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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 11 to 35 of 35. Go back in thread:
Posted by Jasmine Neroli on August 29, 2003, at 23:42:57
In reply to Re: Sobriety and Mania » HenryO, posted by Larry Hoover on August 29, 2003, at 11:06:20
Um Henry. I joined this thread part way through, but have you considered that this person has Borderline Personality disorder, which can have very manic-like and/or psychotic episodes? Sufferers very often get into big time substance abuse and other risky self-destructive behaviours. Basically BPD people have chaotic emotional lives and emotional dysregulation ( to varying degrees - it's the hingepin of their behaviour).
They are often very attractive and charismatic. It can be cyclical and seems to be sometimes co-morbid with bipolar or even maybe related to it- there's a lot of discussion around that in psych circles..
One of the things that makes me suspect this as a diagnosis with knowing so little, is YOUR response to this person. They drag you with them, boundaries become extremely blurred and you feel bound up with them. I suspect all this because it seems like a familiar situation to me, since I have a close relationship with a BPD person, and have worked closely with another. And BPD doesn't have to have the classic self-mutilating behaviour present.
If you want to check out more, try this site: BPDcentral.com or just do a search for Borderline Personality Disorder.
Good luck
Jasmine
Posted by galkeepinon on August 30, 2003, at 2:28:39
In reply to Mania- what about Lithium? experience, posted by HenryO on August 28, 2003, at 9:28:56
I took Lithium for about 3 weeks and it did wonders for me, but I couldn't take the side effects any longer so I went off-too bad, it was really doing well.
> I took it once for a few weeks did nothing for my mood but gave me a lump in my throat.
>
> Any experiences out there?
Posted by HenryO on August 30, 2003, at 4:11:07
In reply to Re: Sobriety and Mania- related to above post » HenryO, posted by jay on August 27, 2003, at 12:57:36
Isn't Lithium the classic med for mania? I haven't heard one of the state (AZ) doctors mention it.
I am certainly hearing some good ideas here. Thank you all for your time and concern.
I don't see any psychosis or much mood swing other than very brief and powerfull moments of sorrow, but they aren't depressive. They are still grand.
I have made it clear that he can't live with me. He is going into a treatment center which has an emphisis on the psychiatric. Then he is going to live in some kind of halfway house yet to be determined.
Posted by HenryO on August 30, 2003, at 4:12:45
In reply to Re: Mania- what about Lithium? experience » HenryO, posted by galkeepinon on August 30, 2003, at 2:28:39
Any other Inositol stories?
Posted by HenryO on August 30, 2003, at 4:20:54
In reply to Re: Sobriety and Mania- related to above post » HenryO, posted by katia on August 29, 2003, at 14:20:38
This above post:
Posted by galkeepinon on August 30, 2003, at 4:54:04
In reply to What are the down sides of Lithium?, posted by HenryO on August 30, 2003, at 4:11:07
Hi HenryO Yes, I believe Lithium is the all time old classic med for good ole mania!;) The reason you may not have heard the doc mention it is because there have been so many new meds come out since Lithium with less side effects, etc.
How are YOU feeling about all this?
Take Care:-)
> Isn't Lithium the classic med for mania? I haven't heard one of the state (AZ) doctors mention it.
>
> I am certainly hearing some good ideas here. Thank you all for your time and concern.
>
> I don't see any psychosis or much mood swing other than very brief and powerfull moments of sorrow, but they aren't depressive. They are still grand.
>
> I have made it clear that he can't live with me. He is going into a treatment center which has an emphisis on the psychiatric. Then he is going to live in some kind of halfway house yet to be determined.
Posted by HenryO on August 30, 2003, at 10:00:07
In reply to Re: What are the down sides of Lithium? » HenryO, posted by galkeepinon on August 30, 2003, at 4:54:04
I'm feeling several things, thinking actually. I'm greatful for the form of mental illness I've got for the first time. I don't like telling him he's too sick for me to let him stay for long. I'm happy I had the health to tell him that. I'm hopeful for him. I'm also thinking that this is a life long recovery he needs. Screwing up could cost him his life. If I my disease flares up I sleep for two weeks. He has a difficult road ahead if he doesn't get a handel on this. I'm worried I'll have to get really tough. If he were to mess up and get high or pull some stunt, I'd have to cut him loose completely. That would be very sad. I am seeing up close now what I was looking at for years but never recognized. In one way its fascinating. He is scarey smart but this illness has run his life since anyone can remember. Its like some Oliver Sachs essay and I don't know that it will have a happy ending. The horrible fact is, I don't like his odds.
Posted by katia on August 30, 2003, at 13:58:31
In reply to Re: What are the down sides of Lithium? » HenryO, posted by galkeepinon on August 30, 2003, at 4:54:04
Hi,
you mentioned about PCOS and Depakote? Why have I not heard this before, specifically from my own Pdoc???? How common is this?
Katia
Posted by galkeepinon on August 30, 2003, at 14:54:44
In reply to Re: What are the down sides of Lithium? » galkeepinon, posted by katia on August 30, 2003, at 13:58:31
Hi, I can't give you an explanation as to why you didn't hear it from your pdoc~sorry, but there has been controversy surrounding this issue. It is quite common, I have very mild PCOS.
Some (but not all) studies have found that PCOS is more common in those who have been taking Depakote than in those taking some other seizure/bipolar medicines.
A possible explanation for the effect of Depakote is that it is one of the few seizure/bipolar medicines that are not *enzyme-inducing*. Enzyme-inducing medications promote the liver's production of substances that lower blood levels of the male hormones involved in PCOS. In effect, enzyme-inducing seizure/bipolar medicines like Tegretol/Carbatrol treat PCOS but Depakote does not. Lamictal has been found to reverse the features of PCOS.
Here's a pretty good link with some great info: http://www.psycheducation.com/hormones/Insulin/polycystic.htm
Depakote also promotes weight gain, which is associated with higher levels of insulin and of active male hormones, both factors linked to PCOS.
Hope this helped:-)
> Hi,
> you mentioned about PCOS and Depakote? Why have I not heard this before, specifically from my own Pdoc???? How common is this?
> Katia
Posted by katia on August 30, 2003, at 15:29:25
In reply to Re: What are the down sides of Lithium? » katia, posted by galkeepinon on August 30, 2003, at 14:54:44
How many other women do you know who has this from Depakote? Did you get it from Dep.?
I already have a history of ovarian cysts.
I'll talk to my pdoc about it after this loonnnnnggg weekend. How long does it take for the onset?
I've been on Dep. for about two weeks.
thanks.
Katia
Posted by galkeepinon on August 30, 2003, at 15:55:55
In reply to Re: What are the down sides of Lithium? » galkeepinon, posted by katia on August 30, 2003, at 15:29:25
Hi Katia, I did get it from Depakote, and I knew 2 other people who did also. It may not happen to every woman though, please don't be alarmed. I know a lot of peole who do just fine on it~~in other words do not develop PCOS. My doctor told me that polycystic ovaries are more common in those with seizure disorders.
There is a GREAT book entitled "PCOS - The Hidden Epidemic" by Dr. Samuel S. Thatcher, you may want to check out.
As far as onset goes, I was on Depakote for about 2 months and my menses have been off ever since.
Hope this helped.
Take Care.
> How many other women do you know who has this from Depakote? Did you get it from Dep.?
> I already have a history of ovarian cysts.
> I'll talk to my pdoc about it after this loonnnnnggg weekend. How long does it take for the onset?
> I've been on Dep. for about two weeks.
> thanks.
> Katia
Posted by katia on August 30, 2003, at 20:47:42
In reply to Re: What are the down sides of Lithium? » katia, posted by galkeepinon on August 30, 2003, at 15:55:55
Do you have a seizure disorder? Are you able to have children b/c of it?
> Hi Katia, I did get it from Depakote, and I knew 2 other people who did also. It may not happen to every woman though, please don't be alarmed. I know a lot of peole who do just fine on it~~in other words do not develop PCOS. My doctor told me that polycystic ovaries are more common in those with seizure disorders.
> There is a GREAT book entitled "PCOS - The Hidden Epidemic" by Dr. Samuel S. Thatcher, you may want to check out.
> As far as onset goes, I was on Depakote for about 2 months and my menses have been off ever since.
> Hope this helped.
> Take Care.
>
>
>
>
>
>
> > How many other women do you know who has this from Depakote? Did you get it from Dep.?
> > I already have a history of ovarian cysts.
> > I'll talk to my pdoc about it after this loonnnnnggg weekend. How long does it take for the onset?
> > I've been on Dep. for about two weeks.
> > thanks.
> > Katia
Do you have a seizure disorder?
Posted by galkeepinon on August 30, 2003, at 20:53:16
In reply to PCOS » galkeepinon, posted by katia on August 30, 2003, at 20:47:42
No-I don't have a seizure disorder. Yes, I am able to have children as far as I know. Somewhere, something goes wrong with our reproductive systems and it starts this process of PCOS. When I tried to conceive, I was put on Clomid.
> Do you have a seizure disorder? Are you able to have children b/c of it?
>
>
> > Hi Katia, I did get it from Depakote, and I knew 2 other people who did also. It may not happen to every woman though, please don't be alarmed. I know a lot of peole who do just fine on it~~in other words do not develop PCOS. My doctor told me that polycystic ovaries are more common in those with seizure disorders.
> > There is a GREAT book entitled "PCOS - The Hidden Epidemic" by Dr. Samuel S. Thatcher, you may want to check out.
> > As far as onset goes, I was on Depakote for about 2 months and my menses have been off ever since.
> > Hope this helped.
> > Take Care.
> >
> >
> >
> >
> >
> >
> > > How many other women do you know who has this from Depakote? Did you get it from Dep.?
> > > I already have a history of ovarian cysts.
> > > I'll talk to my pdoc about it after this loonnnnnggg weekend. How long does it take for the onset?
> > > I've been on Dep. for about two weeks.
> > > thanks.
> > > Katia
> Do you have a seizure disorder?
Posted by katia on August 30, 2003, at 21:01:35
In reply to Re: PCOS » katia, posted by galkeepinon on August 30, 2003, at 20:53:16
Why clomid? And what is it? Is it b/c you have PCOS?
Posted by galkeepinon on August 30, 2003, at 21:28:58
In reply to Re: PCOS » galkeepinon, posted by katia on August 30, 2003, at 21:01:35
I needed Clomid to ovulate. I used it for about a year.
Clomid stimulates the pituitary gland to secrete the hormones LH and FSH, which in turn stimulate the ovaries. When we have PCOS, it makes it hard to conceive. Clomid helps us to conceive. I was on Clomid when trying to conceive, due to PCOS. Chemically, Clomid looks somewhat like estrogen. Like all hormones, estrogen works by occupying a receptor in different parts of the body. This occupied receptor then sends a signal telling that organ to do something. For example, in the brain estrogen directs the release of FSH, which controls the ovary's development of a mature egg. In the uterus, estrogen directs the thickening of the lining. Clomid blocks estrogen's attachment to its receptor.
Clomid affects fertility in a positive way by tricking the body into thinking that less estrogen is present than there really is. The body responds by releasing greater amounts of FSH. Since I wasn't ovulating, this extra stimulation caused me to ovulate. It worked pretty good.
>
> Why clomid? And what is it? Is it b/c you have PCOS?
>
>
Posted by galkeepinon on August 31, 2003, at 19:49:15
In reply to Re: What are the down sides of Lithium?, posted by HenryO on August 30, 2003, at 10:00:07
Hang in there, I hear every word you say here! You sound very knowledgeable about the outcomes, behavior, patterns and symptoms that you are involved with. Sometimes it takes a long time to recognize things that we *thought* we should have recognized years before.
Hang tough and we're all here for you!
:-)> I'm feeling several things, thinking actually. I'm greatful for the form of mental illness I've got for the first time. I don't like telling him he's too sick for me to let him stay for long. I'm happy I had the health to tell him that. I'm hopeful for him. I'm also thinking that this is a life long recovery he needs. Screwing up could cost him his life. If I my disease flares up I sleep for two weeks. He has a difficult road ahead if he doesn't get a handel on this. I'm worried I'll have to get really tough. If he were to mess up and get high or pull some stunt, I'd have to cut him loose completely. That would be very sad. I am seeing up close now what I was looking at for years but never recognized. In one way its fascinating. He is scarey smart but this illness has run his life since anyone can remember. Its like some Oliver Sachs essay and I don't know that it will have a happy ending. The horrible fact is, I don't like his odds.
Posted by HenryO on September 3, 2003, at 1:54:25
In reply to Re: What are the down sides of Lithium? » HenryO, posted by galkeepinon on August 31, 2003, at 19:49:15
He was taking his Depakote and Klonipin. He was taking the steps to get into a mental health halfway house. He looked much healthier. Sounded good.
I threw him out today because he didn't come home last night, he went on a bender smoking crack.
Pretty ugly scene. He is dreadfully desperate and miserable. He looks bad. If I thought that any other action would be more helpful, I'd do it. I offered him a choice, a ride to the state mental health facility wear they know him, or I leave him with his out of gas truck, no money and a lot of atitude. He chose the later.
I didn't cause it. I can't control it. I can't cure it.
Say a prayer for him.
Posted by galkeepinon on September 3, 2003, at 2:06:45
In reply to Threw him out today, posted by HenryO on September 3, 2003, at 1:54:25
>>>>I didn't cause it. I can't control it. I can't cure it.
EXACTLY! Sometimes it hurts when the ones we love do things that hurt us. Did you discuss with him, or was it possible, at any time, to discuss with him, if he felt the Klonopin and Depakote were helping him? Was he feeling better? Feeling any different? Is this 'crack' episode the first or a habit?
So, he was looking much healthier, but you also said 'he looks bad'? Please remember that *if* he is an addict, until he wants help, he is not going to receive any shape or form of it from anyone, or anything. I think that all you can do now IS pray for him.
Hang in there and keep posting:-)He was taking his Depakote and Klonipin. He was taking the steps to get into a mental health halfway house. He looked much healthier. Sounded good.
>
> I threw him out today because he didn't come home last night, he went on a bender smoking crack.
>
> Pretty ugly scene. He is dreadfully desperate and miserable. He looks bad. If I thought that any other action would be more helpful, I'd do it. I offered him a choice, a ride to the state mental health facility wear they know him, or I leave him with his out of gas truck, no money and a lot of atitude. He chose the later.
>
> I didn't cause it. I can't control it. I can't cure it.
> Say a prayer for him.
Posted by HenryO on September 3, 2003, at 2:47:51
In reply to Re: Threw him out today » HenryO, posted by galkeepinon on September 3, 2003, at 2:06:45
It was not possible to discuss much with him in that condition. But I thought the meds were helping, a little, with the mania. In a perfect world he would be in a longterm psychiatric hospital. The crack smoking is his latest pattern. However, I'm sure any "substance" would suffice. This goes back over twenty-five years.
He was looking good yesterday morning before he went out. At 5:00 P.M. today he looked very bad. He is an addict, and he has other serious mental health problems. It couldn't happen to a nicer guy. I hope he recovers.
Posted by HenryO on September 3, 2003, at 3:11:15
In reply to Re: Threw him out today, posted by HenryO on September 3, 2003, at 2:47:51
I'm going to stop posting about this friend now. If some interesting medication related issue arises out of this later I'll offer it up here, otherwise I'm done now. This whole thread has been somewhat off topic. I'm glad it was tolerated. It has been most helpful. Thanks to everyone for their insights and wise words. I am greatful to you.
Posted by galkeepinon on September 3, 2003, at 3:56:46
In reply to Re: Threw him out today, posted by HenryO on September 3, 2003, at 2:47:51
I would imagine it would have been very hard to discuss much with him in that condition, I was thinking before this happened though. Anyway, I wish it was a perfect world, I hear ya!
Most addicts I transfer with are some of the easiest-going, nicest folks you'd want to meet. But then again, they can be manipulative, of course. I'm really sorry you're going through this, keep posting and take care of you ok:-)
And I do hope he recovers also.
> It was not possible to discuss much with him in that condition. But I thought the meds were helping, a little, with the mania. In a perfect world he would be in a longterm psychiatric hospital. The crack smoking is his latest pattern. However, I'm sure any "substance" would suffice. This goes back over twenty-five years.
>
> He was looking good yesterday morning before he went out. At 5:00 P.M. today he looked very bad. He is an addict, and he has other serious mental health problems. It couldn't happen to a nicer guy. I hope he recovers.
Posted by galkeepinon on September 3, 2003, at 3:59:02
In reply to Re: Threw him out today, posted by HenryO on September 3, 2003, at 3:11:15
I just now replied to your previous post, then got this. I agree, we need to get back to medication-related issues here.
Take care!> I'm going to stop posting about this friend now. If some interesting medication related issue arises out of this later I'll offer it up here, otherwise I'm done now. This whole thread has been somewhat off topic. I'm glad it was tolerated. It has been most helpful. Thanks to everyone for their insights and wise words. I am greatful to you.
Posted by KimberlyDi on September 3, 2003, at 8:08:24
In reply to Threw him out today, posted by HenryO on September 3, 2003, at 1:54:25
Tough love approach. Sadly enough, he has to hit rock bottom before he can begin to climb out of his self-dug grave. I was the same way. You did the right thing.
KDi in Texas
> He was taking his Depakote and Klonipin. He was taking the steps to get into a mental health halfway house. He looked much healthier. Sounded good.
>
> I threw him out today because he didn't come home last night, he went on a bender smoking crack.
>
> Pretty ugly scene. He is dreadfully desperate and miserable. He looks bad. If I thought that any other action would be more helpful, I'd do it. I offered him a choice, a ride to the state mental health facility wear they know him, or I leave him with his out of gas truck, no money and a lot of atitude. He chose the later.
>
> I didn't cause it. I can't control it. I can't cure it.
> Say a prayer for him.
Posted by Sebastian on September 3, 2003, at 18:49:01
In reply to Threw him out today, posted by HenryO on September 3, 2003, at 1:54:25
I did that once between hospital stays when I probably wasn't takeing my medicine anymore. My first time on crack, a three day binge, lost my car walked to my ants house and they didn't want to let me in but they did, they had thought I was dead or something. Prity much stayed away from that after that, except for a few quick ones here and there but not like that again. Just saw the post and reminded me of that. Haven't touched anything in years though. Your probably right about him if hes a long time abuser.
Posted by Dr. Bob on September 3, 2003, at 21:01:36
In reply to Re: Threw him out today, posted by HenryO on September 3, 2003, at 3:11:15
> I'm going to stop posting about this friend now. If some interesting medication related issue arises out of this later I'll offer it up here, otherwise I'm done now.
Thanks, I would in fact like follow-ups not about medication to be redirected. To Psycho-Social-Babble or, when I get it set up, Psycho-Babble Substance Use. :-)
Bob
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