accept that THIS was to be his life. Much of what he said reminded of me of how he was feeling when he became suicidal.
I sat and talked to him for several hours, and throughout the conversation I remained as calm and loving as possible as he hurled insults at me and told me that he hated me; everything about me. Every comment he made I countered with some variation of "well, you are not able to think clearly right now Josh, and it's NOT your fault. Your brain is playing tricks on you. The chemistry of your brain is messed up."
I reminded him to look back at how he felt when he came home from the hospital. "Yes, you were happy to be home, but you were also hopeful and motivated and ready to make important changes in your life that were in your own best interest. You have hampered that process by smoking pot. You just have to accept that you CAN'T do that and maintain your equilibrium."
Eventually it hit me that Josh probably hadn't eaten all day, so I asked if he'd like to go get a bite to eat.
"I'm hungry, but no."
He was distraught, in obvious emotional pain.
So I just kept talking to him.
He began to calm down a bit and finally said, "You know, I think we should go get something to eat, I think I can go out and be cordial." (Cordial? Where did THAT come from?!)
As we drove to the restaurant and sat and ate, he became more and more like 'himself'. During dinner he said, "Do you really think that if I stay on this medicine and avoid drugs and alcohol I could be happy, have a happy life?"
"Yes honey, I do, and I know this is hard for you to adjust to, difficult to accept, but until you begin to accept it and do the things you need to do, you will continue to cycle through these extreme mood swings."
We talked again about the need for him to take good care of his body; the importance of eating properly, keeping his body fueled, the benefits of maintaining a regular sleep schedule (which he has been doing a really good job with) and how helpful it is to exercise everyday...walk Blackie or work with his weights.
By the time we got back home he was FINE. Better than I've seen him since he's been home actually. Not manic, not depressed, just JOSH.
He had a friend over to play guitar for a while and then another friend stopped by for a bit.
I have no idea which version of Josh will return from IOP today, but I'm geared up and ready to deal with whoever walks through the door. I just hope we get to the point where the Josh I know walks through the door everyday.
That's what life with Josh is like at the moment, a very wild ride.
Yesterday when he got home from IOP he was angry. He had met with the psychiatrist and the doctor had doubled his medication. He was taking 100mg, now he is to take 200mg. The doctor told Josh that he will probably increase it one more time in the near future to 300mg.
"Mom, I don't wanna take this medicine AT ALL, I certainly don't want to be taking MORE of it!!!"
He complained about the group therapy at IOP, how useless he found it to be. I told him to ask for individual therapy (which he can do there, with a 24 hour request).
"Tell Rob that you think that's what you NEED right now, ask him for individual therapy for the next two weeks. We're paying for you to get the help you need there, just let them know what you feel will help you."
Josh was very dejected, sick of living in this world, unable to accept that THIS was to be his life. Much of what he said reminded of me of how he was feeling when he became suicidal.
I sat and talked to him for several hours, and throughout the conversation I remained as calm and loving as possible as he hurled insults at me and told me that he hated me; everything about me. Every comment he made I countered with some variation of "well, you are not able to think clearly right now Josh, and it's NOT your fault. Your brain is playing tricks on you. The chemistry of your brain is messed up."
I reminded him to look back at how he felt when he came home from the hospital. "Yes, you were happy to be home, but you were also hopeful and motivated and ready to make important changes in your life that were in your own best interest. You have hampered that process by smoking pot. You just have to accept that you CAN'T do that and maintain your equilibrium."
Eventually it hit me that Josh probably hadn't eaten all day, so I asked if he'd like to go get a bite to eat.
"I'm hungry, but no."
He was distraught, in obvious emotional pain.
So I just kept talking to him.
He began to calm down a bit and finally said, "You know, I think we should go get something to eat, I think I can go out and be cordial." (Cordial? Where did THAT come from?!)
As we drove to the restaurant and sat and ate, he became more and more like 'himself'. During dinner he said, "Do you really think that if I stay on this medicine and avoid drugs and alcohol I could be happy, have a happy life?"
"Yes honey, I do, and I know this is hard for you to adjust to, difficult to accept, but until you begin to accept it and do the things you need to do, you will continue to cycle through these extreme mood swings."
We talked again about the need for him to take good care of his body; the importance of eating properly, keeping his body fueled, the benefits of maintaining a regular sleep schedule (which he has been doing a really good job with) and how helpful it is to exercise everyday...walk Blackie or work with his weights.
By the time we got back home he was FINE. Better than I've seen him since he's been home actually. Not manic, not depressed, just JOSH.
He had a friend over to play guitar for a while and then another friend stopped by for a bit.
I have no idea which version of Josh will return from IOP today, but I'm geared up and ready to deal with whoever walks through the door. I just hope we get to the point where the Josh I know walks through the door everyday.
All Josh, All The Time
Originally Posted to my Private Blog On May 10, 2010
Sorry for the lack of updates since Josh came home from the hospital, but things have been very difficult.
He came home last Tuesday and was still very manic...not 'crazy'...just very 'up'; very talkative, racing thoughts, etc.
Everyday since he came home his condition has deteriorated, to the point that last night I was afraid to be with him.
It is very hard to describe what I have been experiencing with him. I've spent HOURS just sitting and listening to him talk, and each day the conversation has gotten more alarming.
As an example of how his mind is processing information, I'll tell you a little tale, but there are probably a hundred such tales I could relay to you that are as disturbing as this one is:
Josh took his extended wear lenses out Saturday morning because he had developed an infection in his LEFT eye.
Last night, as he was raging at me about many, many different things (pacing back and forth at the end of my bed screaming and pounding his fist on the bed and the dresser for emphasis) he started talking about the medication he was taking and all the things he didn't like about it; how it makes him FEEL inside and how he can't possibly live with this FEELING the rest of his life. And then he said, "This medicine is slowly killing the LEFT side of my brain while it builds up the RIGHT side, and if you don't believe that MOM, look at my LEFT eye, that's the dead brain cells coming out of my eye."
Jordan, his girlfriend and my boyfriend came for Mother's Day dinner last night. None of them have seen Josh since he's been home. They were all three appalled by his condition, and I have to say that with the extra activity in the house, Josh was probably 50% BETTER than normal.
After Jordan and his girlfriend left, my boyfriend said that he thought he'd go home too, that he didn't feel like he could handle being there with Josh in that condition.
That kind of disappointed me. I have been there beside him through some pretty difficult stuff. It wasn't COMFORTABLE for me, but I did it because I care about him. I am here ALL ALONE with Josh. I'm scared to death about his condition, about my safety, about HIS safety, and it was a bit hard to swallow that my boyfriend wasn't able to stay with me last night.
On the other hand, he's never had children and so he feels very out of his element with all this (uh huh, join the club!). In addition to that, Josh is NOT himself, by any stretch of the imagination. He is being HORRIBLE to me. My boyfriend saw enough of that last night (although NOT to the degree Josh goes to when we're alone together) and it is hard for him to watch me being treated that way.
On the phone last night he said, "Melody, you've never seen me angry, but if I had stayed I probably wouldn't have been able to continue to watch him treat you that way and I'm sure he and I would have gotten into a pretty good argument about it. Basically, you'd have had two crazy acting people to deal with."
Since Josh came home, he has argued with me regularly about his ability to still smoke pot on occasion, that it actually 'helps' him. So, according to him, he has smoked a small amount of pot twice. He also drank a beer "to detox his system before they drug tested him at IOP Monday morning." Clearly his mind is not working properly and nothing *I* say can deter him from doing these things that I know are counterproductive.
His deterioration may be largely due to him self medicating, or it could be that his medication needs further tweaking.
Backing up to last Wednesday, Josh met with a counselor at the Mental Health Center that has taken over his outpatient care. He was evaluated to determine the level of care he needed. It was decided that he would attend IOP (Intensive Outpatient Program) five days a week, from 9AM till 3 PM. Now THAT's some Intensive care.
After Josh met with the counselor, Rob, I asked to speak to him and tried to impress on him the things Josh had been saying to me about pot usage and his belief that he isn't Bipolar and does not plan on staying on medications for more than 3-6 months.
Rob very nicely told me to stay out of it and let them do their job, that they would be addressing all of this with Josh during his IOP.
I called Rob this morning and left him a VM, "I know that you'd like me to 'stay out of it and let you do your job', but Josh's state is of great concern to me. I'd like to talk with you before IOP today and let you know what's going on with him."
Rob called me back and stated that he couldn't talk to me about Josh's condition, but he could listen to anything I felt he needed to know. On Wednesday, while Josh was in with Rob, I asked the desk clerk if the form that allowed the doctors to speak with me regarding Josh's care that Josh had signed upon admittance to the hospital had come over to them. She checked his records in the computer, asked if I was Melody and said that they had the form there. Rob couldn't find that form in Josh's chart so he was unable to GIVE me any information, but I gave him plenty.
He was very concerned and stated, "Well, maybe this isn't going to work after all, but let me spend the day with him and get a feel for what's going on, and I'll try to get him to sign another permission form today too. Also, I want you to know that my remarks to you last week were in no way meant to make you feel like your fears and concerns shouldn't be discussed with me. I merely wanted the frustration between you and Josh to be diminished where his medication and pot usage are concerned because that is something we will be working on with him. You call me anytime there is something you think I need to know because I'm not going to see the same Josh here that you are living with."
I'm not sure what Rob meant when he said, "Maybe this isn't going to work." Does he mean IOP isn't the answer for Josh? Does he feel that Josh needs to be hospitalized again?
I don't know and until they either locate the original permission form or get a new one signed, I'm unable to GET any information from them.
Sigh
Sorry for the lack of updates since Josh came home from the hospital, but things have been very difficult.
He came home last Tuesday and was still very manic...not 'crazy'...just very 'up'; very talkative, racing thoughts, etc.
Everyday since he came home his condition has deteriorated, to the point that last night I was afraid to be with him.
It is very hard to describe what I have been experiencing with him. I've spent HOURS just sitting and listening to him talk, and each day the conversation has gotten more alarming.
As an example of how his mind is processing information, I'll tell you a little tale, but there are probably a hundred such tales I could relay to you that are as disturbing as this one is:
Josh took his extended wear lenses out Saturday morning because he had developed an infection in his LEFT eye.
Last night, as he was raging at me about many, many different things (pacing back and forth at the end of my bed screaming and pounding his fist on the bed and the dresser for emphasis) he started talking about the medication he was taking and all the things he didn't like about it; how it makes him FEEL inside and how he can't possibly live with this FEELING the rest of his life. And then he said, "This medicine is slowly killing the LEFT side of my brain while it builds up the RIGHT side, and if you don't believe that MOM, look at my LEFT eye, that's the dead brain cells coming out of my eye."
Jordan, his girlfriend and my boyfriend came for Mother's Day dinner last night. None of them have seen Josh since he's been home. They were all three appalled by his condition, and I have to say that with the extra activity in the house, Josh was probably 50% BETTER than normal.
After Jordan and his girlfriend left, my boyfriend said that he thought he'd go home too, that he didn't feel like he could handle being there with Josh in that condition.
That kind of disappointed me. I have been there beside him through some pretty difficult stuff. It wasn't COMFORTABLE for me, but I did it because I care about him. I am here ALL ALONE with Josh. I'm scared to death about his condition, about my safety, about HIS safety, and it was a bit hard to swallow that my boyfriend wasn't able to stay with me last night.
On the other hand, he's never had children and so he feels very out of his element with all this (uh huh, join the club!). In addition to that, Josh is NOT himself, by any stretch of the imagination. He is being HORRIBLE to me. My boyfriend saw enough of that last night (although NOT to the degree Josh goes to when we're alone together) and it is hard for him to watch me being treated that way.
On the phone last night he said, "Melody, you've never seen me angry, but if I had stayed I probably wouldn't have been able to continue to watch him treat you that way and I'm sure he and I would have gotten into a pretty good argument about it. Basically, you'd have had two crazy acting people to deal with."
Since Josh came home, he has argued with me regularly about his ability to still smoke pot on occasion, that it actually 'helps' him. So, according to him, he has smoked a small amount of pot twice. He also drank a beer "to detox his system before they drug tested him at IOP Monday morning." Clearly his mind is not working properly and nothing *I* say can deter him from doing these things that I know are counterproductive.
His deterioration may be largely due to him self medicating, or it could be that his medication needs further tweaking.
Backing up to last Wednesday, Josh met with a counselor at the Mental Health Center that has taken over his outpatient care. He was evaluated to determine the level of care he needed. It was decided that he would attend IOP (Intensive Outpatient Program) five days a week, from 9AM till 3 PM. Now THAT's some Intensive care.
After Josh met with the counselor, Rob, I asked to speak to him and tried to impress on him the things Josh had been saying to me about pot usage and his belief that he isn't Bipolar and does not plan on staying on medications for more than 3-6 months.
Rob very nicely told me to stay out of it and let them do their job, that they would be addressing all of this with Josh during his IOP.
I called Rob this morning and left him a VM, "I know that you'd like me to 'stay out of it and let you do your job', but Josh's state is of great concern to me. I'd like to talk with you before IOP today and let you know what's going on with him."
Rob called me back and stated that he couldn't talk to me about Josh's condition, but he could listen to anything I felt he needed to know. On Wednesday, while Josh was in with Rob, I asked the desk clerk if the form that allowed the doctors to speak with me regarding Josh's care that Josh had signed upon admittance to the hospital had come over to them. She checked his records in the computer, asked if I was Melody and said that they had the form there. Rob couldn't find that form in Josh's chart so he was unable to GIVE me any information, but I gave him plenty.
He was very concerned and stated, "Well, maybe this isn't going to work after all, but let me spend the day with him and get a feel for what's going on, and I'll try to get him to sign another permission form today too. Also, I want you to know that my remarks to you last week were in no way meant to make you feel like your fears and concerns shouldn't be discussed with me. I merely wanted the frustration between you and Josh to be diminished where his medication and pot usage are concerned because that is something we will be working on with him. You call me anytime there is something you think I need to know because I'm not going to see the same Josh here that you are living with."
I'm not sure what Rob meant when he said, "Maybe this isn't going to work." Does he mean IOP isn't the answer for Josh? Does he feel that Josh needs to be hospitalized again?
I don't know and until they either locate the original permission form or get a new one signed, I'm unable to GET any information from them.
Sigh
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