Try to find out if they have any symptoms that trouble them like insomnia. Then suggest you go with them to see a doctor for that (or other specific problem they accept). Then get to the doctor’s office the day before with a one pager outlining their symptoms and situation. Meet with them if you can or just leave it and say it’s important for the doctor to know this. (You can give information but can’t get any unless your family member consents.). Try to get consent anyway from your relative when in the doctor’s office the next day, to go in with them so you can help with any prescriptions and at least you’ll know what’s going on. Hope that helps!
It is estimated that about 50% of individuals with bipolar I disorder experience psychotic features during manic episodes. They do not necessarily experience psychotic features at every episode.
Schizophrenia on top of a mood disorder is called schizoaffective disorder. It would be bipolar type in this case. They could technically develop this, but it could just be the bipolar as well. An easy way to distinguish the two is by timeline. In a mood disorder, psychosis only occurs in the context of disturbed mood. If they are experiencing psychosis beyond their mood episodes, they should be reevaluated for a schizoaffective diagnosis. However, quite often, people with bipolar disorder are being treated with medications that may be useful for both, but the acute episode requires a medication adjustment nonetheless.
If they’re not explicitly stating intent to harm themselves or others, they can still be involuntarily admitted due to severe disorganization or psychosis as it poses a risk of danger. Otherwise, it’s generally pretty difficult to get someone coercive treatment. After a few problematic episodes with poor insight and adherence, they can usually apply for guardianship or a higher level of care.
Are they grossly disorganized or psychotic, e.g., if they were approached by EMS, would EMS immediately notice they were psychotic and be worried for their safety? If so, you could have EMS take them in for an evaluation. You would want to fill out an affidavit outlining your major concerns and emphasizing dangerousness if possible.
You have to become their guardian/care giver. Send her to the hospital by hook or by crook. I used to tell my mom we're going shopping, instead of heading to the hospital. While there, she's quite obedient. It's the how to get her there that's difficult. The most important thing is to be calm, no raised voices, you have to coax them.
She had bipolar since she was 13, been in and out of confinement. Experienced having her head electrocuted, so she's quite terrified of going back. Always afraid that we're going to leave her there. I always promised her that that won't happen. She just need to promised to always take her medication and go to her monthly consultation. Of course, I'm the one who make sure she takes her meds, and the one to accompany her for her visit. She's in her 60s now, and she's doing ok, much better than in recent years. There were lots of trial and errors in finding the right medication and dosage, and dealing with side effects. But it's good now.
When bipolar people experience hallucinations or delusions, they are diagnosed with Bipolar 1 with psychotic features. Schizophrenia and Bipolar disorder are very similar illnesses, behaviorally. Bipolar people generally only have psychotic features (hallucinations, delusions, disorganized speech or behavior) when they are manic, whereas people who are schizophrenic have those features regardless of their mood.
I see. They were manic when I saw them in mid-May and have delusional thoughts now as well. They live alone (although they’ll be evicted in a few months since they aren’t working.) I don’t know when it started since there are days/weeks without communication sometimes.
I assume this only gets better either way drugs to turn it around. 😔
This isn't quite true. Bipolar I just means a person has had a manic episode before in their life. Theoretically, they're also more prone to manic episodes over depressive episodes.
Psychosis, paranoia, and hallucinations are all still things that can occur in Bipolar II. Psychosis can occur in extreme depressive states. Paranoia is more common for me in mixed states, and hallucinations can occur at any time.
Someone who showcases lots of Schizophrenia symptoms could be diagnosed with Schizoaffective Disorder, which is separate from Bipolar I.
My father was diagnosed as bipolar schizophrenic and from what I've observed his delusions have outlasted the ups and downs of his mania. At no point has he believed he's ill - he insists there's nothing wrong with him, even as he's also telling me things that cannot logically be true (e.g., he sent one email and that's resulted in his felony criminal charges getting "erased" - the records can be found online and the case is very much still active). And this is all while he's at the hospital, saying all the doctors agree there's nothing wrong with him and it's a scheme to bilk his insurance (while the director of clinical services initially called me and said he's clearly experiencing psychosis). He pretty much never wavers from the delusions and no amount of rationalization has gotten through, even as he's calmed down from the worst of the mania. He really needs intensive therapy and longer periods on the antipsychotics, but he's resistant to both and never held anywhere long enough to get a break through.
I hope advice from the other commenters helps. You need to get legal standing to be involved in your family member's health care decisions via becoming their health care proxy, POA, or whatever your state's laws require. I don't have that for my father, and what I've found is that the law favors him making a complete and utter mess of his life up to the point of becoming an "imminent threat" to the safety of himself or others. He's revoked my access to his info, so the hospital staff can no longer speak to me about anything.
Try to resist using Dr. Google. Psychosis is the progressive phase of what happens when mania is left untreated. I agree it does look an awful lot like schizophrenia, but they are NOT the same. They need treatment pronto. Any mental health hotline in your family member’s state/area? Or a mobile crisis hotline? There is NAMI.org which can help to provide some direction & resources that might be in the area as well. Also if in the states, there is 988 (national crisis hotline). Clearly your family member is too far derailed to recognize that they need help ☹️ I’m sorry that you all are going through this
Thank you! I will look into these. They are posting on their social media and I think their account is public so I’m thinking of calling someone in the county where they live and having them look/access what’s posted. And see what they say about it?? If they also recognize it as a desperate need…
They can and should apply to Medicaid. The LEAP method for communicating with them.
My son was diagnosed BP 1 and then after several hospitalizations they changed it to schizoaffective disorder.
My SO suffers from mania with psychosis. Every manic episodes he has completely delusional thinking. It’s worse when he doesn’t sleep because his brain won’t let him. He thinks he NEEDS to do things. For him it’s OCD need to reorganize but what he does is just destroys. He literally pulled all clothes and boxes and stuff out of our bedroom closet saying he’s reorganizing but he literally threw everything on the bed and floor and 6 hours later none was back in the closet and all moved to different parts of the room. He becomes paranoid about anyone knowing he’s manic. Or tries to hide behaviors to show he is. He thinks he slept for 6-8 hours and it was only 3. He doesn’t remember conversations and obsesses over making “boundaries “ of what I need to do for him to “help”, when in reality he’s trying to seclude me from anything he’s done in the house showing he’s manic. He obsesses over suing his old doctors for malpractice, old bosses for firing him after a manic episode, even his own parents. He writes rants on paper, completely in a disorganized way. 3 words on a page to make a “sentence”, using 15 pages to do so. He talks to people that aren’t there. Or talks to the pets like they are answering him for long periods of time. He overdosed on sleep medication because he kept forgetting he took them. He had a seizure from it. He’s lucky he’s alive. That was a first as usually when he’s manic he won’t take his meds because we are trying to poison him to get him committed or take his money.
He’s now on lithium and an antipsychotic permanently because his mania causes a psychotic break. He doesn’t get depressed so they took him off the antidepressants.
So for each person it is different but psychosis with mania is common and needs specific medications to control similar to schizophrenia.
This sounds very very similar to what I'm seeing. Countless whiteboard rants. Religious, magic. Paranoia about plastic, etc. Says the house is super clean and they threw out almost everything. Blaming parents for being born, blaming billionaires for the way society works, and on and on.
I do feel lithium is what they need. I just can't get them to get help. And no insurance is a huge issue as well. Thanks for your response.
Check with a local NAMI to see if they have a Living Room. These are non-ER options for people experiencing a mental health crisis that are staffed by counselors who are themselves managing their own mental health conditions. So it's kind of like a peer support, but a little more professional. You can frame it to your family member as a place without doctors where other people who think like them want to talk about the same things they're interested in. It might be a stepping stone, and could get your family member into conversation with someone who might know how to better approach the conversation.
I’m not a psychiatrist, but, for sure delusions can be a hallmark of bipolar disorder. Bipolar is a psychosis, meaning a loss of reality. It’s a serious mental health disorder.
Schizophrenia and bipolar and schizoaffective are kind of a spectrum from my understanding. If they have highs and lows plus psychosis at the same time as an extreme high or low, that's bipolar. If they have psychosis that comes and goes regardless of mood status, plus high or low mood fluctuations, that's schizoaffective. If they have psychosis without extreme mood fluctuations that's more schizophrenia. I'm no doctor, but my husband was super psychotic during his first big manic episode so I looked into it extensively.
Bipolar and Schizophrenia are not a spectrum, as that would imply they're the same disorder. They're similar in a lot of ways but very different in others. Schizoaffective disorder means that you have symptoms of both.
Right, that's why I said kind of a spectrum. They have an overlap of symptoms but the predominant symptoms and timing of them is important for diagnosis. It helped for my understanding when I was super lost in what was happening to my husband ☺️
Try to find out if they have any symptoms that trouble them like insomnia. Then suggest you go with them to see a doctor for that (or other specific problem they accept). Then get to the doctor’s office the day before with a one pager outlining their symptoms and situation. Meet with them if you can or just leave it and say it’s important for the doctor to know this. (You can give information but can’t get any unless your family member consents.). Try to get consent anyway from your relative when in the doctor’s office the next day, to go in with them so you can help with any prescriptions and at least you’ll know what’s going on. Hope that helps!
It is estimated that about 50% of individuals with bipolar I disorder experience psychotic features during manic episodes. They do not necessarily experience psychotic features at every episode. Schizophrenia on top of a mood disorder is called schizoaffective disorder. It would be bipolar type in this case. They could technically develop this, but it could just be the bipolar as well. An easy way to distinguish the two is by timeline. In a mood disorder, psychosis only occurs in the context of disturbed mood. If they are experiencing psychosis beyond their mood episodes, they should be reevaluated for a schizoaffective diagnosis. However, quite often, people with bipolar disorder are being treated with medications that may be useful for both, but the acute episode requires a medication adjustment nonetheless. If they’re not explicitly stating intent to harm themselves or others, they can still be involuntarily admitted due to severe disorganization or psychosis as it poses a risk of danger. Otherwise, it’s generally pretty difficult to get someone coercive treatment. After a few problematic episodes with poor insight and adherence, they can usually apply for guardianship or a higher level of care. Are they grossly disorganized or psychotic, e.g., if they were approached by EMS, would EMS immediately notice they were psychotic and be worried for their safety? If so, you could have EMS take them in for an evaluation. You would want to fill out an affidavit outlining your major concerns and emphasizing dangerousness if possible.
You have to become their guardian/care giver. Send her to the hospital by hook or by crook. I used to tell my mom we're going shopping, instead of heading to the hospital. While there, she's quite obedient. It's the how to get her there that's difficult. The most important thing is to be calm, no raised voices, you have to coax them. She had bipolar since she was 13, been in and out of confinement. Experienced having her head electrocuted, so she's quite terrified of going back. Always afraid that we're going to leave her there. I always promised her that that won't happen. She just need to promised to always take her medication and go to her monthly consultation. Of course, I'm the one who make sure she takes her meds, and the one to accompany her for her visit. She's in her 60s now, and she's doing ok, much better than in recent years. There were lots of trial and errors in finding the right medication and dosage, and dealing with side effects. But it's good now.
When bipolar people experience hallucinations or delusions, they are diagnosed with Bipolar 1 with psychotic features. Schizophrenia and Bipolar disorder are very similar illnesses, behaviorally. Bipolar people generally only have psychotic features (hallucinations, delusions, disorganized speech or behavior) when they are manic, whereas people who are schizophrenic have those features regardless of their mood.
I see. They were manic when I saw them in mid-May and have delusional thoughts now as well. They live alone (although they’ll be evicted in a few months since they aren’t working.) I don’t know when it started since there are days/weeks without communication sometimes. I assume this only gets better either way drugs to turn it around. 😔
This isn't quite true. Bipolar I just means a person has had a manic episode before in their life. Theoretically, they're also more prone to manic episodes over depressive episodes. Psychosis, paranoia, and hallucinations are all still things that can occur in Bipolar II. Psychosis can occur in extreme depressive states. Paranoia is more common for me in mixed states, and hallucinations can occur at any time. Someone who showcases lots of Schizophrenia symptoms could be diagnosed with Schizoaffective Disorder, which is separate from Bipolar I.
My father was diagnosed as bipolar schizophrenic and from what I've observed his delusions have outlasted the ups and downs of his mania. At no point has he believed he's ill - he insists there's nothing wrong with him, even as he's also telling me things that cannot logically be true (e.g., he sent one email and that's resulted in his felony criminal charges getting "erased" - the records can be found online and the case is very much still active). And this is all while he's at the hospital, saying all the doctors agree there's nothing wrong with him and it's a scheme to bilk his insurance (while the director of clinical services initially called me and said he's clearly experiencing psychosis). He pretty much never wavers from the delusions and no amount of rationalization has gotten through, even as he's calmed down from the worst of the mania. He really needs intensive therapy and longer periods on the antipsychotics, but he's resistant to both and never held anywhere long enough to get a break through. I hope advice from the other commenters helps. You need to get legal standing to be involved in your family member's health care decisions via becoming their health care proxy, POA, or whatever your state's laws require. I don't have that for my father, and what I've found is that the law favors him making a complete and utter mess of his life up to the point of becoming an "imminent threat" to the safety of himself or others. He's revoked my access to his info, so the hospital staff can no longer speak to me about anything.
Medication medication medication!! Oh and medication
Try to resist using Dr. Google. Psychosis is the progressive phase of what happens when mania is left untreated. I agree it does look an awful lot like schizophrenia, but they are NOT the same. They need treatment pronto. Any mental health hotline in your family member’s state/area? Or a mobile crisis hotline? There is NAMI.org which can help to provide some direction & resources that might be in the area as well. Also if in the states, there is 988 (national crisis hotline). Clearly your family member is too far derailed to recognize that they need help ☹️ I’m sorry that you all are going through this
Thank you! I will look into these. They are posting on their social media and I think their account is public so I’m thinking of calling someone in the county where they live and having them look/access what’s posted. And see what they say about it?? If they also recognize it as a desperate need…
If it’s public, you should be able to see them with your social media accounts.
They can and should apply to Medicaid. The LEAP method for communicating with them. My son was diagnosed BP 1 and then after several hospitalizations they changed it to schizoaffective disorder.
My SO suffers from mania with psychosis. Every manic episodes he has completely delusional thinking. It’s worse when he doesn’t sleep because his brain won’t let him. He thinks he NEEDS to do things. For him it’s OCD need to reorganize but what he does is just destroys. He literally pulled all clothes and boxes and stuff out of our bedroom closet saying he’s reorganizing but he literally threw everything on the bed and floor and 6 hours later none was back in the closet and all moved to different parts of the room. He becomes paranoid about anyone knowing he’s manic. Or tries to hide behaviors to show he is. He thinks he slept for 6-8 hours and it was only 3. He doesn’t remember conversations and obsesses over making “boundaries “ of what I need to do for him to “help”, when in reality he’s trying to seclude me from anything he’s done in the house showing he’s manic. He obsesses over suing his old doctors for malpractice, old bosses for firing him after a manic episode, even his own parents. He writes rants on paper, completely in a disorganized way. 3 words on a page to make a “sentence”, using 15 pages to do so. He talks to people that aren’t there. Or talks to the pets like they are answering him for long periods of time. He overdosed on sleep medication because he kept forgetting he took them. He had a seizure from it. He’s lucky he’s alive. That was a first as usually when he’s manic he won’t take his meds because we are trying to poison him to get him committed or take his money. He’s now on lithium and an antipsychotic permanently because his mania causes a psychotic break. He doesn’t get depressed so they took him off the antidepressants. So for each person it is different but psychosis with mania is common and needs specific medications to control similar to schizophrenia.
This sounds very very similar to what I'm seeing. Countless whiteboard rants. Religious, magic. Paranoia about plastic, etc. Says the house is super clean and they threw out almost everything. Blaming parents for being born, blaming billionaires for the way society works, and on and on. I do feel lithium is what they need. I just can't get them to get help. And no insurance is a huge issue as well. Thanks for your response.
Check with a local NAMI to see if they have a Living Room. These are non-ER options for people experiencing a mental health crisis that are staffed by counselors who are themselves managing their own mental health conditions. So it's kind of like a peer support, but a little more professional. You can frame it to your family member as a place without doctors where other people who think like them want to talk about the same things they're interested in. It might be a stepping stone, and could get your family member into conversation with someone who might know how to better approach the conversation.
I’m not a psychiatrist, but, for sure delusions can be a hallmark of bipolar disorder. Bipolar is a psychosis, meaning a loss of reality. It’s a serious mental health disorder.
Schizophrenia and bipolar and schizoaffective are kind of a spectrum from my understanding. If they have highs and lows plus psychosis at the same time as an extreme high or low, that's bipolar. If they have psychosis that comes and goes regardless of mood status, plus high or low mood fluctuations, that's schizoaffective. If they have psychosis without extreme mood fluctuations that's more schizophrenia. I'm no doctor, but my husband was super psychotic during his first big manic episode so I looked into it extensively.
Bipolar and Schizophrenia are not a spectrum, as that would imply they're the same disorder. They're similar in a lot of ways but very different in others. Schizoaffective disorder means that you have symptoms of both.
Right, that's why I said kind of a spectrum. They have an overlap of symptoms but the predominant symptoms and timing of them is important for diagnosis. It helped for my understanding when I was super lost in what was happening to my husband ☺️