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Showing posts with label Medications. Show all posts
Showing posts with label Medications. Show all posts

Monday, July 11, 2011

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.

Monday, June 27, 2011

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.

Friday, September 10, 2010

The Struggles Begin

Josh had a paper due yesterday that he's known about for several weeks. He got ONE paragraph of it written after working on it all night. He didn't go to classes yesterday either.

So I talked to Josh last night about missing classes yesterday and not getting his paper finished. I told him, "First of all, I'm not mad at you, so don't get all defensive, I'm concerned. You have a golden opportunity here and I hate to think you're not gonna be able to take advantage of it."

He said the paper was impossible.

"OK, but the key here is that it was impossible for YOU. I doubt any other student saw the project as anything more than another paper, just like a zillion papers they've written before, right?"

"Yea."

"OK, so really think about this...why did it seem impossible to YOU?"

"I don't know Mom, I just couldn't even get past the very beginning. I did all the research and everything and I just couldn't pull it together, like my thoughts were a jumbled mess."

"OK, why do you think that happened? I mean, was it a function of having put it off till the last minute and the pressure you put yourself under caused you to not be able to form a coherent thought OR are your thoughts just jumbled? I know that with my work, I KNOW how to approach a certain job, I'm good at what I do and I step through a job very methodically; I do THIS, then I check THAT, etc. But if I'm under pressure, whether I've procrastinated or something unexpected has landed in my lap that I have to get done NOW, I can get all disorganized with it and I find myself attacking the job from all angles, and I can't seem to get myself to FOCUS and step thru it logically."

"Yea, it was kinda like that. Maybe I need to get back on my adderall?"

"Then you should make an appointment and go see the doctor, and maybe while you're there you could discuss a sleep aid with her. Do you feel depressed at all?"

"No."

"Well one thing to think about, and I know you don't want to believe you really have Bipolar, but you need to really consider that it's possible that the trouble you had with this paper could be the 'disordered thinking' that is part of Bipolar."

"I don't know how Bipolar could make me not be able to write a paper, it seems more likely it's my ADD. There are tons of people with Bipolar who can write a paper mom."

"Yep, tons of Bipolar people ON BIPOLAR MEDICATION can write a paper. But with Bipolar your brain doesn't process information properly and I think you owe it to yourself to really think about the possibility that the problem you had with this paper may NOT be ADD, but just a part of Bipolar. I know you wanna think you're not Bipolar, but things like this...this disordered thinking, are a part of it. If you think back to last fall semester, you had this same problem writing one of your fiction stories, something you used to be able to just sit down and pound out. I don't know Josh, if you want to REALLY be successful in school this year, you've got to take a hard look at what's happening and be willing to explore all the possibilities and do whatever it takes to make it better. Maybe see the doctor and try adderall, cause that will work IMMEDIATELY, if the problem is ADD, but if you find yourself still struggling, I think you need to consider a bipolar medication maybe."

He didn't make a decision, but I'm going to ask him to make an appointment with his doctor tomorrow. I've learned that *I* have to stay right on top of these things, cause he'll just let it slide and not address it. That's not gonna work, so I'm gonna have to push him to ACT.

Something I've been doing for the last year, with mixed results. The problem is he'll finally act after he's gotten himself SO FAR DOWN, I have to really keep pushing him to ACT NOW.

I did remind him that HE will have to repay the grant money if he fails a class, that I'M not going to repay it, the grant is in HIS name, they will look to HIM for repayment.

"Something else to consider is dropping all your classes now, before the grant funds, and getting a full time job and see what the next year or so brings in terms of this Bipolar stuff. You can go back to school at anytime."

"So you think I should drop out of school?!!!"

"No, *I* think you should address what's happening right now and realize you need help. Josh, something has shifted for you. In High School and your first year of college, you didn't have these issues and you can stay in denial and NOT look at the reality here, but if you're gonna be in denial, you might as well be there in a full time job MAKING money instead of at an institution of higher learning WASTING money."

Monday, July 19, 2010

Still Playing the Waiting Game

Not much new to report where Josh is concerned. He continues to be 'fine'.

He got all of his student aid issues resolved and has enrolled for fall classes. His grant money and student aid is conditional on him not failing any classes or getting any withdrawls or incompletes.

He is only taking three classes and his classes will be on Tuesdays, Thursdays and Fridays, they all begin at 12:30. This schedule should work well for him since he won't have to drive either direction during rush hour traffic and he can sleep in which is the schedule he prefers.

Right now his sleep schedule is completely topsy turvy. He goes to bed between 4-6 AM and sleeps until 3 PM or so. I pointed out that not only is his schedule upside down (which won't work once school starts), but he is also sleeping 12 hours some days.

"You know Josh, people who are depressed tend to sleep too much, you need to check yourself to make sure you don't feel like you're slipping into a depression."

"I think I'm fine, I'm not sad or having any dark thoughts or anything."

"OK, but you need to monitor that because now would be the time to address it so that you will be ready when school starts."

He has been very slow to address his job situation. He has typically been working less than ten hours a week and this week, they didn't schedule him at all. In light of that, he has submitted some applications online, but his money situation has now become dire. Last week his car battery died and instead of giving him or loaning him the money to buy a new battery, I let him figure it out on his own, my thinking being that a new battery would take most of his available cash and he would FINALLY feel a need to act on the job thing. That seems to have had the desired effect.

He went without a car most of the week until he got his paycheck. He jumped his car and drove and bought a new battery.

In general he has been very pleasant. Often he'll do dishes or other household tasks before I can even mention them to him. Now, don't get me wrong, it's not like he's tearin' it up around here, but I see improvement in that area.

He also agreed to clean the house every Friday in lieu of paying me rent and he has done a pretty good job with that. Sometimes he won't get everything finished on Friday, so he finishes up on Saturday, but he's at least doing it with a smile on his face.

He still spends too much time alone, but also sees his 'good' friends fairly often. They will all be returning to college soon, but so will he AND I hope he has a new job as well. School and work will fill a lot of his time and force him to get on a more normal schedule.

I feel pretty comfortable about his return to school. There is no way to know what might happen as the school year progresses. It's quite possible that Bipolar symptoms will appear and I can only pray that if they do, he will address them properly. I think not moving forward with school plans would be detrimental to him at this point, he needs the routine that school provides and to feel like his life is moving forward after having it all derail so badly during the last year.

He would like to think he's not Bipolar, but I'm not convinced he isn't. I expect there to be further issues down the road and it is impossible to say that if he's in a Bipolar state of mind will he still 'see' the need for medication. I guess we'll cross that bridge when we get to it.

It's very hard feeling like we are sitting on a time bomb, just waiting for it to explode, but that's what we're doing. There is very little that we can do to prepare for that eventuality. Josh isn't willing to discuss the possibilities very much, about the only thing we've agreed upon is to seek his therapists help if things go tits up.

I have missed the last several DBSA meetings due to other obligations, and I won't be able to attend tonight either, but hope to go back next week. It is very hard to sit in those meetings and listen to other people's horror stories when Josh is doing so well. It feels a bit like what survivor guilt must feel like. It's nice to know that the group is there though because I have a feeling I'll be needing their support again in the future.

Josh is doing well, but that doesn't mean he's 100% where he needs to be. I'm watching him closely, there is no part of me that feels like we're out of the woods or anything. I'm just trying very hard to enjoy this respite; I'm getting a lot done around the house and enjoying time with my friends etc.

Basically, I'm waiting for the other shoe to fall.

Thursday, June 24, 2010

He's Baacck!

Josh is doing so well the last several days. It seems all his sadness is gone, he is functioning well, taking care of the things he needs to take care of. Hey! He's even back to ragging on me about everything, but only in the nicest way. He says his mind isn't racing and his thoughts are not at all disordered.

I'm not sure how long this will last, but I'll enjoy it while it does.

Today he told me, "It's kinda funny to say this, but I kinda hope I have a thyroid problem, I mean, who would wish for that?"

"Someone who knows the alternative is a mental illness. Weighing them, a thyroid problem would win out in anyone's book."

No matter how Josh's blood work comes back, I'm going to insist they perform a thyroid scan. There still may be traces of medication in Josh's system that could cause the blood tests to be skewed. I'm not taking any chances.

One of my girlfriends has an Autistic daughter. She gave me a book and an article to read the other day that pretty much says that there is no such thing as Autism, or ADHD, bipolar or schizophrenia. According to these professionals, all of these conditions have a biological basis; heavy metals, hormone imbalances, etc.

They propose that if you look, you can find an underlying condition and treat it, and they say that most doctors just aren't trained in these areas, that they are so busy running their practices that they don't take the time to fully explore ALL other possibilities before attaching a label.

I suppose there is something to all this and I imagine, over time, this field of study will probably advance and gain more support.

She has encouraged me to meet with her daughter's doctor for a full work up, just to see what MIGHT be out of whack. I haven't discussed any of this with Josh yet, but there is a lot of information out there that points to the fact that many people are misdiagnosed as Bipolar, but are really suffering a thyroid problem, so we'll start by ruling that out.

Sunday, June 20, 2010

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.

Thursday, June 17, 2010

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.
Originally posted on my private blog on June 6, 2010

Josh and I got home yesterday afternoon. All in all it was a good trip, one I can at least look back on and 'see' what Josh on medication 'looks like'.

His intention is to see the nurse at the mental health center and get instructions for stepping off his medication now that we're home. And one of the first things he did after we got home was smoke pot. Sigh.

No way does he think he has Bipolar Disorder and therefore he doesn't need to be on medication.

There were many opportunities on vacation to discuss all this with Josh, where I was able to illustrate to him THEN (back home raging and being all over the place emotionally) to NOW (on medication and much more stabilized mood wise). But he doesn't SEE it, doesn't see the difference as being medication based as much as just vacation based.

"There's no stress here Mom and that's the difference."

In all of this I keep getting the strongest feeling that God works in mysterious ways. That this trip (that was supposed to be enjoyed by my boyfriend and me) turned out being shared by Josh and me, well, it seems there was a higher power at work that created this set of circumstances.

As we traveled home, there was another moment that felt like God's hand at work. We stopped in a rest area and as we walked out of the building towards our car, there was a guy in front of us RAGING at the older gentleman that was with him. The guy was in his late twenties and it was clear that he had some kind of mental handicap. He was screaming and cussing and was very animated in his disgust with this older gentlemen.

They arrived at their car, and there was a woman waiting there for them holding a very young baby. This guy reached into the car and pulled out a large heavy plastic shovel and started threatening the older gentlemen with it telling him he was not getting in the f*@king car with them.

The older gentlemen stepped away to the sidewalk and his demeanor broke my heart. Submissive, clearly in pain.....lost.

I saw myself standing there and Josh raging at me. I so related to what this gentlemen was going through and I said to Josh, "I hate to say it honey, but that guy? He is behaving so much like you behave when you're in a rage."

"I don't act like that!"

"Yes you do, you are just that way when you get upset with me."

As we entered the interstate, Josh shut off the radio, "We need to talk about this, cause that is NOT how I act."

"Yes it is Josh and I understand that you can't see it, but you are THAT BAD, so angry and loud that the neighbors become concerned for my safety."

We talked back and forth about it with Josh defending himself by stating that HIS behavior is MY fault. The way I talk to him, the things I say inflame him. I pointed out that he's not had any rages on vacation and that, believe it or not, I'm the same person this week on vacation as I was last week at home AND honestly? NOTHING I could say or do would justify him treating me the way he has. He was becoming more and more upset so I finally defused the situation by telling him that I needed to concentrate on my driving.

But I couldn't really get him to see that his behavior over the last several weeks was inappropriate to the circumstances and that on this medication, his irritability was greatly diminished.

He pointed out to me that his rages have become worse ON the medication and I pointed out that on THIS dosage of medication, with no pot or alcohol interference, he had been FINE.

Like all the conversations we had about the subject of Bipolar and medication while we were on vacation, this one ended in frustration for both of us, but if nothing else, we had the conversation and I left him with food for thought.

But I don't think it was just a coincidence that we encountered that guy at the rest stop.

In the end, nothing has really changed regarding Josh. We are back at square one really. He's going to stop his medication, he doesn't accept the reality of his condition, and the roller coaster is slowly climbing back up the big hill.

I'm unhappy that not more was accomplished on vacation. It would have been really nice and tidy if he'd had a moment of clarity and could SEE the facts, but that didn't happen. At the very least I now know that THIS dosage of medication with no substance abuse works. It would need to be tweaked, there might be additional medications needed to deal with sleep issues or some of the side effects of the medication, but we were closer than we've been so far in hitting 'normal'.

On vacation, on this medication, our conversations were 'normal'. No delusion, no bizarre subject matters.

I imagine when he stops his medication, his thought processes will return to being more abnormal with hints of delusion.

He CANNOT have a normal life, normal relationships in that state. I've made it clear to him that I am not willing to go back to living as we have been, with him raging at me. I tried to discuss 'what if' with him. "What if you go off your medication and you begin raging at me again, what if you become manic and delusional again?"

He wouldn't discuss it, totally dismissed it as me being unreasonable. "Mom, we don't need 'a plan' about 'what if' cause I'm gonna be fine."

He doesn't SEE, can't seem to 'get' the reality of how he WAS compared to how he IS on medication.

The only thing I really accomplished on vacation was getting him to agree that if he intended to stop his medication, that he do it under the care of a professional AND while he's said he doesn't intend to continue therapy, on the way home he said he'd like to see MY therapist.

I emailed her last night and gave her a brief synopsis of the situation and asked if she'd be willing to see Josh and possibly as time unfolded, she could point him in the direction of a psychiatrist, because he REALLY needs to be under the care of a psychiatrist.

So, that's where we are right now and it's not a very comfortable place for me to be. I have no idea how Josh will be once he's stepped off this medication. It's POSSIBLE he'll be fine, but more than likely things are going to go to hell in a handbasket (again).

I'm still very sad about the ending of my relationship with my boyfriend. I could kick myself for putting myself through the last couple of months, I should have walked away long ago, because the fact of the matter is that he isn't capable right now of having a grown up relationship. And with all I'm going through with Josh, I don't have what it takes emotionally to try to hold it all together.

Dealing with loss is always hard, and I'm kind of dealing with a double whammy of it. As hard as it is to deal with the loss of my relationship, the much more difficult loss I'm feeling is the loss regarding Josh.

I don't want him to be defined by Bipolar Disorder, but I can't help but feel that I've lost 'normal' and I'm not sure when or even if we'll ever find 'normal' again. I FEEL like I've lost my son, and while I know it doesn't HAVE to be that way, sitting here today I haven't a clue if I'll ever see MY Josh again, and that is a loss that is so hard to deal with.

If I'm Ever Gonna be a Grandmother, It Better Happen Soon

Originally posted on my private blog on June 3, 2010

Yesterday Josh and I traveled 7 hours round trip to Orlando to visit Universal Studios/Islands of Adventure.

When we arrived back at the condo last night, we showered and crashed. I laid in bed thinking that I'm getting too old for this shit. I have always envisioned myself taking my grandkids to Disney World, etc. After yesterday, I'm thinking that by the time I have grandkids, I'm gonna be too old to walk, let alone spend the day walking around in the hot sun, having my brains scrambled on coasters.

We did have an enjoyable day though and today is our last day here.

We check out tomorrow and begin the two day drive back home.

Josh had a very sad moment Tuesday night which in turn made me very sad.

I've tried to talk to him further about what happens when we get home, I've stressed the importance of him doing 'whatever he plans to do' regarding medication under the care of a psychiatrist. If I push too far, he gets angry, so I'm walking a fine line.

It's very hard to accept that he's going to undo all the good this trip has done. He is stable on medication although his periods of sadness still need to be addressed, as do some of the side effects, but he is closer to his normal self than I've seen him for months now.

He still hasn't accepted that he has Bipolar Disorder, let alone accept what he has to do to control it. And I just keep talking as opportunities appear.

I will try to hold onto the gift that this time together has been no matter what happens when we get home. I now have a vision of what is possible for him, even if he can't see it.

Please keep us in your prayers, as I continue to pray that God will guide me.

Vacation Update

Originally posted on my private blog on May 30, 2010

We're here on this beautiful Florida Island. My time is focused almost solely on Josh. I have a pocket of free time in the mornings because I'm an early riser and Josh sleeps until about 10. I may not be able to finish this post and tie it up with a bow, so I'll get to the important points first.

Josh is doing better everyday.

Our trip down was difficult, but only in the sense that I felt I was traveling with a 12 year old Zombie. Josh didn't talk a lot and when he did there were moments of delusion that popped out. He complained a lot about the medication he was taking, how it made him feel both physically and mentally. I have been concerned that forcing him to stay on this medication for the duration of our vacation was a mistake, there is a fair measure of guilt that comes into play when you hear and see the effects of your decision.

But each day I've seen improvements in his general mood, I've seen very little delusion. He is less Zombie like, but very 'slow' thinking, which is unlike him. Yesterday was the best day yet. We went out to breakfast, did our grocery shopping for the week and then spent several hours at the beach. We drove into town last night and played putt putt, stopped for ice cream and then came back to the condo and watched a movie together.

Josh seems to get very sad in the evenings and there are tears and proclamations that his future is nonexistent.

I talk and cry with him, reassure him that on the other side of all this, there is hope. I hold him when he cries and tell him how much I love him.

Josh told me that he finds this place very relaxing and you can see that in his demeanor. He is very calm, but he worries about the short term memory loss that is a side effect of this medication. I remind him that many of these side effects dissipate over time, that his body and brain are working hard to adjust.

Putt putt is something that the boys and I have always done together, no matter where we vacation. I pretty much suck at it and Josh, being the very competitive person that he is, takes the whole thing very seriously. When he suggested Putt Putt last night it thrilled me that he wanted to do something that was so much a 'normal' part of our vacations.

I schooled him. I've NEVER beaten him at Putt Putt before, the ending score was very close. I was three over par, he was four over. I told him later, "Well, I considered letting you win, like I used to do when you were little."

He got a sly smile and busted out laughing, cause he knows I never LET him win in the past, I just suck.

And right there in that little story is the saddest part of this for me. To see him like he was while we played, his reaction to my little joke...well, it's heartbreaking to think that such a small, seemingly insignificant moment can take on such magnitude, because all I can hang my hat on right now are the smallest of 'victories'.

When we stopped for ice cream last night, the two girls working the counter were HOT, and they were all over him, didn't take their eyes off him. They flirted and he flirted back. Josh so badly wants a girlfriend and he's feeling unattractive and undesirable. The fact of the matter is that Josh is a very good looking guy, but in his current emotional state, he'd scare any girl away who got close enough to see his cracks. Clearly though, he's still 'got it'.

When we sat down with our cones I told him, "Those girls were eye f@*king you."

This town is very different than the island we're staying on. As we drove through, there were hot men and women everywhere, barely clothed. On the island, it's mostly families and couples and the median age is probably 40. Not many hot bodies on the beaches here.

"Maybe you'd like to come over here to the beach one day? It might be more fun than the beach at the condo."

"I dunno Mom. Yea, there are lots more hot girls over here, but I'm not gonna really meet any of them and it might just drive me nuts having to look at them all."

My problem is going to be keeping Josh occupied. I imagine everyday we'll spend several hours on the beach (as long as no oil washes ashore) or at the pool and then we'll have an afternoon activity of some kind planned. I'm going to try to find time tomorrow morning to search for activities off island, I even considered looking into driving to Orlando and spending an evening and day at Universal Studios/Islands of Adventure.

Keeping us occupied could wind up costing me a fortune :)

So, all in all, he's doing as well as I could hope for and I have my fingers crossed that there is no backsliding, that each day continues to present gifts.

I'm missing my boyfriend; missing the vacation that we were supposed to share.

Like Josh, it's easy to look at where my life is at RIGHT NOW and wonder about my own future. I'll be 53 years old in a few weeks and once again, I'm all alone. My desire to find that one special person to spend the rest of my life with seems like just that, desire, with little hope. On the other hand, as Josh said yesterday, "Jesus Mom, you don't LOOK 53, you're in great shape and you're smart and funny, don't count yourself out. Just like those girls in the ice cream store, I see guys checking you out all the time."

"Yea, well, that's what guys do honey, it doesn't mean much."

"Well, guys don't check out the unattractive girls Mom."

I do know this. I feel strongly that everything having to do with this vacation has played out the way it was supposed to. Bringing Josh here was fraught with concerns and yet, so far, I can see that this time can be very valuable for him. This time with ME, this time to adjust to his medication. And I believe the situation with my boyfriend has played out as it was meant to. Who knows, perhaps this is what needed to happen FOR him?

And because I so strongly believe in the concept that everything happens for a reason, I have to have faith that there was a reason for all of this and that God has plans for me and for my future that I can't even imagine at this point.

Now, Josh is up and I'm off to make him breakfast.

The Little Boy Who Cried Wolf

Originally posted on my private blog on May 24, 2010

I don't remember my parents reading to me when I was little. I'm not saying they didn't, in fact in a family album I have that belonged to my father, there are pictures of my sister sitting on his lap while he read her a book, so I'm sure they did read to us, I just have no memory of it.

And that makes me wonder (and I intend to ask the boys) if they remember ME reading to them, because I did. A lot. Jordan would sit on my lap for HOURS, literally HOURS, from a very young age, and listen to me read. Josh was more the type of kid who'd listen to two or three books and be done, but I read to him everyday, several times throughout the day.

Anyway, I don't remember being read to, but I remember my father telling me the story of the Little Boy Who Cried Wolf. I can remember asking him, at bedtime, to tell me the story again. I must have heard it hundreds of times, and each time my heart would race when the Wolf really was after the little boy and he'd cry and cry for help, "Wolf! Wolf!", but no one would respond because he'd tricked them so many times by calling "Wolf!" when there really wasn't a Wolf after him.

This tale has many lessons in it, but the one that brought the tale to my mind earlier today is the lesson of abuse of trust. Somehow in my twisted little mind, it made me think of my boyfriend. He's like that little boy who keeps tricking the villagers and then is shocked when they don't respond as expected.

Sad.

He spent the evening texting me and ALL his texts were in regards to his feelings about the loss of his vacation plans. At one point he asked if we still couldn't go on vacation together, after all, there are two bedrooms in the condo. Then he commented, "We could have broke up after vacation you know."

It hurts beyond belief that a vacation seems to be a greater loss to him then losing our relationship. I can imagine how disappointed he is to have plans we've been making since January fall apart in this way at the last minute, but his immaturity and limitations are really showing when he A) can't for a second put himself in my place and realize that what I'm going thru with Josh trumps EVERYTHING, and B) can't take just a gander at his behavior that resulted in this turn of events.

I feel awful that all this fell apart as it did at the last minute, and on top of that I'm trying to cope with Josh, I'm consumed with doubts and fears.

Josh slept until noon Sunday and when he got up I talked with him about going to Florida with me. He was resistant, but as we talked I could tell he was coming around. "You know Josh, the other thing is that I don't really want to go to Florida alone. I'm sad about what's happened with my boyfriend and I and you and Jordan are the only people who really know everything that happened, I may need you there to talk to, to help me when the sadness gets to be too much."

"Don't play that card Mom."

"No really, can you imagine how hard it would be to be all alone and sad and have no one to talk to about it? You're so good at helping me remember why this is the best thing for me."

In the end he agreed to go to Florida with me, and he agreed to stay on 150 mg of medication until we got home.

He had to work from 2-5, and during the few hours we were together he was irritable, but generally OK.

He went to work and during the afternoon two of my neighbors 'stopped by'. They both expressed concern about Josh's outbursts yesterday and they both pointed out that Josh seems to be getting more and more volatile. I hadn't told my neighbors about Josh's diagnosis or his hospitalizations, but I shared with them the saga that began with Josh's depression and ended with him being diagnosed with Bipolar.

My neighbor across the street told me that his son (who is a year younger than Josh...Josh and he used to be best friends, but had a falling out four or five years ago) is Bipolar. "But he was never as volatile as Josh seems to be, and Melody, I don't want to intrude but as I've listened to his outbursts over the last month or so, I'm increasing concerned for your safety. I felt I needed to come over and talk to you and let you know that I'm here for you, Chuck next door is here for you. I know you're all alone here but I don't want you to feel alone, we're right here if you need us.

When Josh got home he was pretty upset. His boss had ignored his schedule request for vacation and wouldn't respond to his phone calls. Throughout the evening he got more and more upset, feeling like his boss purposely scheduled him knowing he wouldn't make his shifts and then he could fire him. (I'm quite sure Josh hasn't been a model employee over the last few months and his boss has had to cover Josh's schedule when he was hospitalized, so it's quite possible he's trying to force a situation). I have no idea how many times Josh called and texted him, and nothing I said could get him calmed down about the whole thing.

THEN, he got the blue screen of death on his computer when he was trying to get online to schedule classes for the fall, so that created more yelling and fuming.

And THEN he went to watch a movie that had come in the mail from Blockbuster and when he opened it, it was cracked in two.

He started yelling and carrying on and flew out of the house and left in his car.

When he finally returned, he was very agitated and began crying and had a meltdown about how pointless life is and how MUCH he doesn't want to be here anymore.

By this time it was 10 PM. I had 'suggested' at nine that he take his meds but he got angry and told me he'd take them when he wanted to. So I 'suggested' it again, and again he got mad at me.

"Well Josh, you promised to take your meds the way your supposed to from now until we get home from Florida."

"Fine, I'll take them, I'll do what you want."

I don't think he ever took them though. He went to his room, I shut the house up for the night and turned out the lights and went to bed.

At 11 I heard him leave. I knew he was going to get his friend, Issac (who is really no friend to Josh. He has no job, no car. His girlfriend is still in High School and so when she has to go to bed for the night, he'll call Josh to come get him and then Josh has to drive him home....usually at 2 or 3 in the morning). I called him, "Are you going to get Issac?"

"Yes"

"Josh, I'm trying to sleep, I have to work tomorrow and YOU shouldn't be driving if you've taken your medication."

"Mom, we're just going to quietly hang out in my room and you don't need to worry about me or my driving or my medication! Do you want me to just drive this car into a tree?! Cause if you don't shut the f@*k up, that's what I'm gonna do!"

Yes, the animals are running this Zoo!

I woke up at 1:30, Josh was coming in from taking Issac home. I have no idea if he took his medication, but if he'd taken it at 10, he'd have been sawing logs by midnight.

Here's my dilemma. I really feel that IF Josh would take his medication as he should for the next few days, by the time we leave for Florida he will be manageable. Being away for 11 days ON his medication will be good for him. So I'm trying to cut him a wide berth here to get him to Florida with me. BUT, if he's NOT going to take his medication as he should until we go, or if he mixes it with pot and alcohol, he's not going to be in a good state of mind when it's time to go and there's no way I can take him in a car for a two day drive if he's in a volatile state.

Everyone has an opinion and half the people tell me I should just go without him if he's not in a good frame of mind at the time. They think I should just leave him here and whatever havoc is created as a result may be enough havoc to create a 'bottom' for Josh.

Other's, like my neighbor who has a Bipolar young adult, feel there is no way Josh should be left up to his own devices, that the ramifications of such a thing are too great, that the seriousness of this situation is dire.

And me? I've been awake since 1:30. Unable to sleep, eaten up with fear, wallowing in pain and sorrow.

Josh will more than likely sleep well past noon today, he was up so late, which means tonight he'll be up even later and sleep later tomorrow, so I predict that he won't sleep at all tomorrow night and by Tuesday he will be right back where he was Saturday. And if you ask my neighbors, they'll tell you that wasn't a very good place.

I told my sister (who unfortunately lives out of state or she'd come and stay with him while I'm on vacation) that it seems there should be a place where you could 'send' this kid where he could live for a month under constant care, with ongoing therapy. However, if such a place existed, it would cost more money than I have and in the end, my kid would probably come out stabilized and quickly mess it all up anyway.

She feels that, just like with my boyfriend, the time will come when I'm DONE with Josh too and setting him out on his own won't feel like such a horrible thing to me.

The ONLY thing I know to do right now today that MIGHT help is to call the therapist at the IOP and ask for his advice. And to go to the Bipolar Support Group meeting tonight.

Projecting forward, I see no way that Josh will be in a frame of mind where I'll feel safe taking him to Florida and I see no way, that in my heart I can go and leave him here on his own. If only he would go to his Father's while I'm gone, cause I NEED to get away from all this for awhile, but I can't go if I'm not comfortable that he's being cared for.

Sorry for the long, rambling post. When I started it at 5 AM I had no idea it would go to where it's gone. Anyway, cut me some slack, I'm operating on less than three hours sleep.

And The Adventure Continues

Originally posted on my private blog on May 23, 2010

Sometimes when the suckage of life is at an all time high, the best thing we can do for ourselves is to keep in mind that, in spite of the suckage, what we are experiencing is simply Life. (At least that's what my blogging buddy A/ keeps telling me).

In all things that occur, the good and the bad, there is at the core of it, lessons to carry forward, emotional muscles to develop, real growth.

Let me take you through the last few days, step by step, so you have an idea of my headspace as things transpired, because the end result is that yesterday was the second worst day of my life.

It's dangerous to label a day as 'the worst day of my life', because life is prone to try to one up itself, which is what has happened to me. In my old blog I wrote a post entitled, "The Worst Day of my Life, Hands Down", about the day I placed my older son into a youth facility against his will in the hopes that he would get clean and sober and get his life turned around.

But then life one upped me and I got to experience what REALLY has been the worst day to date; the day Josh had his first manic episode just a few weeks ago. THAT day was so much more difficult than what I went through with Jordan, to see your child in a state of delusion and have no idea WHAT to do in terms of helping him is far worse than having a child destroying his life with drugs and alcohol. One situation you KNOW how to handle, the other leaves you feeling ill equipped and lost.

And I've been lost every single day since Josh's first manic episode.

Yesterday also trumps my worst day with Jordan.

When Josh decreased his medication to 150 mg, it seemed to improve his general mood. He was much more like himself, in the few days he was on a decreased dose, he exhibited no anger, not even the slightest frustration. I was hopeful that perhaps the improvement would last and that maybe we would maintain an even keel.

Nope.

In addition to Josh's mood swings, I was dealing with ongoing issues in my relationship with my boyfriend. The things that had plagued us just seemed to multiply, and Josh's situation was causing me to reconsider whether I had the energy left to devote to a relationship that was becoming increasingly difficult. I love my boyfriend, SO much, but sometimes love just isn't enough to overcome the obstacles.

The most troubling aspect of our relationship was that I lacked a sense of security in this relationship, and without trust, without open communication, you really can't have a relationship. In spite of all this, I wanted very much for us to enjoy our vacation together, we always have a great time together and we both needed to get away from our individual stresses.

SO, Friday night I went over to his house and we packed for the trip. He packed his clothes, I helped him gather up the kitchen things we'd be taking and he packed them. I spent the night and on Saturday morning he went to work and I went home.

When I got home I walked into the second worst day of my life.

Josh was in the shower and he'd left his bathroom door open, so as I went into my office I called a hello into him so he'd know I was home and not come tearing out of the bathroom naked.

"Did you just get up?"

"Do you want the truth or do you want me to lie to you so you don't worry?"

"The truth."

"Well, I never got to sleep last night."

When he got out of the shower and got dressed he came into my office. It was about 10 AM, and from 10AM until bedtime last night, I lived through a pretty awful day and broke up with my boyfriend in the process.

Josh's mood was 'off'. He wasn't manic, he wasn't depressed, he was almost 'zombie' like. He made perfectly good sense 99% of the time and then he'd say something totally nonsensical, like, "Well Mom, you and I could coexist in this house happily if you'd just open your bedroom window."

"Open my bedroom window?!"

"Yes. You have this window open and if you open your bedroom window it would.........(insert far off stare)......balance things."

Early in the morning he got VERY angry with me. He kicked my desk several times and pounded on it several times hard enough that the things on my desk jumped.

I finally got him calmed down but he was talking about plans he had for when I went on vacation. That he and his buddy were going to go down to my ex's wooded property and 'detox'.

"I'm gonna get this medicine out of my system, no drugs or alcohol, no cigarettes. I'm going out into the wild and come back with clarity."

Well, you can imagine my discomfort with this plan. First of all Josh planned on stopping his medication cold turkey....while in the middle of no where....with no cell phone reception....in company with a 20 year old who wouldn't have a clue how to handle the Josh that might appear on no medication.

Josh became agitated off and on, more and more delusional and eventually I called my ex and asked him if he could please come over, that maybe he could reason with Josh. He said he'd call Josh.

Josh talked to his dad for over an hour; calm, seemingly reasonable and cogent, but I only heard a snippit of their conversation.

In the meantime, I text'd my boyfriend and told him that Josh was a mess, in a rage, and that I was trying to talk him into going to the hospital for an evaluation.

Knowing that Josh has scared me before with his behavior, I was expecting a call back, asking if I was ok, or if there was anything he could do to help.

Instead I got a series of texts lamenting what this would do to our vacation. Pointing out how unfair it was that this might effect our vacation plans. Bitching about how hard he's worked doing side jobs during the prior month so he'd have spending money for vacation.

And I was finally done with him, because, not only was trust and communication an issue for us, but that part about being there for each other....obviously wasn't.

The rest of the day with Josh was awful. At one point after Josh insisted he was going to stop his medications in an unsafe manner, he was kicking furniture and pounding his fist into the walls I finally said, "OK, well, you're an adult and you can do what you want, but I don't have to sit by and watch the results. Right now you need to go pack your things and go to your father's."
He said he wouldn't, I said he would or I'd call the police and have him removed from my house. He took my phone and the house phone so I couldn't call the police. I headed out the front door to use a neighbor's phone and he threw the phones at me and stormed off.

So I called his father again (who by this time was sick of the both of us) and asked him to PLEASE come over. For whatever the reason he said, "let me call you right back."

When he called back he asked to talk to Josh and pretty soon Josh was screaming at him (something that NEVER happens). Josh handed the phone back to me and said, "I'm done talking to him and I'm done talking to you."

I took the phone outside and talked to my ex who told me, "Jesus, it's impossible to talk to him when he's like that, you can't reason with him at all!"

Ya think? Welcome to my 24/7 world sweetheart!

In the end my ex told me, "You know Melody, this is so heartbreaking and I feel so helpless and I know you do too, and I don't know what the RIGHT thing to do is, but in the end, maybe you need to let him hit bottom. He says he's not coming over here, he's just gonna GO. You have no control over him, but if he leaves your house, you have even less control. I don't know, that's maybe the eventual outcome, you need to kick him out and stop padding his fall."

"Yes, but Jerry, HORRIBLE things could happen. He could do something and get arrested, he's clearly on the edge of another manic episode and he shouldn't even be driving, he could have a wreck, hurt himself, kill someone else. I mean, there are just some very serious consequences that could occur. How can I kick him out knowing that?!"

"All I know Melody is that until he gets on board with managing his condition, nothing is going to change. You're going to keep going through these types of episodes."

In the end we decided I should try to calm Josh down, let him stay, let him go to work his 5-9 shift and that hopefully when he got home I could get him to take his medicine and get some sleep. That after a night of sleep he would probably be much better mood wise, much easier to deal with and reason with.

So that's what I did. I calmed him down and spent the rest of the afternoon just talking with him, watching him sink further into delusion as the day continued.

He went to work and my boyfriend came over. We had a discussion about the issues in our relationship, about his lack of support on a day when I needed it the most, and in the end, I broke up with him. So much for our vacation!

When Josh came home from work, I encouraged him to take his medication and told him I'd visited the pharmacist who gave me a compatible over the counter sleep aid in case Josh couldn't sleep. The pharmacist advised me that Josh probably hadn't taken his medication the night before. "It's extremely sedative in nature, if he'd taken it, he would have slept. But if your son won't take his medication tonight, give him this. If he takes his medication, give it two hours to work, if he still can't sleep, then give him a dose of this."

Josh needed to take 3 - 50mg pills. He agreed to take one. I finally convinced him to take two. I made him a bite to eat, he ate and went to bed, where he's still asleep.

Josh probably didn't take his medication Friday night and he told me he'd been drinking whiskey, he couldn't tell me how much. This young man just keeps shooting himself in the foot because he won't get on board and stay on board with his treatment plan.

I got the bill yesterday in the mail for his hospitalization. $9,600. This is the REAL tangible cost of all this. How many more hospitalizations is it gonna take before he gets on board. And the intangible costs are mounting as well.

When Josh gets up today I'm hoping that he is in a good frame of mind and can listen to reason. I would like for him to agree to continue his medication at 150 mg, agree to go to Florida with me for 11 days where he will have no access to drugs/alcohol and can just chill with me. I'd like to see what the results would be if he stayed on this dosage for two weeks without the interference of outside substances, that maybe by the end of that time period he would see the benefits of the medication and the need for abstinence with drugs/alcohol.

He may not be agreeable to this, one never knows what mood is going to be present on any given day. I may be in for another really bad day. Who knows?

What I do know is I'll just keep doing the best I can with it. I keep making mistakes, and as a result I keep making things worse, but I'm learning everyday.

If Josh doesn't agree with my Florida plan, than I'm not going.

Sad situations all the way around, BUT, my child is alive and sleeping soundly in his bed.

Right now, that's enough.

Too Many Freakin' T-shirts!

Originally posted on my private blog on May 20, 2010

I haven't been able to post an update for some time because things around here change almost by the minute.

Josh is fine, almost normal, one minute, and in the next minute he's screaming, "F@*k you!" to me and running around the back yard beating the ground with a baseball bat.

Don't ask.

He is quite unhappy at the moment. He doesn't believe he is Bipolar, he HATES the way his medication makes him feel and he thinks his IOP is a huge waste of time and money.

So, he's decided to decrease his medication from 200 mg to 150. At 100 mg he was still all over the place mood wise, but at 200 he says he physically feels awful and his ability to control his anger and stress is worse. He's going to TRY 150 mg, but if he isn't happy with that dosage, he is going to step himself off the medication and use pot in limited amounts to help calm him and help him sleep at night.

He is no longer going to the mental health center and doesn't feel like he needs ongoing therapy.

While all of that sounds pretty terrible, there are parts of it that may not be as bad as they seem.

I attended a support group Monday night that is presented by the DBSA (Depression Bipolar Support Alliance). It was an interesting and informative evening.

One couple in our group has a 17 year old daughter who is Bipolar. Her mother told me that a year and a half ago her daughter chose to stop taking her meds. She smokes a limited amount of pot each evening to help her sleep and she has done well without meds.

"Honestly, I've heard this time and again over the years, pot seems to be a magic bullet for some people with Bipolar, as long as they limit the quantity. I hate to say it, but I wish they'd legalize it."

A book I read on the subject of Bipolar stresses the importance of medications but points out that there are people who are misdiagnosed and also people who have one depressive and manic episode and NEVER have another one. There are no statistics for these situations though.

So, maybe Josh is right and he doesn't have Bipolar (although after reading that book, I'm more convinced than ever that he is) OR, he has Bipolar, but perhaps he can manage his moods by using pot in modest quantities.

In the end, none of this is MY decision, he has to be responsible for his condition and he has to choose how to manage it. The only thing I've said to him is that I'm OK with whatever he chooses to do, as long as it manages his mood. I'm not willing to live like we've been living; highs and lows, screaming and yelling. If he goes off his medication and has problems, he'll need to reconsider his options.

My heart goes out to him and I pray that he'll be able to manage his moods without medication, but if he can't, well, more wild days ahead for us.

I am leaving in one week on vacation and while I had considered taking Josh with me, I've nixed that idea. He is so volatile, and all his anger is directed towards me. I need to get away; get renewed and refreshed, and I think he needs to get away from me too. His father has agreed to check up on him everyday and Josh has agreed to go visit his dad every other day while I'm gone. Because he's adjusting his medication, I have no idea what he will be like, but he's agreed to hold his dosage at 150 mg until I return. If he's going to step off of it, he'll wait until I'm home to do it.

And then there's my boyfriend. We are to take this vacation together in one week, and to be completely honest, our relationship is not turning out to be all I'd hoped for.

If we do go on vacation together, I can't imagine our relationship lasting much beyond that, which is very sad.

Thank you faithful readers. So many of you have emailed me or commented about your concern for Josh and me and that means so much to me.

This situation with Josh has been the most difficult thing I've ever faced, but I am surrounded by loving and supportive people, like my blogging buddies, it makes everything a bit easier.

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.