My Brother (Long Read)

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DreamCorridor

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I never know how to properly structure these questions because I feel like there's just so much background information and I don't really know what's relevant and what isn't. However, I will try my best.

Back in 2004 my brother suffered a severe panic attack and was placed on 20 mg of Paxil and it helped him immensely but over time he really didn't consistently take the medication and there were times where he would just go off of it and go back on it for one reason or another. He was feeling pretty good for a while but he would still have anxiety and some panic sometimes whenever he was in a vehicle when someone else besides him was driving. So back in very early 2016 he heard about Lamotrigine and that it could possibly help him control his anxiety better. After he started taking it for a little while he began to feel energetic, maybe even manic, and need less sleep. Within no-time he found a job which he had never really shown interest in getting before. But the Lamotrigine made sleeping difficult still so he began to take 2 - 3 mg of Ativan multiple times a week in order to sleep. Now, here's where the mainline of the topic comes into play, back in September 2017 my brother's mood began to change. He would cry and become more depressed than he ever had.

We've tried several configurations of his current medication. Taking more Paxil and Lamotrigine or less but trying to cut down on the Ativan as best he could manage in case he was going through a sort of withdrawal from it, things like that. He won't stay "normal" for more than a few weeks at a time without also being "bad" for a weeks or even months after. To be fair, he did a lot of permutations of his medicine within a very short period. As crazy as this sounds he did some sort of alterations more that 10 - 15 times within a two-month period. Back in early April he tried Lamotrigine Extended Release so he could have it in his system all the time instead of just taking 100 mg once a day. When he did that he said that he felt GREAT, almost as if he was manic or hypomanic, he wasn't depressed or anxious at all and he didn't want Ativan. But he COULD NOT sleep whatsoever, he slept for a few hours in the span of a week. After not sleeping wore him down he switched back to the regular Lamotrigine and his sleep slowly returned but then he become EXTREMELY depressed. Then he tried Abilify for a little while but he could not sit still and complained of his brain feeling "cloudy" or "underwater." So he stopped the Abilify. He stayed depressed and checked himself to a mental hospital where they gave him Ativan and 10 mg of Ambien every night while starting him on Latuda. But the doctor's there didn't actually send in the perscription so he got off of it. And he was far worse coming back from the hospital. But he tried to recover until he had an OCD obsession about his body and tongue and then he flipped out again and went back to Ativan because it helped him. Then, about 8 weeks ago, he tried to switch from Paxil, which he's been on for a long, long time to Celexa. He did a cross-tartration of slowly going down on one while going up on the other. And he felt better for a few weeks again, better than he had since September 2017, but had some OCD and anxiety that freaked him out so he tartrated back the other way and now he's back on Paxil 25 mg.

He feels now like he ruined his one chance at being normal again and he ruminates on trying to get back on the Celexa again. But he also freaks out thinking that SSRIs are keeping him bad and making his condition worse and harming his mental state.

Every single day since September 9th, my mother and I have done our best to help him.

He absolutely FREAKS OUT worse than you could possibly imagine.

I repeat, WORSE THAN YOU COULD POSSIBLY IMAGINE.

He runs around the house yelling and screaming 24 hours a day of us just "letting him go" and how he "missed his last chance to get better." He says that he's "only human" and that anyone would wish for death after a year of near constant struggling.

I'm afraid to give him Ativan because sometimes I highly consider the fact that he took 4 - 6 mg of Ativan a week when he was better and taking it throughout the year sporadically as a possible cause as to why he's so terrible now.

Or maybe he's just currently withdrawaling off of the Celexa.

He has anxiety, depression, obsessive thinking, suicidal ideations, muscle spasms, hand trembling, and worst of all he's been unable to sleep for days.

He doesn't want to die.

He WANTS to get better.

I just don't know what to say or how to explain it.

We very recently went to a brand new psychiatrist and I was explaining everything to her as best as I could since my brother was freaking out in her office.

She said to not micro-manage his medication anymore and to not take Ativan.

She said that when he stabilized as much as he can to begin taking 2.5 mg of Zyprexa.

So he'll be on 25 mg of Paxil, 100 mg of Lamotrigine, and 2.5 mg of Zyprexa.

Is there any insight that anyone can offer?
Please, I don't want to lose my brother but I can't watch him suffer anymore.
 
calypso

calypso

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It sounds like your brother is going through a lot. So are you fromt he sound of it. Coming on and off meds is typical for people diagnosed with bipolar. I have bipolar 2 and still tried to mess around with my meds to take fewer.

The trouble with highs is they are addictive and you don't want to come down from them. When you do its with a crash into depression. Lack of sleep and poor diet are often subsidiary causes of the behaviour. If you live in the UK did you now that you can get helpyourself and refer him to a pdoc yourself. I would see the GP personally and tell him/her everything .

Ipresume a pdoc put yourbother on the meds? I doubt the link between Lamotrigine and going manic is usual. I'm on it and it balances me out- after all its a mood stabiliser. Canyou ring the Crisis teamwhen he is at his worst. He iwll need to be put ontheir list with a referral from the GP or the pdoc.
 
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DreamCorridor

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My brother has never really had "highs" ever before.

He only got them when he was on the Lamotrigine at first and when he tried the Extended Release variant.

We live in California and we've been going to pharmacists, and doctors for months.

Honestly, my brother suffered for a long time.
He never truly been "normal".

I am drowning.
 
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calypso

calypso

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Oh you are from the US - ignore some of the stuff I said then. I am in Britain. If he has had this reaction then obviously he needs to come off it. Can you get any respite care where you can get him in a place for a while to give you some time away. Or can you get away for a brief period to just recharge your batteries?

Has he any insight into his behaviour? If not then there is not much else I can suggest but if there is then he can also get therapy and talk about it to learn skills to cope with his behaviour better. Just a thought.

You must look after yourself! Don't be afraid to put yourself first at times
 
D

DreamCorridor

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We want to maybe get him into a place where they can stabilize him but we're afraid that the doctors will have no choice but to give him Ativan and Ambien which would make his depression and anxiety worse in the long run.

His new psychiatrist just said to try as best to not make anymore changes to his current medication and just add Zyprexa. But I'm just so very worried that if he starts it and has an adverse reaction to it, another disappointment might drive him over that edge to finally take his life.

I don't suffer from any mental illnesses and I feel a level guilt and sadness for my brother but I honestly can't give myself some time to breathe.

I can't stop focusing on him and his issues because I know that no matter how overwrought with sadness I feel towards him, he must feel 100x worse to act the way he does.
 
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Taizy

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Your brother is very fortunate to have you and your support; this might sound frustrating but I think you're already doing all you can for him by riding out the therapies, drug changes and lows with him. The main thing that got me through my darkest times was knowing I had family there. Maybe look into a local carers group you and/or your Mum could go to so you have support and a place to share feedback and frustrations.
 
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Leahkelly

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Hello
I’m going through a similar situation with my 24 year old son, It all started 2 years ago 2 weeks before his college graduation. He studied exercise health and science and had very healthy way of living
All of a sudden we realized he was obsessing with constantly washing and changing clothes
Few weeks later started taking to himself, isolating himself , no eating, and screaming . Long story short - he was hospitalized 3 long times . He was sectioned and put on Zyprexa 15 mg which he stopped 2 weeks after the last hospitalization and got even worst. I said no more hospitals and called many private psychiatrists everyone was sending me back to the psych unit but one agreed on seeing him and he increased Zyprexa to 25 mg,since then 09/27/17 he gained 80 pounds and affected his liver. At the very beginning I realized th the Zyprexa doesn’t do much but just keeps him sedated and I with out the psychiatric knowing started reducing the pill. Today he is on 2.5.I have read a book about people who have those simptoms that have very high copper in their blood and I asked his doctor to test him and he told me that this can not be the reason and no one knows what is happening .I called a holistic psychiatrist and she ordered lab test including mold test and we found the issue. My son was overloaded with Very toxic mold and vitamin D deficient At the moment hi is on mold treatment and on tons of supplements and he is a different person, she saved my son ‘s life
 
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