Posted by Larry Hoover on August 28, 2003, at 7:05:16
In reply to Re: Sobriety and Mania- related to above post, posted by HenryO on August 28, 2003, at 1:32:42
I'm going to offer up my musings on this, Henry. I don't know if I've got any good advice. This is a difficult case, seeing it from here.
> Well your right on the money as far as what's been prescribed to date, Depakote and Klonopin. Geodon was too much of a buzz. Zyprexa is on the list of stuff to try.
What was his response to these meds? I know many doctors who will not treat mental illness until the addictions are under control, but this man seems to require getting the mind stabilized as a first course of action.
What I fear is, that if you find something to rein in his mind/behaviour, that he's going to have a sense of loss of self. I've seen that happen, in a similar case. He may have some mourning to do, as he comes to terms with drug-induced changes. He's been the focus of everyone's attention for a long time.
Another issue, with respect to the alcohol use, is coming to understand why he used it. No matter how bad it got, we all chose alcohol to achieve something, as it gave us benefits. Once you understand that better, you can perhaps have more success in finding non-drug alternatives for those benefits. (I hope I'm not presumptuous about the depth of your involvement.) If he's used it to pass out, then he may need a sleep aid. If he's used it to forget, then he will benefit from counselling (and, firm application of the steps, of course). There may be many reasons why he drank, and I've known manics who drank because it "set them off". So, they were, in a sense, addicted to their own mania. That's complicated behaviour.
> I just am not sure that I am in any position to be of long term help, or even intermediate help.
I also wonder if you're not a little emotionally involved in this one, too. Finding some measure of success here may border on the impossible, and will certainly require a hefty investment in effort. I'm just suggesting, "Be careful".
> A regular drunk is a known quantity to me, I can handel that, but this I think is a brain malady and may need specialized care.
In my area, there are a number of specialized dual diagnosis (i.e. addiction/mental health) programs, with specialist counsellors and pdocs. Maybe you can get a referral through local substance abuse treatment centers?
> His emotions just roll through with this overwhelming intensity and then its on to something new. This oddly optimistic OK what's next attitude. And always this bigger than life attitude/energy that infects the people near by. He's attractive as hell, until people just have to get off the ride.
It could be pure mania. There could be some ADHD. One thing to also consider is the impact on his body from all his activities. Alcoholics are notorious for nutritional deficits. Alcoholics, bipolars, and ADHDers, as classes, tend to respond to nutritional supports. His meds may not work well if his body remains in defecit conditions.
> I call it mania, but I'm starting to wonder about a more sophisticated diagnosis. Something is going on, on top of the other standard addict rap. The suffering has been costly, longterm and bewildering. His family is cooked.
I'm glad he still has family. But, I hear you loud and clear.
> I feel sort of lucky for the first time to be a depressive.I'm afraid I understand that comment very well, too. ;-)
Lar
poster:Larry Hoover
thread:254628
URL: http://www.dr-bob.org/babble/20030828/msgs/254971.html