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Wishbone

Wishbone

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Try not to blame her, it's sort of part of the illness and after she's done with this episode she'll be at risk for a depressive one, so just help her to get well and leave any nagging or anything til a later date.
But just to give you some insight into what it feels like as the one going through it: imagine having this thing and having to take medication for it, but when you take the medication it makes you feel either horrible and sluggish and numb, or better to the point where your own mind kinda tricks itself into thinking you're well. But not only well...like you don't even have an illness, and if that's the case you don't need medication! So you stop. And then it all comes back round again. You'd think we'd learn but it's happening to the brain so whatever changes happen up there, logic isn't sitting there with it at the time.
 
albagobragh

albagobragh

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Try not to blame her, it's sort of part of the illness and after she's done with this episode she'll be at risk for a depressive one, so just help her to get well and leave any nagging or anything til a later date.
But just to give you some insight into what it feels like as the one going through it: imagine having this thing and having to take medication for it, but when you take the medication it makes you feel either horrible and sluggish and numb, or better to the point where your own mind kinda tricks itself into thinking you're well. But not only well...like you don't even have an illness, and if that's the case you don't need medication! So you stop. And then it all comes back round again. You'd think we'd learn but it's happening to the brain so whatever changes happen up there, logic isn't sitting there with it at the time.
That's an excellent way of explaining what taking anti-psychotics feels like.

From my perspective, taking APs is like continually dragging a mental weight and depending on the dose, is like having a permanent mind-cloud. Then there are the side-effects which vary from person to person. It's only when the dose is significantly reduced or you come off it that you REALLY notice the difference in cognition.

The problem then is that whatever underlying health condition you have manifests itself to other people but generally you think you can cope, or are unaware.

I've fibbed to my wife and psychiatrist in the past about what I had been taking, surely if I'm so dependent they'd notice right? But it's only since been sectioned and placed on a CTO, where I was 'obliged' to take a depot once monthly, that I learned the wisdom of not playing fast and loose with the meds. Don't get me wrong, I want off them, but whatever I do, I do with the approval of my MHT and for the first time I wonder if my goal is achievable.

Note, for those reading, NEVER reduce or stop anti-psychotics without approval of/discussion with your MHT, these are powerful drugs and it is dangerous.
 
LunaBloodmist

LunaBloodmist

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I'm glad she is getting treatment, and I hope things get better for you and your family. I have been guilty of being inconsistent with my meds too. Either I was resisting because I don't like being on meds or I had gotten to a point I felt fine and could skip a few doses. It only set me back. I feel for you and your wife. You are a good husband for supporting her. My mom's depressive episodes scarred me too when I was growing up, but we are all human, it's not always sunshine and rainbows unfortunately 😕
 
J

johnmadden

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I suppose the issue I have is that she wasn't on anti-psychotics, and has only ever taken them when going through an episode. For four years she has only been taking lithium, and my understanding is that this does not have the same kind of mental fog impact that the anti-psy medicine does. perhaps I'm wrong.
 
LunaBloodmist

LunaBloodmist

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I suppose the issue I have is that she wasn't on anti-psychotics, and has only ever taken them when going through an episode. For four years she has only been taking lithium, and my understanding is that this does not have the same kind of mental fog impact that the anti-psy medicine does. perhaps I'm wrong.
Sometimes it can be time for a change in meds and therapy. I take both Latuda and lithium. Latuda evens me out overall and lithium helps stop the impulsive, manic, risky behaviors. Withdrawing from either is dangerous. When I was on a higher dose of latuda, if I skipped it, my whole day was ruined. I've since told my doctor I want to be on a lower dose in case I forget to take it. But I know that I still need it. It's trial and error with meds, and it can be hard.
 
albagobragh

albagobragh

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I suppose the issue I have is that she wasn't on anti-psychotics, and has only ever taken them when going through an episode. For four years she has only been taking lithium, and my understanding is that this does not have the same kind of mental fog impact that the anti-psy medicine does. perhaps I'm wrong.
My apologies john. I guess the thing to do is, at the appropriate time, have the discussion why she stopped it. There must be a reason behind it. What I would say is that your instincts were good in noticing signs that she had stopped even if you believed she had taken it.
 
K

keith74

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I understand that there is a sense that a person should be able to decide whether they want to take medication or not, but there are other people involved, not just me but our daughter, and then there is the trauma of going through a manic episode and having to be hospitalised. It damages trust as well having been lied to for weeks.
I've gone through this with my wife and we have both gotten various therapy for it (both individual and also couples). What we have learned is that for the relationship like this to be successful, both members of the relationship must have a say in the decision making regarding treatment. This was made very clear by the couples therapist we saw who specializes in relationships involving mental illness. This is because the way how the illness greatly impacts the relationship as a whole. The needs of the spouse must be listened to also and must have input in the treatment. Otherwise it is very difficult for the relationship to persist in any healthy way. Before, I let my wife handle all the decisions regarding treatment. But now we work as a team and we both take equal responsibility for her mental health. She makes sure she checks in with me and involves me in the decision making regarding her treatment. I make sure I check in with her also and do my best to help put her in an environment that she feels comfortable. She no longer takes offense that i am checking on her mental health - she appreciates it now. When we work as a team, it makes us feel better about everything. I hope you and your wife can take this approach also. It really works.
 
LunaBloodmist

LunaBloodmist

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I've gone through this with my wife and we have both gotten various therapy for it (both individual and also couples). What we have learned is that for the relationship like this to be successful, both members of the relationship must have a say in the decision making regarding treatment. This was made very clear by the couples therapist we saw who specializes in relationships involving mental illness. This is because the way how the illness greatly impacts the relationship as a whole. The needs of the spouse must be listened to also and must have input in the treatment. Otherwise it is very difficult for the relationship to persist in any healthy way. Before, I let my wife handle all the decisions regarding treatment. But now we work as a team and we both take equal responsibility for her mental health. She makes sure she checks in with me and involves me in the decision making regarding her treatment. I make sure I check in with her also and do my best to help put her in an environment that she feels comfortable. She no longer takes offense that i am checking on her mental health - she appreciates it now. When we work as a team, it makes us feel better about everything. I hope you and your wife can take this approach also. It really works.
That really sounds like a team effort. I'm happy you guys tackle it together. I wish my bf would do the same. Sometimes he'll ask if I'm okay or if I took my meds (mainly when I'm freaking out), but doesn't respond much when I mention therapy or try to assess the behaviors/decisions that got us to such a bad place. He often says I am living in the past and he just wants to move on. I admire the support between you two.
 
K

keith74

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That really sounds like a team effort. I'm happy you guys tackle it together. I wish my bf would do the same. Sometimes he'll ask if I'm okay or if I took my meds (mainly when I'm freaking out), but doesn't respond much when I mention therapy or try to assess the behaviors/decisions that got us to such a bad place. He often says I am living in the past and he just wants to move on. I admire the support between you two.
Thanks! It took us a long time to get here through. We've been married for over 10 years and only recently do I think we have a proper treatment in place. My wife was actually pretty good in dealing with it on her own so I took things for granted. Things finally blew up starting late last year and while doing my research on how to help her and myself (I first came here looking for help while she was in the throes of an intense dysphoric manic episode), I learned that I really wasn't doing my part in helping her manage her illness when she was at baseline. I've asked a lot of questions here and got tons of great advice. I also read a bunch of books on my own and talked to therapists and other professionals. I'm in a better position to help her now and I know it is important to keep it up - which is why I'm still on the forum learning as much as I can from everyone here (thank you all for sharing btw!). It's good that your bf will check in on your a bit. It is a good start. Hopefully he will get more interested/involved with therapy and discussing things as it is import to get things off your chest and talk about past missteps and how to improve going forward. It really helps with any future episodes down the road.
 
LunaBloodmist

LunaBloodmist

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Thanks! It took us a long time to get here through. We've been married for over 10 years and only recently do I think we have a proper treatment in place. My wife was actually pretty good in dealing with it on her own so I took things for granted. Things finally blew up starting late last year and while doing my research on how to help her and myself (I first came here looking for help while she was in the throes of an intense dysphoric manic episode), I learned that I really wasn't doing my part in helping her manage her illness when she was at baseline. I've asked a lot of questions here and got tons of great advice. I also read a bunch of books on my own and talked to therapists and other professionals. I'm in a better position to help her now and I know it is important to keep it up - which is why I'm still on the forum learning as much as I can from everyone here (thank you all for sharing btw!). It's good that your bf will check in on your a bit. It is a good start. Hopefully he will get more interested/involved with therapy and discussing things as it is import to get things off your chest and talk about past missteps and how to improve going forward. It really helps with any future episodes down the road.
Yea, we've got a long road ahead of us if we plan to stay together. He has to work on himself and anything going on with me stresses him out. I know he cares, just dont think he is able to handle it right now. I tried to tell him in the beginning 😅 i dont know if he ever does any research of his own, but it doesnt seem like it. He doesnt really have opinions about mental health topics. His tactics are burying it and moving on. But he's said he hasnt opened up to someone like this before, who knows if thats true or not. Like i said, he's got his own issues. We've hit a very low point, I'm hoping it makes him realize what's been happening, and what needs to happen. Its good that we have more time apart now. We shall see...
 
Wishbone

Wishbone

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I suppose the issue I have is that she wasn't on anti-psychotics, and has only ever taken them when going through an episode. For four years she has only been taking lithium, and my understanding is that this does not have the same kind of mental fog impact that the anti-psy medicine does. perhaps I'm wrong.
Lithium sapped me of all feeling, left me numb, no emotion. I've described it on here previously as feeling like a carboard cutout of myself, the real version was gone. It's a strange feeling to have no emotions at all and not a nice one. So I asked to come off Lithium and changed onto something else.
This is always an option for her but it depends on how she feels about the Lithium and how her illness typically presents.
For example, without being medicated, would she mostly have:
Euphoric manic episodes?
Dysphoric manic episodes? (also called 'mixed episodes', more irritability, anger etc)
Hypomania? (the level below mania, lots of energy but tends to be a 'good' energy, but can also get mixed)
Does she reguarly get depression?
Do her moods change fairly quickly? (Rapid cycling)
Or does she get all of the above at different times?

Different medications are geared towards different things, but Lithium, being the oldest and most established, is often first-line treatment for a catch all approach, but it doesn't work for everyone or isn't accepted by everyone. One of the key issues is feeling well enough on the medication to be happy to take them as non-compliance is a big deal.
 
J

johnmadden

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Without being medicated - or on completely the wrong medication, which she was for years.... - she could go a year or so without anything and then it would start. She has the mixed episodes - very energetic, extremely irritable, prone to fits of laughter, lots of anger, sleep deprivation - and can go on like that for a few weeks, hiding it as best she can, until a tipping point where the psychosis takes over (paranoia, hearing voices, imagining things happening that haven't, etc). That lasts for days, even after the start of anti-psychotics. Then she will crash and be very low. On lithium, she was what I would consider her normal self - more normal for many of the last 20 years since the first episode. But it is hard to know whether it was lithium that restored her to that position, since she just decided to stop taking it. I keep thinking that the decision had to have been triggered by the start of a new episode because if she was thinking straight, she wouldn't have stopped taking the medication.
 
Wishbone

Wishbone

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I guess that's one for asking her when she's well enough to answer but it could have been either the nullifying effects, believing she's 'well' and doesn't need them, or a new episode starting and still getting past the Lithium. Time will tell. How's she doing now?

I forgot to mention the pyschosis. So yeah it sounds like she's going up and way out there pretty quickly doesn't it. If she has been on Lithium alone then I imagine they'll pop her on something else too (eventually once out of this, as a maintenance 'every day' drug), but again it would come down to compliance. Do you know what they've got her on at the minute?
 
K

keith74

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Without being medicated - or on completely the wrong medication, which she was for years.... - she could go a year or so without anything and then it would start. She has the mixed episodes - very energetic, extremely irritable, prone to fits of laughter, lots of anger, sleep deprivation - and can go on like that for a few weeks, hiding it as best she can, until a tipping point where the psychosis takes over (paranoia, hearing voices, imagining things happening that haven't, etc). That lasts for days, even after the start of anti-psychotics. Then she will crash and be very low. On lithium, she was what I would consider her normal self - more normal for many of the last 20 years since the first episode. But it is hard to know whether it was lithium that restored her to that position, since she just decided to stop taking it. I keep thinking that the decision had to have been triggered by the start of a new episode because if she was thinking straight, she wouldn't have stopped taking the medication.
Sounds like she is classic bipolar 1 with psychotic symptoms (my wife is similar though we aren't sure about the psychosis yet).

Note that it is very common to second guess if you need meds when you feed stable. Even though my wife swore to be compliant with her meds after her last episode, I see a slight hesitation now that she has been stable for a month or so. Before then, she was very compliant (even eager) as she was coming out of her depression.
 

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