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Don't even know where to start, dementia? Bipolar? Shizo?



New member
Jan 29, 2015
So I am not sure exactly where to start, my 34yo sister has a very strange set of conditions which are deteriorating. I studied psych in college and can read the DSM, its almost like she has a bit of everything, seriously. There is so much going on we are struggling to know where to start, pls help!

Bi Polar - Check she has a ton of mood swings that have ranged to manic episodes getting her hospitalized. The manic episodes tend to go to completely psychotic / schizo levels, where she thinks she is in another dimension, dead etc. She also swings into depression, puts on weight, sleeps excessively.

Attention deficit Disorder - Check she is constantly on a minute to minute basis starting things and not finishing them, starts cleaning than gets impulse interrupted to do something, stops whats she is doing starts something else.... just literally goes around in circles. Forget about holding a job, no sense of time, always late. This started as just an artistic flaky temperment in her early 20's and is progressing to a level where it almost looks like dementia now in her early 30's.

Dementia Symptoms - Check I mean literally she can not focus to follow a tv program or read a page or hold a conversation. I watch her struggle between words to just talk. Its really sad. She is loosing her ability to organize and create thoughts. Often time her sentences do not connect she just changes thought lines on the fly, and confuses herself. She cannot follow conversations or news. She was never a genius but passed high school and college. Now its just like she literally cant follow a basic conversation. Something is degenerating. Her inability to follow conversations, leads to a sense of lack of confidence, insecurity which is also crippling and making her increasingly less likely to interact with the world. She is increasingly frustrated and withdrawn from the world.

The psychiatrist that she goes to keeps trying to treat it like its bipolar with first line drugs, and its just not working. Its hard to get her to stay on the meds, and i feel like they keep on making that the treatment / conversation. Is it just me or should we be focuson on cognitive testing brain imaging and not just stuck in a waiting for a magic bipolar mixture / silver bullet? To date there has been no cognitive testing. I am starting to doubt the competence of her doctors.

I just dont feel like the doctors are working systematically ruling out things, i think this is a super wierd special case and it almost needs like a team of doctor approach. Lymes disease, Dementia, Etc. I have no confidence in the current doctor, and dont even know where to start. Is it silly to think to start on the cognitive testing and brain imaging to rule out dementia?

She was also just in a very tramatic bicycle crash and hit her head super hard and has really gotten worse with a severe concussion that she has added to the mix, adding to the complexity.

Any advise?


Sep 25, 2012
Planet Lunatic Asylum
Any advise?
Hi - i think it's very difficult with all these areas - we know so little about the brain & how that relates to psychology/emotions/consciousness. i think generally the current approach is a case of throwing drugs at it all & seeing what helps.

Even with dementia, it's very hard to tell/know exactly what is going on.

The person centered approaches i think show most promise - more comprehensive approaches that look at the whole person within the context of their life.

Not sure what to suggest? Maybe other people will have some ideas.