A Book Review

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.

Fingers Crossed

Josh had his physical today. We both love our doctor, he actually delivered Josh, so he's been in our lives a long time. We didn't see him today though, our appointment was with our favorite Nurse Practitioner. She also has cared for us both for years and she has a very holistic approach to medicine, always more apt to suggest a supplement over a pharmaceutical.

Anyway, I went in with Josh because I wanted to be sure the NP understood Josh's recent history. She was pretty shocked that Josh's thyroid levels were as high as they were upon admittance to the Psych Hospital, and yet nothing further was done in an attempt to ascertain if there was an underlying Thyroid problem.

She ordered further blood work, and because she felt Josh's thyroid was enlarged, she ordered an Ultra Sound on it.

As we talked with her, I became a bit more hopeful that Josh may not be Bipolar at all, that perhaps a hyperactive thyroid created a vicious cycle of sleep deprivation that led to the mania he experienced.

I feel like Josh having a thyroid problem and NOT Bipolar is kinda like winning the lottery. Not likely, yet.......if you read the symptoms of hyperactive thyroid and then read the symptoms of sleep deprivation (Josh had had only two hours sleep in a three day period when he became manic), it's very easy to get your hopes up. I mean, after all, SOMEBODY wins the lottery, right?

So we'll wait and see.

Josh right now has been totally himself, right down to being a bit short with me sometimes, bordering on rude. (No screaming and yelling, let alone pounding his fist or slamming a door)

He's still having trouble sleeping, but he's getting a solid 8 hours, unfortunately he often isn't asleep before 4 am, this morning when I got up at 6 am, he was still up. For now, his schedule allows this strange sleep pattern, but eventually he's going to need to get back on a more normal routine.

I look over the last year of Josh's life and can see how everything that has happened could be explained by a hyperactive thyroid. The thyroid controls so many functions and the hormones it produces are very powerful. I've said before that his eyes have bothered me for some time, his eyeballs seem to 'bulge'. This is a symptom of Grave's Disease and if you read the following link, under the heading of "How is the Diagnosis of Grave's Disease Made?", the second paragraph talks about 'clues' that might lead to such a diagnosis. The very last line talks about family members with related autoimmune disorders, such as I have....vitiligo.

My sister had a hyperactive thyroid, so there is family history, but the biggest factor to me is MY autoimmune disorder (vitiligo) that is known to cause blood relatives to be more prone to ALL autoimmune disorders.

And if you don't think sleep deprivation plays a part in all this, read this.

I may be grasping at straws, but I just keep coming back to Josh's thyroid problem not being addressed in the hospital.

So, we'll address it now if there is a problem, and then we'll wait and see if Josh shows anymore symptoms of Bipolar or not.

The Realities of Hospitalization

When Josh became manic, I didn't even know he was manic. I didn't know what manic meant. If I'm being honest I would tell you that I came home and found Josh acting nutso.

Ahem.

Anyway, long story short, off to the Psych Hospital we went, with me encouraging him the entire way that this was the right thing to do.

And he'll probably hold that against me the rest of my life.

It was not a good experience for him, but I've come to realize that Mental Institutions aren't a good experience for anyone.

It seems the goal is to bring em' down or lift em' up, begin a medication and get them out of there in a perfectly timed maneuver that has them walking OUT the door at precisely the moment their insurance stops paying.

Unfortunately, fiscal concerns determine the level of care received, and the hospitals aren't driving the bus, the insurers are.

That's a fact.

A sad fact.

In addition to that, there is very little competition to force better care. We live in a fairly large metropolitan area and I can only think of maybe four Psychiatric Hospitals in a 50 mile radius.

Mental Institutions are pushed up against a wall to make a profit, so things like, oh...communicating with caretakers, falls by the wayside, as does educating caretakers.

Seriously, Josh came home with a prescription and a piece of paper that explained side effects to watch out for and a notation that he had an appointment the next day with some dude. I had no idea what the dude's purpose was, just that Josh was to see him.

I also didn't know what to expect in the coming days. I wasn't prepared for his rages, or disordered thinking. I didn't know what my JOB was.

A simple pamphlet could have alleviated some of the missteps I made over the first days and weeks. A one page sheet of paper could have imparted much needed information.

Because in the end, Josh's best interests were not served by the lack of communication and education I received from the hospital...which was zip.

Another aspect of Hospitalization where mental illness is concerned is that the person in charge of making decisions and asking the right questions (the patient) is temporarily incapacitated mentally! Add to that the fact that historical data about past episodes and behaviors are being collected from someone who thinks he's a messiah put here to spread the truth, and it's pretty evident that THE DOCTORS SHOULD BE TALKING TO SOMEONE WHO ISN'T SUFFERING A MENTAL BREAKDOWN!

Even though Josh had signed a release so the doctors could talk to me, even though I left messages asking the doctors to call me, they didn't.

Because time is money.

So basically, they can prescribe whatever they want cause they know the patient isn't capable of any input into the decision.

Josh NEVER wants to go to the hospital again, and I don't want him to EVER have to go to the hospital again, but when you're in a state of mania, your options become limited.

It's just possible that if hospitals were able to provide the necessary level of care, communication and education that this Disorder requires, then repeated hospitalizations may not be needed, thus saving insurance companies money in the long run.

If a patient could stay in the hospital long enough to become stable, go on a medication that a loved one helped choose after discussing side effects, lifestyles and past behaviors, and then went home with a caregiver who knew what the hell was going on, the cycle of non-compliance could be shortened.

I'm just sayin'

Knowledge is Power

When Josh landed in the hospital and the man who had evaluated him opened his mouth and said, "Your son is in a mild manic state and from his history, it's clear that he has Bipolar Disorder," I was too exhausted and frightened to fully get the gravity of the diagnosis.

Oh, I knew it was bad.

I remember standing and talking with a teacher on Field Day when Jordan was in Elementary School. For some reason, this woman shared with me the story of her son, who was what was then called Manic-Depressive. Unfortunately, it was a fairly typical story of a young man who struggled against the Disorder and lost his battle with it at the age of 24 by killing himself.

I can remember so clearly having the sensation of this woman's pain pouring over me in waves.

So, I knew it was bad.

But I really knew nothing at all.

I now know more than I ever wanted to know about this Disorder, and I'm pretty sure I'll never stop learning.

The internet is a both a blessing and a curse when researching something of this nature. There is a wealth of useful information to be had and what you read there can scare the holy crap out of you.

I visited message boards and forums and the stories I read kept me awake at night, it seemed like everyone was so badly affected by Bipolar. What I quickly realized though is that the people who are posting on message boards fall into one of maybe three categories.

1. People like myself who are new to the Disorder and are seeking help.

2. People who are struggling with the disorder and are seeking help.

3. People who have the disorder and have no intention of addressing it properly, but want to whine.

The fact of the matter is, that for the most part, people who are struggling post on message boards. People who have control over the disorder and are living perfectly normal lives, thankyouverymuch, are out living their perfectly normal lives and not posting messages on boards and forums.

So keep that in mind when you are searching for information. Don't be discouraged by the dearth of happily ever after you read there.

While searching for information about various medications, there are horror stories aplenty too. Because these drugs affect everyone so differently, it can be disheartening to read about other's experiences with side effects and withdrawal symptoms. It is beyond alarming what some people have been through on the journey for the right combination of medications.

It didn't take me long to decide that I needed a book. A good book. A simple, but thorough book, and so I headed to Borders.

I came home with a book that I felt was appropriate to the situation, "Bipolar For Dummies", because I definitely qualified as a Dummy on the subject.

As a starter book, I would highly recommend this one. It covers all aspects of the Disorder and has a section for Caretakers. It is very technical in explaining the Disorder and I completely understood what "happens" in the Bipolar Brain. Granted, I couldn't explain it to anyone else if my life depended on it, but I understood it as I read it.

The book was copyrighted several years ago, so the information may not be the most up-to-date, but I still think it provides a good jumping off point in the quest for Knowledge.

Next I contacted the local chapter of The Depression and Bipolar Support Alliance: DBSA and I began attending Support Group meetings.

This was a difficult step for me to take, and I hate to admit it, but it took me several weeks to make that call. And another week to actually attend a meeting. It seemed like stepping across that threshold was me acknowledging the reality of Josh's illness.

Yes, even parents have to work through denial.

If you're faced with a diagnosis of Bipolar, get over your denial quicker than I did, because the help and support you will find at DBSA will be invaluable to you. I actually look forward to our Monday night meetings.

Once I'd armed myself with knowledge and support, I realized that I didn't have a clue how to actually deal with my son on a day to day basis.

All of a sudden this son of mine was completely unfamiliar to me. He was unstable when he came home from the hospital, and while the medications had brought him down from his high, his disordered and occasional delusional thought processes were something totally new to me. I had no idea how to communicate with him.

At a time when I REALLY needed to be able to communicate with him effectively.

Josh displayed HORRIBLE rages when he came home, all directed at me. Anything was liable to set him off. One day he was sitting in my office talking to me and a bird flew by my office window. In a natural response to peripheral movement, I shifted my eyes to the window. Josh jumped up, pounded his fist in the middle of my desk hard enough to make things on it jump, and screamed at me, "Pay attention when I talk to you!" Clearly I'd done nothing 'wrong', but in his mind I was Satan incarnate sent up from the bowels of hell with the express purpose of infuriating him. His rages could have been induced by the medication, irritability IS one of the lovely attibutes of Bipolar Disorder, but some medications ramp it up a notch, to one notch just below homicidal.

So I learned. Slowly. Over WEEKS.

The problem was that everyday, a different version of Josh climbed out of bed. What worked yesterday in that mood, inflamed him today in this mood.

I'll save anyone out there who is dealing with a newly diagnosed Bipolar person some time and tell you a little secret. No matter what, stay calm and agree with everything they say.

OK, so I hate to admit this too, but early on I would make matters worse by arguing with Josh and occasionally I got downright mad at him.

Who wouldn't? Seriously?!

It takes time to realize that this person in front of you HAS NO CONCEPT OF WHAT THEY'RE DOING.

Oh, you know it on an intellectual level, but it takes real effort to remember that in the heat of a very violent moment.

The truth is that stress is one of the worst things for a Bipolar person. Stress builds and builds and builds inside them, and can send them directly into a manic state; do not pass go, do not collect your Seroquel.

So for days, maybe even weeks *shudders* I made matters worse for Josh, and myself, but I learned. Eventually I learned.

I learned to agree with anything he said, "Yes, I'm the most horrible parent in the world, I don't know how you've lived with me all these years, and yes, I need therapy and probably a parenting class or two."

But the biggest thing I learned was to let go and let God.

And God seems to be doing a pretty good job of handling this, because yesterday? JOSH climbed out of bed. My Josh. The one I knew before that awful man in the hospital uttered those words, the one I knew before depression settled over him like an early morning fog, the one who used to be happy and surrounded by friends, rushing here and there, living a busy, fulfilling life.

It seems the medication has quickly worked its way out of Josh's system and, where he was slow and foggy, he's sharp and bright. Where he was sad and desolate, he's happy and hopeful. He's not the slightest bit manic and his thought processes seem to be in good working order.

Today while I was out of town, Josh went out to play baseball with two of his OLD friends. You know, the friends HE pushed out of his life way back there when he was depressed and on the way to suicidal. And as I type this, one of those friends is in his room with him, doing what they used to do...play a video game.

The most difficult lesson I've learned though is that tomorrow is a complete unknown with this Disorder, especially at the stage of acceptance that we are in.

We aren't treating the Disorder at all at this point, although Josh is being very careful about his sleep schedule, because for him and many who suffer with Bipolar, sleep deprivation is a one way ticket to Mania City.

Josh could be fine for days or months, or possibly even years before the monster rears it's ugly head again. And Josh could wake up TOMORROW headed towards a manic state.

So I've learned to take all this one day at a time, appreciating the good days and looking for more lessons in the bad ones.

Because in the end? I'm just about all Josh has right now and I don't intend to let him down.

Manic Monday

Originally posted on my Private Blog(edited to assure anonymity), April 29, 2010

Josh was placed in the Psychiatric Pavilion of our local hospital yesterday and was diagnosed with Bi-Polar Disorder.

I'm heartbroken by this turn of events.

Sunday, Josh visited his Father. He hadn't slept the night before and he was gone all day. When he got home he said that he and his Dad had spent the day together talking. He felt very good about the way the day went. He laid down and slept a few hours. That evening, when he got up, he and I talked for four or five hours. He was very talkative, but the conversation was normal and very interesting.

I went to bed that night and awoke around 2 AM. Josh was still up, and we talked another four or five hours until it was time for me to shower and get ready for work. When I left for work he was fine.

I returned about three hours later to find him still up and it didn't take long for me to figure out that something was very wrong with him.

He was talking 90 MPH and his thoughts were racing all over the place. He talked about the 'truths' he had discovered and his need to get the 'truth' to as many people as possible. He felt that this was his purpose in this life, so that in the next life he could become a God. And then he said, "That's why I went to the High School today."

I calmly asked questions about his 'trip to the High School' and found that he'd gone there because he felt compelled to go there to help 'someone' learn the 'truth'. He went into a lot of detail about his visit, the four people he talked with there, none of whom seemed to be interested in the help he was offering.

I knew he'd gone to the High School because he showed me a piece of paper that the receptionist had given him. She had written one of his teacher's phone numbers on it, then on the line below she wrote 'X' and an extension number, then she drew a line and below that she wrote the teacher's email address. It looked like a math equation.

"And see Mom, she wrote it like an equation! And THIS is the answer," he said pointing to the email address, "all along I've thought that God made a mistake, he didn't allow for something like the internet, how it's negatively impacted our lives, so I thought he screwed that up, but LOOK! She gave me the answer, and the answer is technology! THAT'S how I'm supposed to spread the truth, on the internet!"

As I sat listening to him blathering on, my mind was racing, trying to figure out what to do. Eventually I decided to call my older son, Jordan and ask him to come over and help me decide how to handle the situation.

My plan was to use the restroom and call Jordan from there, but Josh was stuck to me like glue. When I said I needed to use the restroom and I'd be right back, Josh said, "Oh, I'll go with you!" And he continued with his train of thought.

"You can't go with me!"

"Sure I can. Mom you shouldn't be embarrassed by your body, it's the vessel God gave you to walk around in."

"Well, you are not going in the bathroom with me, I'll be right back."

So I snuck in the bathroom and called Jordan and told him, "Don't ask questions, just get over here NOW....and act like you just decided to stop by."

When Jordan got there, he had NO idea what was going on, so he did what big brother's always do, he began arguing with Josh about the nonsense that Josh was spewing.

I'd have thought Jordan would have known better than to argue with a crazy person, but apparently not.

In no time, Josh began to get agitated with Jordan and pretty soon he was in tears, clearly in pain because Jordan 'didn't understand him'.

I asked Josh to take our dog, Blackie out back for a few minutes and I took Jordan in the garage and let him have it.

In his defense he said, "God dammit Mom! I'm not gonna just sit there and listen to him carry on like that, it's ridiculous. I hate it when he gets like this!"

"You've seen him like this before?!!"

"Yes, and it's always when he's not slept the night before. He's come over three times and acted just like that."

"God, why didn't you tell me?"

In the end, Jordan calmed down and kept Josh distracted while I called the Stress Center where Josh had gone last January when suffering from Depression. They advised me to take him in for an assessment or call the police and ask them to come and do a Safety Check on him. If they determined that he was a danger to himself or others, they would be able to take him by force for an assessment.

Neither option set very well with me. I honestly didn't think I could convince Josh to go with me to the hospital. I was afraid he'd get upset and leave. On the other hand, I couldn't stomach the idea of Josh being dragged away in handcuffs in the back of a police car.

And then two police officers arrived at our door, apparently alerted by the High School.

Josh and Jordan were in the Garage talking. I stepped out onto the porch and talked to the officers and told them what was going on, the state that Josh was in and asked them what they intended to do. They said they would tell Josh that the High School had been concerned about his demeanor and asked them to check on his welfare, that they would try to determine if Josh was a danger to himself or others, and if he was, they would take him for an assessment.

I went out into the garage and opened the garage door and told Josh that a couple of gentlemen wanted to talk to him. Josh was not the least bit ruffled when he saw two police officers standing there.

I cannot tell you how impressed I was by the way the officers handled Josh. They were respectful, professional, caring and concerned. They talked to Josh for close to an hour and Josh was very honest with them about his reasons for going to the High School. They discussed his prior stay at the Stress Center, the medication he had been taking for depression and his abrupt cessation of it, and I think he told them a little bit about the 'truth'.

The officer came in and told me that Josh agreed to go to the hospital for an assessment, but asked if he couldn't just have an assessment by his normal therapist who he was seeing the next morning. The officer felt that either option would work, he didn't sense that Josh was a danger to himself or others. We decided to let his therapist do the assessment. After talking calmly with Jordan and then the officers, Josh was much less manic so I thought that waiting would be OK.

That probably wasn't the wisest decision for several reasons. First of all, later that evening I realized that we would go to the therapist in the morning and he would surely say that Josh needed to be in the Psych Ward and we'd be right back to possibly having to drag him away in handcuffs. Secondly, while Josh seemed calmer when the officers left, he became fairly manic again fairly quickly. He was scheduled to work that night and I couldn't imagine how he could possibly carry off a shift in his condition.

Jordan said that Josh had been in that state at his house one night and left his house and went to work. "Mom, it might actually be good for him to get out of his head for a while, let him go to work."

So I mentioned to Josh that if he went to work, he wouldn't be able to talk about the 'truth' there.

"Of course I won't. I'll be thinking about it, cause I can do my job by rote, but I won't talk about it."

Looking back, I can't believe I let him go to work, but I did and he apparently did fine, because he came back four hours later. He was 'better', but still a bit manic. I kept encouraging him to go to bed because we had to get up early the next morning, but he wasn't tired.

So I fed him.

That did the trick, pretty soon he was sawing logs.

I slept on the couch to assure I would hear him if he got up. I didn't want him out spreading the truth in the middle of the night.

It was hard getting him up the next morning and he got fairly belligerent with me.

"Josh, you promised the police officer that you would see Peter this morning."

"Well, reschedule it."

"No, the officer said that if you wouldn't go with me this morning, to call him and he'd come and take you. Should I call him?"

"No! Get out of my room and I'll get up."

The therapist met with both Josh and me and it was hard for me to basically say, in front of Josh, "Josh has lost his mind", without coming out and saying it, but I was able to get my point across without insulting Josh. The therapist felt Josh was in a manic stage of Bi-Polar Disorder and told Josh that he needed to go to the hospital for further assessment. Josh was agreeable to that, but refused to sign a release for Peter to speak to the hospital prior to our arrival.

In his manic state, Josh became very big on the concept of 'things happening the way they're supposed to'. He felt that if the hospital wanted to talk to Peter, he'd sign a release there.

Like I said, it's kind of useless arguing with a crazy person.

As we drove to the hospital, Josh was becoming more awake and more manic. He talked a lot about his fears, wondering and worrying if this was the best thing to do. I reassured him that it was and that if he looks back he'd realize that I helped him find the right place when he became suicidal.

"You're right. OK, I trust you and if you think this is best, then I'll do it."

Thankfully he said that all day long as the decisions became harder.

We were at the hospital for five hours before they admitted him and he was very manic all day. We spent most of the time alone together in a small room with him talking non-stop, his thoughts zooming around the room at light speed THE ENTIRE TIME.

By the time they admitted him I was exhausted, and he was worse, having expended more energy sitting still for five hours than I'd expend were I running full out for the same amount of time.

I was so proud of how he handled himself. He was respectful to everyone he encountered, and while he was clearly confused, he struggled to understand what was being told to him and he asked appropriate questions about his disorder, the medications used for it and what the hospitalization would entail.

He signed himself into the facility and was told it would be about an hour before they would be taking him up to his room.

"Could my mom take me to get a bite to eat instead of waiting here?"

So we went for a late lunch. He told me he was nervous, especially because they didn't have a bed for him in one unit, so the unit they were putting him in was more restrictive and he wouldn't be allowed visitors AT ALL.

We talked about who he wanted me to call (his Dad, his brother, his Boss, a couple of his friends) and what things he wanted me to bring back to him, and then he looked at me and said, "Mom, I love you so much, I couldn't have done this without you."

I cannot tell you how heartbreaking it is to sit and watch your CHILD in that state.

And act like you're discussing a new movie.

When I came home from the hospital, without my child, I walked into his room and basically fell apart. Every ounce of control I had used for two days trying not to let Josh see my concern was gone and I totally lost it.

I have a lot of people supporting me and everyone I've told about Josh's diagnosis has relayed a story of someone they know who is Bi-Polar and lives anything from 'perfectly normal' lives to 'amazing lives'. But the reality is that many people truly suffer with Bi-Polar Disorder. Many people stop taking their medications and suffer their entire lives. Others are medicated and still experience depressive and manic stages.

Sitting here, I have no idea how this disorder will affect Josh's life or my own. It's quite possible Josh will need care giving his entire life, or he may be one of the lucky ones who excels in spite of being Bi-Polar.

When I called his Father, he was pretty upset by the news. His mother had mental health issues and while we were married, she had one episode and wound up in the Psych ward.

"Do you remember when your Mom was in the Psych Ward? THAT's exactly what Josh was like the last two days, only with much more intelligence."

Neither he or I could remember what they diagnosed his Mother with, but Bi-Polar disorder is almost always genetic and there is no mental illness on my side of the family, so I have one more thing to blame my ex for.

Just kidding.

Josh will be hospitalized for three to four days and when he comes home, he won't be stabilized. I'm going to have to put together a schedule over the weekend so someone will be here with him 24/7. Beyond that, there's not much for me to do but wait.

Josh and I are able to communicate via phone and he calls me often. Every time I talk to him he sounds better. The last time I talked to him this evening, he sounded like his old self.

And then he started crying and telling me how much he loves me and how horrible he feels for being such a shit to me for the last six months.

"Honey, stop it. You haven't been yourself for the last six months and I understand that."

"But Mom, you don't understand, I've been denying you and how could I do that? I was laying in bed a little while ago thinking about you, about how when we were sitting in that room all day you were so loving and kind to me. You need to teach me how you do that, I want to be the kind of person you are."

"Josh, I'm a parent, that's what parents do. One of these days you'll be a parent and you'll see what I mean."

He told me he remembered how manic he had been, "And I NEVER wanna be like that again!"

I hope he remembers that and stays on his meds, otherwise both are lives are going to be very difficult.