Brittle: Goldilocks’ Dilemma | Psychology Today

My purpose in writing this blog is to share what we experienced with our son, starting from the first symptoms of his illness and through the many episodes that followed. We also hope to provide commentary, both as parents and as psychiatrists, on the issues these experiences raise, including how the diagnostic process works in mental health and how to work with treatment providers. Masu. medicine problem. I hope that reading this will be helpful to people with mental health issues and their families and friends.

brittle

Source: Marcel Dominique/Pixabay

In diabetes, the concept of a “vulnerable diabetic” refers to patients who have difficulty finding adequate insulin doses. If the dose of insulin is slightly too high, it can lead to dangerous hypoglycemia, and if the dose is too low, the blood sugar level will rise so much that it will continue to have negative health effects and lead to diabetic disorders with impaired consciousness. Levels of ketoacidosis can also be reached. Similarities with Bill bipolar The disease applies. Considering the side effects of mood stabilizers and neuroleptics, it was already very difficult to find a combination that he could tolerate. Additionally, the doses required to keep him stable were so high that they caused more side effects, including weight gain, lethargy, and general malaise. No wonder Bill has repeatedly tried to reduce the dose of the neuroleptic medication or stop the medication altogether.

During his first hospitalization, he was thought to have schizophrenia and was treated with haloperidol. Because the drug affects the whole body, not just the brain, he suffered from painful leg cramps known as extrapyramidal effects. He was switched to Risperdal, another drug in the same class, but it had no further effect and continued to cause leg cramps, although less intense than those caused by haloperidol. Because of the side effects, his psychiatrist naturally prescribed the lowest possible dose, which, combined with Bill’s own desire to minimize his dosage, ultimately contributed to his frequent seizures. It is possible that it did. relapse.

The main side effect of the mood stabilizer lithium is tremors, which Bill disliked because his hands trembled and he felt self-conscious. Lithium is the oldest mood stabilizer and has the strongest evidence base for both its mood-stabilizing effects. mania and depression. An alternative drug, Divalproex (Depacos), also works as a mood stabilizer and was often prescribed to Bill.

His mood may suddenly change from calm (normal) to manic to depressed. It’s difficult for his doctors to deal with such sudden changes in mood, and they rely on Bill to keep him informed of his mood status in order to make medication adjustments. Ta. He often did not recognize the elevated mood until it had already begun to take hold, by which time he was often caught up in the desire to maintain the high, accompanied by feelings of happiness, elation, and euphoria.

As we learn more about him, mentally abnormal person Because his symptoms had a strong manic flavor (as opposed to schizophrenia), his psychiatrist switched him to so-called atypical neuroleptic drugs, including Seroquel, olanzapine, and clozapine. These drugs produce more sedation and sedation, but they also have strong effects on thought disorders, hallucinations, and delusions. Bill liked the antipsychotic effects as well as the sedative effects that helped him sleep. However, he was always reluctant to give up his manic state and enjoyed it.

Attempt distant intervention

I was concerned about the fact that Bill seemed to be experiencing somatic delusions, or at least heightened somatic focus, which is not uncommon in manic states. “you sleeping got it? “I asked him.

“Yes,” he assured me (even though his diary showed he was already starting to get less sleep).

“I’m going to call the staff at Recovery House and let them know I’m worried,” I told him. I called and told him that Bill seemed unstable and asked if he could give me more medication. They said they would call a doctor to be on-call, but I later found out he hadn’t received any additional doses of neuroleptic medication.

As a family member, this is one of the most difficult aspects of trying to provide support. Even though they stay in touch, they are unable to actually have a meaningful impact on the treatment process. This is important because any additional information that must be conveyed (such as knowing they are hiding medication or saying they are hearing voices again) is important information that the care plan will or should know. is very frustrating. It also causes family problems. “Am I being too intrusive?” Do I have a right to disclose information that my family has not given me permission to disclose? Will this damage my relationship with them? All of these questions , which makes the position of being a bystander in the position of knowing important information all the more frustrating.