Author Topic: someone close to me is sick  (Read 5360 times)

misskris3

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someone close to me is sick
« on: February 04, 2016, 01:57:43 pm »
hi,

I'm new here. I don't suffer from depression, but someone close to me does. I actually think he is bipolar, because of a few major decisions he has made in the past month or two, followed by conversations where he is trying to explain how amazing and happy he feels...followed further by him saying he is really down and depressed and going to a therapist for help.

I've lightly commented that maybe what he has is bipolar disorder, but I'm not sure what else to do. He is seeing a therapist but he doesn't live in the same country as me right now (one of the rash decisions was to stay in China where he was traveling, despite having an apartment, job, dog, girlfriend at home). I've been hurt by him and what I believe is his illness twice now, by the decisions he's made and thought of as 'good' or 'happy', only to hear from him shortly after expressing regret and feeling really low and depressed.

I see this pattern in him, more than he sees himself I think. and the professional he just started seeing has not diagnosed him but before he left home, he was diagnosed with depression and on meds (20mg cipralex), which he says he is taking "sometimes" in China because he doesn't have a lot of it left and isn't sure he will be able to find it there.

I'd just love any advice you might have for me after reading this.

I'm in love with someone who is unstable, and who I believe suffers from bipolar disorder.

thanks so much for reading.

paulm

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Re: someone close to me is sick
« Reply #1 on: February 05, 2016, 01:14:35 am »
Hello Misskris3 and welcome.  I can't diagnosis your friend, but I can tell you a few facts and encourage you to keep asking questions. When dealing with any mental illness, knowledge is power.

 Taking cipralex on an occasional basis usually doesn't do much to defeat depression.  All anti depressants need a few wks at least to take hold and to provide us with a boost.  When we quit taking them, even for a short time, they then need to start over. In fact irregular use may cause the medication to lose it's effectiveness and possibly quit working all together.

 The other problem with taking an antidepressant if someone has bipolar that they may cause rapid cycling.  Rapid cycling is a bit of a misnomer because it can mean a few mood changes in a year or many mood changes in a mth.  However for those of us with bipolar, we don't need any help with mood swings, so for some of us, anti depressants can be extremely bad for us. About 30% of us will be affected that way.

 Unfortunately there is little that you can do to convince someone that they have bipolar unless they are willing to accept that diagnosis and they probably aren't going to do that if they are manic and may not do it if they are depressed. As a result sometimes you only have a very narrow window to discuss the subject and often that is when a person is level. Unfortunately , nobody likes to talk about bad things when life is fairly normal. Neither the person who has bipolar nor the their loved ones. We keep thinking , well this time they/I will be ok and they/I don't want to upset things right now. 

 Bipolar can cause many of us to do regretfully actions. The guilt we feel latter can be overwhelming. Why don't we seek treatment if we have this over whelming guilt? I wish I knew, but it is a fact that the illness can make us take the wrong path while thinking that everything is great.

 When he comes back, if he will let you, it would be a good idea to go with him to a doctors appt and explain your concerns. For some reason, doctors can take an awful long time coming up with the right diagnosis when it comes to bipolar, something like 5 yrs.  Partly because some of us that suffer from bipolar don't have the same memories of an event that our loved ones do. A quick example. When i'm manic, I may feel as if I'm the life of a party and remember it as such, whereas my wife may feel much differently. So a second opinion at the doctors office is often helpful when getting the diagnosis right.

 The MDAO, the charity that provides this forum, have a pretty good guide on how to help someone who has a mood disorder. It doesn't provide any quick and sure answers, but then with a mental illness there are no quick and sure answers, but it may help. I have listed a link to it below. In the mean time , keep asking questions and feel free to use the forum to vent out some frustrations. Good Luck and Take Care. paul m 
https://mooddisorders.ca/guide/guide-to-helping-someone-with-a-mood-disorder
« Last Edit: February 05, 2016, 01:16:26 am by paulm »

misskris3

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Re: someone close to me is sick
« Reply #2 on: February 05, 2016, 09:06:26 am »
thanks paulm, I really appreciate the response and the guide as well.

the trouble is, I don't think he will come home any time soon. he keeps saying he can't come home, his only support here is me, so he doesn't feel a desire to come back to his family (which may be part of the problem- I know mental health issues run in his family because his sister was diagnosed this summer with borderline personality disorder). perhaps I can just keep asking him questions about it and suggesting he consider mentioning bipolar disorder to his new therapist.

I think maybe the cipralex did hurt him in the long run. he was diagnosed with depression in October, and started taking it and didn't feel a whole lot better but was managing. and then he went on a higher dose shortly before he left for his trip, and then decided to stay.

I talked to him last night and he had found an amazing therapist there (he had been shopping around a bit), who is going to start CBT with him. so maybe she will diagnose him, but I'm not sure. I wish I could go with him, but not being in the same country makes it hard.

do people who are bipolar take other medication that helps them to be stable? I'd say he is usually fairly stable, but in the past year he's had two or three really high moments followed by some serious lows. I didn't realize it went undiagnosed for so long. I know his doctor here just concluded that he had depression after a few tests and questionnaires. Is it a similar test for diagnosing bipolar disorder? I sent him the definition of bipolar disorder that is found on a mental health hospital website, and it describes his life in the last month or two with quite a striking resemblance.

we are seeing each other in a month in Hawaii, where I was vacationing and he decided he had to see me so is coming, but his plan is to go back to china after a week away. Actually, I don't even expect him to get on his flight, given his unstable actions in the recent past.

I just don't know how else I can be there for him, if he is getting help but not the right kind. I don't want to suggest he try and get a prescription for something, but I think he needs something to help him stabilize. it's so hard to worry about someone who is literally across the world.



paulm

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Re: someone close to me is sick
« Reply #3 on: February 06, 2016, 01:34:41 am »
Hello Misskriss. I can only relate my own experiences and some of the experiences of those close around and that may be far different from what proper medical advice may advise.  The following is going to sound confusing, but I will try and give you a couple of links at the end that may help.

 In regards to bipolar itself. There are 4 different types of bipolar and each type may over lap. There are also rapid cycling and mixed states, which a person may or may not suffer from as well.  The illness can come on suddenly at any age, or it may take yrs to develop into a problem.  Some people with bipolar never experience any symptoms until something sets it off. Like antidepressants, anxieties, stress etc.  Remove what is setting it off and for a lucky few it may disappear totally.

 Unfortunately bipolar tends to be a progressive illness, that is , unless it is stopped at some point we continue to get worse, not everyone, but a majority.

 In regards to medication, most of us that have bipolar take medication, at least initially until it is under control. Even then a vast majority of those who remain stable in the long run continue to take medications every day. Some people take one medication, some people have to take 5-6 medications to control it.   Most medications that are used to treat bipolar have short term and sometimes long term very unpleasant side effects and they are a big reason why some people won't take medication.

 Believe me, even if you suggested a medication, it would be pure fluke if that medication was the one that worked.  That's assuming that he has bipolar and not some other illness or combination of illnesses. It's usually a long road to find out what works. 

 In regards to therapy.  Most really reputable therapists would either insist on the patient with bipolar having a doctor or referring them to a doctor once a diagnosis of bipolar becomes evident. Therapy alone does not help much if the person has mania as a therapist cannot prescribe medications( the exception being if the person has a long term relationship with that therapist and is able to manage their own behaviours with the limited use of medication).  CBT is not known to help someone with mania unless they are really stable at the time and even then DBT (dialectical behavioural therapy) is the more preferred therapy. Unfortunately most therapists are not trained in DBT, unless they have specialized in that field. A psychologist, with a phd, may have a working knowledge of it. ( side note, a psychologist cannot prescribe medications and a psychiatrist can. In a perfect world we would have one of each , it's not a perfect world).

 In regards to border line personality disorder. Just about everyone with untreated and serious bipolar will have signs of having BPD. The major difference is in treatment. Bipolar usually requires different meds and BPD most often responds better to therapy and sometimes medication.   I was once diagnosed with BPD and Bipolar, once my bipolar was brought under control the signs of BPD disappeared.

 In regards to tests for bipolar.  One problem here is perception. A test found at http://www.blackdoginstitute.org.au/docs/Self-testingforbipolardisorder.pdf   The problem with this test is that before diagnosis I would have answered "no more than usual" for most of the questions. Had my wife given my answers for me, her answers may have been radically different, but maybe not enough to push me into the "has it category" .  Doctors have better tests, but it all comes down to the same thing, how good are we at self examination and what is our own perception of ourselves and how much time the doctor is willing to spend probing.

 The largest obstacle to a test for bipolar is time. Feeling really lousy or suicidal makes it easier to diagnose depression. But someone who stays up all night and accomplishes a great deal with their excess energy from short term mania, may feel that nothing is wrong, so tests will show little.  Patients tend to be lousy at self examination, until the illness really affects their life so they often respond wrongly to questions. The question did you feel overly energetic means nothing to someone , we would all like to feel energetic all of the time.  In all my decades of living with bipolar I've had one really good psych evaluation. Between the questionnaire that I took and the interview with a nurse and then a specialist it took about 4 hrs and that was only to confirm that I had bipolar and that I was receiving the best possible treatment for it.  (I had already been diagnosed for 3 yrs at the time with bipolar)

 A good psychological evaluation includes a physical , to rule out physical causes, a complete family history, a complete psychological interview, repeated several times if needed and interviews with family and loved ones to bring out inconsistencies etc. That doesn't happen very often in Canada.   

 Keep learning and pick your spots when to talk to him. Good Luck and Take Care. paul m
 https://mooddisorders.ca/faq/bipolar-disorder

 

misskris3

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Re: someone close to me is sick
« Reply #4 on: February 15, 2016, 09:58:33 am »
thanks paulm, I really appreciate the advice and the links. I've been learning more and more about it.

during his ups, he really throws himself into new projects and work and is constantly dreaming up new ideas. it's really hard to be supportive of these when I know that a down will follow, and he doesn't quite seem to see the pattern yet- but it definitely is a pattern.

how does your wife communicate with you or how did she in the past, when you were having ups and downs? I feel like there has to be a good approach, but I don't know it. if I point out the pattern, he's quick to say 'whatever- im feeling confident right now and im just going to go with it, I don't have to tell you about my ideas then'. or something.

he's going to therapy but only for his depression, which he says is because of people- how interactions with people bring on depression that is within him, not because of work. he has a lot to learn and wrap his head around, but I think his therapist really needs to consider bipolar because right now he's all confident about these work ideas and just loading it on- like 4+ projects on the go, and soon he will crash.

I don't know how to communicate this with him. even pointing out past times that this has happened, and past failed projects doesn't seem to help.

paulm

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Re: someone close to me is sick
« Reply #5 on: February 18, 2016, 06:37:36 am »
Hello Misskriss3. Sorry about the delay, but I was away for a few days. Trying to communicate to someone that they may have bipolar is something that stumps even doctors. If the person is in the midst of a mood swing it can be very hard.

 How did my wife communicate to me that I was self destructing? After pleading, tears, talking endlessly , offering much support, she left me until I agreed to see another doctor. (at that point we didn't know what was wrong).  Once I got the diagnosis of bipolar, trying to persuade me that I did have bipolar and that I needed to take a lot of meds that I didn't like and change my life style was another long struggle involving separations etc.

 She also quickly discovered that it was of little use to talk with me when I was manic. When manic I could pass a lie detector test because I either believe what I'm doing is right or that the ends justifies the means.   

 Fortunately , it is a rare person who is manic for prolonged periods , unless there is an under lying cause. So the only time to talk sense to them is when they are not manic, unfortunately it can be hard to tell when they are manic or not. 

 It's also hard to talk to someone who is having a nice normal day. It's hard to have a good discussion about bad things on good days, but that is about the only time that they may listen to you.

 If he is manic, talking about failed projects will not work as he has new projects and probably a list of reasons why he feels that the old failed topics weren't his fault.  Talk with him when he's not manic and you may have some luck.

 How does my wife keep me on the straight and narrow. I have no more chances left. If I majorly screw up once more because of not attending to my bipolar, then she won't be around.  You will notice that I said " not attending to my bipolar" . I know I have bipolar and I know what it takes to be well. (well reasonably well most days)

 I'm sorry that I can't offer better advice. Take Care. paul m

Daniel F

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Re: someone close to me is sick
« Reply #6 on: February 18, 2016, 12:19:44 pm »
Don't forget about this great resource we developed at MDAO, the Family Matters Guide for Families: https://indd.adobe.com/view/93357642-cd4e-408e-a483-a1e54f4216a8

misskris3

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Re: someone close to me is sick
« Reply #7 on: March 01, 2016, 11:11:21 am »
thanks Daniel.

I've just heard that he is stopping his cipralex 20mg cold turkey, because he left it too last minute there to see a doctor and get some and I guess will have to wait two weeks?

in this time, we're supposed to be meeting in Hawaii.

has anyone ever stopped that medication abruptly? how long did the symptoms last? I'm super worried about him. and I'm supposed to see him on Sunday, and he stopped them yesterday.


paulm

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Re: someone close to me is sick
« Reply #8 on: March 02, 2016, 12:35:01 am »
Hello MissKriss3.  Quitting any medication suddenly can toss the brain and body into disarray. I've never stopped taking cipralex cold turkey, but I have heard that it can be tough. The good news is , if the withdrawal symptoms are bad you can just start taking it again and then taper off. The longer a person takes cipralex, the more chance of withdrawal symptoms.

 I have listed an article on Lexapro, which is the USA name for cipralex.  http://mentalhealthdaily.com/2014/05/07/lexapro-withdrawal-symptoms-how-long-do-they-last/ 

 I hope that your visit goes well. Take Care.paul m

misskris3

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Re: someone close to me is sick
« Reply #9 on: March 18, 2016, 11:23:44 am »
well, the visit went awful.

he told me he can't be with me while he figures out how to be happy. and then we proceeded to spend the week together, where I was able to witness just how sick he is. so many ups and downs, it was like being on a rollercoaster. grandiose, narcissistic views of himself and doing good trying to help people etc, super over confident but then crying the next day saying he feels like a lost little boy, then saying he's sorry he just has to focus on work right now and the rest will follow, then talking about all his work projects and ideas and getting angry when I say maybe he should focus on one or two until he's feeling better, saying I don't understand and have never liked his devotion to work.

suffice to say, I'm very emotionally drained and very tired. and my hands feel tied, I don't think I can do much more. I'm trying to cut him out so we don't speak, for myself and my own sanity. last week has led to some pretty serious anxiety for me, and I just mostly want to crawl into a dark hole and never come out.

the worst part about it is that no one else in his network knows just how sick he is. no one has seen it, since he is back to hong kong around new people and not family or friends, and I cant do anything anymore.


paulm

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Re: someone close to me is sick
« Reply #10 on: March 20, 2016, 01:14:29 am »
Hello Misskriss3. I sorry that you had such a bad time. Unfortunately the ones that care the most about us are often the ones who get hurt the most.  So you have my sympathy.

 I still feel extremely bad about how my illness made my wife's life such a hell for such a long time.  She still is insecure about life at times because of problems that my illness caused for us. Including my being narcissistic, having grandiose thoughts and crying that I was lost and didn't know what to do and those were among the more minor problems that I had. I also did a lot of other things that left permanent scars (mental , not physical) on her.

 Sometimes you do have to look after your own sanity and let go until the person is ready to recognize the illness. Unfortunately sometimes that just never happens. I realize that my words probably are not helping much and I'm sure that you are suffering immensely. It's a horrible illness, that causes horrible problems. I'm sorry for your loss. I can only suggest that you tried your best and that you should be proud of yourself for that. Take Care. paul m

misskris3

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Re: someone close to me is sick
« Reply #11 on: April 25, 2016, 11:40:22 am »
I'm beginning to think that it just isn't going to happen- him actually understanding and healing from his illness. he is filling his life with so many avoidance tactics, work, projects, and most obvious, running away from any of the people or problems he was facing at home. he still lives in hong kong, and we rarely speak now. I feel like I lost my best friend, the person I wanted to spend my forever with.

im having a hard time letting go. and im having a hard time with the weight of it all- that mental illness was the dagger in our relationship. how do you cope with that? it's not that he was a bad person, or treated me terribly. but that this big thing got in the way.

I'm also struggling to let go because for so long, I felt like the closest person to him. he mentioned more than once that I was the only person he really talked to about things, and I know that his family doesn't go there with him or access any kind of actual emotions with eachother.

I guess I don't know how to feel like it's final, and that it's over, given the circumstances.

paulm

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Re: someone close to me is sick
« Reply #12 on: April 26, 2016, 10:53:06 pm »
Hello Misskris3.  I'm sorry that things have not worked out. Sometimes people with a mental illness never realize just how ill they are and sometimes even when they do, they may refuse to do anything about it.  This is very hard on the people who love them.

 Mental illness may have been a dagger in your relationship.  With some serious illnesses our loved one dies and then we are allowed to mourn and move on. With a mental illness, it's not always that clear cut, but often the results are the same, the relationship dies. Unfortunately it can be (not always, but sometimes) much harder to mourn this type of loss and then move on. There are always those nagging questions, what if I had held on just a little longer, what if I had done or said something different, what if.... , well I could go on forever, but I'm sure that you get what I mean.

 I cannot tell you when you will know when the relationship is dead or when to call it quits, however you can take pride in the fact that you gave it your best shot.  If you do decide to move on, please take time to mourn your loss.  Take Care. paul m