Information needed about Bi-Polar disorder

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LafayetteLady -> Information needed about Bi-Polar disorder (6/20/2009 9:02:43 PM)
Hi everyone! I am looking for some help for a friend of my son's. He has been diagnosed with bi-polar disorder and currently seems to be having some difficulty. At this time he is taking 400mg of seraquel and 1000mg of depakote daily. He is having outbursts which tend to be on the violent side (breaking things, yelling and screaming). He has pushed his father to the limit to be honest. Yes, the young man has some other issues as well. His mother (who lost custody of him when he was 8, now almost 16) died last year. She was a drug user and drinker to my understanding and I know that he has some big anger issues with that. He also has ODD (normal oppositional teenager times 100). I've become somewhat of a mother figure to the young man and while he doesn't make much progress with any counselors (hates all of them of course), he does trust me and I have made some progress getting him to talk about some stuff that is bothering him. Anyway, today, his dad and him got into another battle, and his dad is ready to ship him off to child protective services. This would be a very bad thing, and the poor kid would be lost forever. Given his history, it is not likely they would put him in foster care, but right into a "treatment center." He claims that his medication is not working as well anymore. He has not been taking at the same time every day like he is supposed to and we're working on fixing that issue. What I'm hoping people here can help me with is anything non-pharmaceutical that can help him with this. I've talked with him about keeping a journal. Of course he hates writing, but I asked him to try it for a week, explaining that no one is going to read this at all and it doesn't matter what or how he writes. It is simply a method of letting out his frustration in a different way. Various physical activities haven't really helped much. Anything anyone can offer would be greatly appreciated. This is a good kid, and with the right direction I think can overcome this.

Rule -> RE: Information needed about Bi-Polar disorder (6/20/2009 9:33:07 PM)
quote: ORIGINAL: LafayetteLady He claims that his medication is not working as well anymore. Possibly his liver has learned to detoxify them. quote: ORIGINAL: LafayetteLady Anything anyone can offer would be greatly appreciated. Perhaps you could offer to host him one day every fortnight? It would lighten the burden on his father.

estah -> RE: Information needed about Bi-Polar disorder (6/20/2009 9:46:31 PM)
Greetings, What he needs is a means to let go of the steam from the frustration and anger...a sports of some sort...a fighting sport that focus on meditation and defensive methods is a suggestion. estah

Kalista07 -> RE: Information needed about Bi-Polar disorder (6/20/2009 9:52:34 PM)
One of the downfalls of most medications is that eventually, they do lose their effectiveness over time. One of the key things he needs to learn how to do (and you can help him with this) is to monitor his own symptoms. i would encourage you to do a google search on bipolar disorder...Many of the pharmaceutical companies have website that have 'tracking' tools, using this and taking it to his psychiatrist would help his doctor to be able to assist him in locating the correct doseage. Many times adolescents experiences are not taking seriously because they (generally) do not want to be on the medication at all. Personally, i'm not a big fan of serequel (sp) because it is so sedating and for many people in early addiction recovery it mimic the effects they were seeking when they were getting high. Personally, i tend to like lamictal more for mood disorders. You might talk to his dad and see if he can begin spending more time at your house. Check in on the dad's stress level. i would recommend someone that he knows cares for him and has unconditional positive regard for him go with him to see his psychiatrist. The thing that helps people with biploar to thrive is to provide them with structure. Consistency goes very far with people with this type of disorder. i'm sure i'm not telling You anything You don't already know; my experience with teenagers is they do not respect or value sitting down and talking to someone. They have no problem talking while driving, walking, playing a game, doing dishes, etc. i'm sorry he has not been able to find a therapist that he can respect, trust, or confide in.... Please let me know if i can be of any further help. Kali

SassyBird -> RE: Information needed about Bi-Polar disorder (6/20/2009 9:56:39 PM)
I have written you on the other side, LafayetteLady. I hope you do not mind, and wish you best of luck and strenght.

DefiantFlower -> RE: Information needed about Bi-Polar disorder (6/20/2009 10:00:58 PM)
Could the ineffectiveness of the meds be non-compliance? If he does not want to take the meds, (depakote can be a heavy one!) along with his history, he might not actually be taking them...just because. Because someone else expects it of him. Perhaps helping him see the benefits of it would help, if this is the case. Also, I definitely agree with you about the whole plunking him into the system deal. That would be the exact opposite of what he needs. If this is not already occurring, and on a satisfactory level...which I suppose you could ask of him...perhaps he just needs to be able to talk to his dad? To have an open line of communication, a trust and acceptance that can be hard after the death of a mother. A few thoughts...hope this helps!

slaveboyforyou -> RE: Information needed about Bi-Polar disorder (6/20/2009 10:44:55 PM)
One of my dearest friends is bi-polar, and her youngest son is too. It's hereditary by the way. She's in prison, and her son has been arrested 3 times (he's only 15.). I've been her close friend for years, and I was like an uncle to him. It's extremely frustrating to deal with bi-polar diagnosed people. Trust me, they don't mean to act like they do. The medications get altered constantly. I imagine it's not working for him. He needs to be in therapy, and he needs to have a professional monitoring his medication. I know he hates his counselors. Normal adolescent boys don't like authority figures. I didn't like them, but I coped. But I didn't have constant mood swings and my mind wasn't racing from depression to mania for no reason constantly. I remember my friend not talking to me for weeks and not wanting to get out of bed....and then wham! I'd get a call at 2 in the morning from her rambling in an excited state about some new idea she had. I remember her son breaking things and making threats. He threatened his school resource officer, and was damn lucky the officer was a kind woman. He could have got sent to juvie for awhile for that. I'm pretty patient, so I dealt with it. I still deal with it. I don't give up on people easily. But I'm telling you right now, you can't fix it. It will never be fixed; it's a lifelong illness. All you can do is make suggestions. You can't force someone to get help. It's never a good idea to try and reason or argue with someone when they are in a rage. When a bi-polar person is in that mode, you need to seperate the source of that rage from him/her. You can't reason with them when they are like that. When they calm down, then you talk to them.

DomKen -> RE: Information needed about Bi-Polar disorder (6/20/2009 10:46:26 PM)
Those are some big doses of some very powerful drugs. In general a teenager probably should never be dosed that heavily. I strongly suspect his outbursts are out of control manic phases due to noncompliance. The best course would be to get him in to see a doctor who isn't quite so eager to dose so heavily. The trick to long term compliance with a bipolar treatment regime is finding a balance where the mood swings are under control but the person isn't doped to the point of feeling deadened.

aravain -> RE: Information needed about Bi-Polar disorder (6/20/2009 11:03:36 PM)
~FR~ I'm sorry to sound like a douche/mean/whatever... but he needs to go to a treatment center. Note, not a hospital, but a long-term treatment center. With issues like that... well they're trained to deal with it. 400mg of Seroquel? 1000 Depakote? 16 years old? What is this doctor, 10? If THESE doses aren't even helping (hell, if these doses aren't making him such a zombie he can't really pronounce English anymore) then something's majorly wrong with his system, or he's not taking the medication, or it's not working anymore... not to mention he's SIXTEEN. Why is he taking drugs at that powerful a doseage!? He needs to go somewhere where they know how to deal with this. ~Aravain (who is now going to go back to reading the Ohio revised code [&o])

slaveboyforyou -> RE: Information needed about Bi-Polar disorder (6/20/2009 11:13:17 PM)
quote: but he needs to go to a treatment center. Note, not a hospital, but a long-term treatment center. With issues like that... well they're trained to deal with it. 400mg of Seroquel? 1000 Depakote? 16 years old? What is this doctor, 10? If THESE doses aren't even helping (hell, if these doses aren't making him such a zombie he can't really pronounce English anymore) then something's majorly wrong with his system, or he's not taking the medication, or it's not working anymore... not to mention he's SIXTEEN. Why is he taking drugs at that powerful a doseage!? He needs to go somewhere where they know how to deal with this. Long term treatment centers are majorly expensive, and a lot of times insurance will refuse to cover it. He doesn't need that unless a medical doctor suggests it. Like I said in my previous post, you leave decisions like that up to competant professionals. Forcefully committing someone to treatment is serious business. You don't do it just because you're frustrated. Just like any other doctor, you go get a second opinion when the current treatment isn't working. You don't just throw up your hands and force them into treatment so you don't have to deal with it.

DomKen -> RE: Information needed about Bi-Polar disorder (6/20/2009 11:18:55 PM)
Outpatient treatment with a good doctor would work more than likely. No need to a commitment yet. But he needs to get treatment by someone who isn't quite so gung ho for heavy meds.

slaveboyforyou -> RE: Information needed about Bi-Polar disorder (6/20/2009 11:52:09 PM)
quote: Outpatient treatment with a good doctor would work more than likely. No need to a commitment yet. But he needs to get treatment by someone who isn't quite so gung ho for heavy meds. Agreed.

purepleasure -> RE: Information needed about Bi-Polar disorder (6/21/2009 4:17:06 AM)
Ask the physician if Geodon would be a suitable medication for him. It has made a world of difference for my brother.

pahunkboy -> RE: Information needed about Bi-Polar disorder (6/21/2009 4:20:47 AM)
quote: ORIGINAL: slaveboyforyou quote: Outpatient treatment with a good doctor would work more than likely. No need to a commitment yet. But he needs to get treatment by someone who isn't quite so gung ho for heavy meds. Agreed. I was thinking the diagnosis is wrong and the DR should be changed. ...I have seen that when I worked in MR/MH group homes- the outbursts.

SavageFaerie -> RE: Information needed about Bi-Polar disorder (6/21/2009 8:56:26 AM)
my heaert goes out to you and the young man. My son has severe bi-polar and would go off and on his meds. He hs had two psychotic mainc episodes. One was so severe the judge order continuted treatment in a center till his medications took hold. This episode was a very disturbing effect as he has manifested that he was God and it was his job to save everyone. He second he was old enough where he could just check himself out after 72 hours is we managed to get the police there to take him to the hospital. Due to his frequent non compliance of his medications. he has been arrested 2-3 times for drunk driving. Lost his job because one involved him having a rental car which he damaged. Through the probation system he is now ordered to go to a outpatient facility and check in every day, it includes therapy and medication compliance or closely monitored to make sure what he is taking is effective. This has been a god send. While I dont live in Texas where he is, he lives with my mother and I get updates from her. His anger issue are in check, he is somewhat functioning better, although as bad as it is the facility had been helping him with trying to get on disabiliy....got his first denial with the reason that he is too smart.....oka when did having a IQ over ride a valid condition. His father was bi-polar so I suspect it was inherited. I know how you feel about being helpless to improve. I agree with the others that the medication is not working and the dose is insanly high. They have other bi-polar meds out there and again I would suggest he changes drs that dont just do the 5 minute writing out scripts routine with little to no questioning as to if whats being taken is working. He is blessed to have someone he trusts and will tell you how he is really feeling. One thing I would consider is having his father or you sign a release or medical power of attorney allow someone else to attend his session. I have poen signed off with my mental health dr and she help fill in things that I forget and is a huge help. I will also sign one for the medical dr next week when I see my new primary dr for the first time.

maletpeslave -> RE: Information needed about Bi-Polar disorder (6/21/2009 10:09:33 AM)
I found out (after the fact) that someone I was involved with in BDSM was in fact bipolar. Ugh, bad memories. I feel bad for those that have it, but something that doesn't bring pleasant memories.

DarkSteven -> RE: Information needed about Bi-Polar disorder (6/21/2009 10:25:32 AM)
I don;t know much about drugs but have a friend who was taking 300 mg of Seroquel and it would knock her out for a day. She began having psychotic side effects from it. If your surrogate son can find an alternative that works, have him do it.

girlygurl -> RE: Information needed about Bi-Polar disorder (6/21/2009 10:38:30 AM)
I commend you for taking him under your wing. Getting professional medical help is the safest bet. Unless you're a trained professional in dealing with individuals with bi polar it's unsafe for him and possibly you. If his mother used and drank is it possible that he suffers from fetal alcohol syndrome? There may be more than one illness this young man has to deal with. Again, I think you're a wonderful person to open your heart to this young man.

LafayetteLady -> RE: Information needed about Bi-Polar disorder (6/21/2009 12:41:13 PM)
Thanks so much to everyone who responded, including those of you who wrote me privately. I will try to answer everything I can. Rule: The issue about his liver is a valid one, and to be honest, I don't think the is receiving regular blood work to make sure that the meds aren't destroying his system. Actually, the young man is at my house several nights a week. I have also told his father that I have no problem with him coming to live with me for a while so that his father can have a break. As a single parent of a child with behavioral issues, I know how stressful it can get. estah: He wants to join football in the fall and has mentioned specifically he likes the idea of tackling people. Here at my house, we have lots of wood that needs splitting and I will regularly set the boys to the task. Chopping wood is a great way to get out aggression. Kalista07: We are working on recognizing the symptoms. It is a very slow progress as you know. His father has done a great deal of research regarding seraquel and is happy with the results. The young man is not, and to be honest, I agree that the dosage is crazy high. He is due to see her on the 25th and I'm working with him on telling her what he doesn't like about it and possibly even offering suggestions on other things. I'm 98% sure that at his age, the doctor has to consider his views over his father's. I would love to be able to get a list of the different meds he has been on in the past. I just know of the seraquel, the depakote and in the past topamax. I'm going to look up the lamictal you suggested as well as review all the sites you emailed me (thank you so much again). You are right on the money about his not wanting to take meds at all. We talked about it this morning and I was explaining to him that while he feels like a "guinea pig" because his meds get changed, that's the only way the doctor can find what works best, because everyone responds differently to everything. But I understand him not liking the zombie feeling the seraquel gives him, which is why I'm hoping to get him to talk with his doctor about other possibilities. Kalista, you have been a Godsend in this and I really can't thank you enough. SassyBird: I never mind emails on the other side, and again thank you for your help and information. DefiantFlower: Yes, there is definately some non-compliance with the meds. And there seems to be a bit of a power struggle between father and son (which is partly due to age) of who is in control. Interestingly enough, when he is in my house, there is never a complaint or question when directed to take his meds (I have a small supply that we keep here at my house so that he doesn't miss). Slowly, I've been opening the door on his feelings about his mom and making some progress (I've learned with my son that each tiny step is worth a lot). Talking to his dad is a really big issue. Have that whole "man" thing going on and working with the son is easier than working with the dad. Getting dad to change and be more affectionate is a big step. I've suggested that the young man help get things going by telling his dad he loves him which might get the response back that he so desperately wants. Right now, he is still so angry with his dad, that I'm not getting anywhere. slaveboyforyou: While there is a professional monitoring his medication, I think a big part of the problem is that he is not proactively telling the psychiatrist how it is working. There is a lot of "it sucks" but no real information. Hopefully, as I mentioned above, I can get him to take a more active role with her when he sees her on the 25th. Understand, I am well aware that I can't "fix" it. Nor am I trying to. But I can help him to deal with it and learn more positive constructive ways of getting through it. He never has those violent outbursts with me, so we aren't ever talking during that time. I'm lucky that way. We have made some progress as I mentioned, no matter how slow going it appears to be. The biggest step was his knowing that he can trust me and that he can tell me anything and I'm not going anywhere. I have the trust that he can't give to a counselor (my son has the same problem). A lot of that problem is based on things counselor's have done to them in the past. By that I'm mean their therapeutic methods being inappropriate for the problems the boys have and violating their trust. Right now, I'm hoping that I can just help the current living situation remain stable. So far, so good. DomKen: I completely agree that those doses are really huge. The problem with changing doctors is that he has been seeing the same doctor since he was 8 years old and dad trusts this doctor implicitely. It appears that this psychiatrist's only purpose is to monitor the medication and he only sees her like once every three months. I disagree with that approach totally, but not in the best position to change it. That's why I'm working with him to take a more proactive approach with the doctor telling her why he has problems with what he is on and offering suggestions on other meds that he may not have tried yet. I know when my son was on medication for ADD, the doctors never told me that as time goes on and the dose gets increased, that it would increase aggressive tendencies as well. When I asked them, they didn't deny it, they just weren't bothered to tell me up front. Great right? I agree that commitment would be inappropriate at this time and would do more harm than good. Without getting his father on board about a new therapist or new doctor, all the kid has is me. I may not be a licensed therapist, but I'm not totally incapable either. At least I can him to talk to me, which is more than anyone else seems to be able to do. aravain: A treatment center is a cost prohibitive option for starters. Further, at this time, the young man wouldn't respond positively to it. The only options for hospitalization right now would amount to "stabilization of medication" without enough delving into what works or doesn't work. Sadly that means they would up what he has withough concern for the zombie like effects. I think slaveboyforyou responded pretty well to your statement about this. purepleasure: I'm making a list of the all the medication suggestions everyone is giving and then going and looking at the various differences. Thank you so much for the suggestion. pahunkboy: Diagnosis isn't wrong, but doctor likely should be changed. At this point and time, that is not within my power. SavageFaerie: I would love to be able to get a medical POA for him, but I doubt it is going to be possible, unless dad's frustration level gets to the point where he turns over custody to me (which may happen). Again, that leaves me with attempting to get him to list what he doesn't like about the current meds and to present alternatives that he wants to try. Honestly, at this point, if she refuses to listen or do anything about it, I may end up encouraging him to apply to the court to have a medical POA issued to someone else. But my hope is that if he offers the information in a calm cohesive manner, that it will at least open up a dialogue. Based on the information I have, I have a feeling she might be one of those "5 minute" ones you talk about. I think we can all agree what their value is. DarkSteven: Yep, seraquel is some heavy shit. Knocks him out and keeps him from being fully lucid for several hours after he gets up. I can't blame him for his issues with it. Will put him to sleep (dead to the world kind) within a couple of hours and then keep him asleep for about 12. If things remain like this, he won't be able to work or drive. Or he will need to take the meds at like 5 in the afternoon to wake up lucid enough to drive to a job. That's no kind of life for anyone. girlygurl: I'm more like a "supplement" to the professional help he is receiving. I have pretty good instincts and don't believe I am in an danger with him. We talk. He will talk to me about things he won't talk about with other people, such as his feelings about his mom. We have talked about why he doesn't lose his temper with me, even when I might be being a little hard on him. It seems that the trust he has in me, and the fact that he knows I'm not going to give up no matter what makes a difference.

LafayetteLady -> RE: Information needed about Bi-Polar disorder (6/21/2009 1:06:54 PM)
Just a small update for those who may be interested: This morning we talked more about his mom. I think the difference between me and his therapists is that they take the "what do you want to talk about today" approach, never asking questions about anything in particular. We talked today about how angry he is with his mom for not choosing him over the drugs. He told me there have been many times he has thought about going to her grave and yelling at her. He seemed surprised when I offered to take him there to do just that. I'm trying to help him realize that he has every right in the world to be mad as hell at her and it is completely healthy to go and tell her, even if she may not be able to really "hear" him. His girlfriend (whose dad died when she was 8) told him how she did just that. I suggested that he write her a letter and tell her everything that she did that pissed him off. The idea, as many of you will realize and know, is that holding the anger in and then taking it out on others (such as his dad) isn't constructive. Expressing anger isn't a bad thing, it is HOW you express it that makes a difference. I believe that telling his mother off would be a productive thing even if he is talking to the "wind." While we aren't going there today, he now knows that his idea of doing that isn't crazy so maybe sometime in the future we will make that trip. He is also aware (and a bit surprised) at everyone's outpouring of help and suggestions. Yes, I told him that I posted (although not the name of the site, lol). I think part of the surprise was that he knew I told him that I would do what I could to help him, but having received so much "lip service" before, didn't really realize the extent I meant. We are going to be looking at the websites that were suggested to me on the other side and researching the other meds. Perhaps giving him a sense of control over what is happening and how it gets dealt with will have a positive effect. Knowing that there are other people out there with the same issues as him is helping as well. For those of you who offered to let him email/chat on line with you, don't be surprised if in the near future, he takes you up on it. Little steps, but all in the right direction. Thanks.

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