Bipolar Support Group

Good Morning, all!

I have recently taken charge of my mother's care and moved her in with me. She is 63, a disabled vet, and has been diagnosed years ago with schizo-effective, BPD. Out of pride, and due to the stigma surrounding mental illness during the time she was growing up, she has never fully accepted her illness, actively resisted treatment and, as a result has had many, many severe manic episodes and hospitalizations.

Age and time has somewhat toned down the wild and unfortunate antics that she once exhibited in her younger years during episodes,(eg. going outside completely naked, yelling at people, or calling the FBI with numerous delusive ideas), however she still becomes paranoid, controlling, and sometime violent when manic.

Since she is now with me, I have been able to administer her meds to her and she has been cooperating pretty well so far. My concern is that she is exhibiting signs of hypo-mania and I fear it is only a matter of time before she goes full-blown. I can't understand what is causing this as she is taking her meds.

After reading a few posts on this site, I found out that some individuals with BPD may purposely self-induce hypo mania by tweaking their med. dosages or with caffeine - in effort to get that euphoric, energetic high. I suspect that my mom is doing so and the tell-tale signs are surfacing-the loud talking,chain-smoking, wearing odd, brightly colored clothing, staying up late and irritability. She often tends to talk about very embarrassing or inappropriate events in her past and begins calling high-school classmates from 40 years ago and distant family members randomly, and at all hours of the night- because she has just recently began making coffee for herself in the mornings and gets upset if I advise against it. Now I am wondering if there is any natural way to counteract the effects of caffeine on a person with BPD?

I am trying to get in contact with her doctor but wanted to get some opinions on this from the forum. I appreciate all feedback and/or criticism, positive or negative. Thanks in advance!

Her meds are:

80 mg Ziprasidone every 12 hours

1 mg Benztropine 2x per day

50 mg Atenolol once a day (for Hypertension)

Even if we take our meds as prescribed, we can still have episodes of hypomania, mania or depression.

Some bipolars need to have their medications adjusted very often.

When was the last time your mother saw her psychiatrist? CALL her psychiatrist immediately or have her psychiatrist EVALUATE her right away.

Once a person become hypomanic or manic, medication is your only option; you must contact her psychiatrist. There is no natural antidote to these episodes or caffeine toxicity.

If you must, lock up the caffeine (get a safe or use a filing cabinet). Put non-caffeinated coffee and drinks out for your mother. You seem to be worrying about the little stuff. Put in another call to your mother's doctor. Please see my response to you in your other post.

Time is the primary antidote to caffeine; have her drink extra water.

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Post edited by: sarahtroy, at: 07/12/2012 09:49 AM

Thanks Sarahtroy:

I left a message w/ her doctor and am waiting for a call back. Thanks for the suggestions regarding hiding the coffee. I am going to try that and, just in case she presses the issue, I bought some decaf today hoping she won't be able to tell the difference!

During her last hospitalization the subject of "long-term care" in the form of an assisted living home came up during the pre-discharge family meeting. I decided to take her in. However, if I am unable to handle this I will need to explore other options. The most difficult part of this situation is that when she is back to her baseline, my mom is the sweetest most caring, intelligent and witty character, and the thought of her being confined to a facility (especially once she's been stabilized)breaks my heart!

What's interesting is that I have an aunt with the same diagnoses as my mom who, unlike my mom has accepted her illness. She and her husband (who also has BPD) have become spokespersons and activists for the organization NAMI. She has not had a hospitalization in almost 15 years. I guess this goes to show how one's quality of life can be affected by choosing to or choosing not to accept and hold a realistic idea of oneself and choosing to embrace your strengths and weaknesses and moving on!

I appreciate your taking the time out to respond to me - blessings to you and have a wonderful weekend!

<daughter*here>

Hi again,

I used to work in long-term care facilities. Actually, as I was responding to your post, my thought was that was where she needed to be. I'd consult with an attorney first, to get the durable power of attorney for health care in place, etc. You'll want to prepare for your mother having both medicare and medicaid. (If she doesn't already.) She can spend down her money by starting out in an assisted living facility, or on other things. The attorney will help her preserve as much as her money that can be preserved.

Long-term care facilities are not the horrible places they used to be. You might pick a facility that has an assisted living side, and a long-term care side or building next door. Maybe your mom can start out in the assisted living facility. Since assisted living is a rather new popular option, the buildings tend to be more modern with lots of windows (light) with very cute apartments. Residents can go to many daily activities. It feels like an apartment complex to them. I was in one the other day that I wouldn't mind living in - the apartments were so cute and the common areas felt luxurious!

My experience is that families unnecessarily dread placing parents in long-term care, and parents try to make their kids feel guilty about it. Long-term care, if it is needed, is the most appropriate placement. Most good facilities have very good activity programs for when your mom is better. Some facilities have rooms with only 2 beds in them - that's what I'd go for. They are not prisons. You can take your mom out for the day or to your place for a weekend when she is doing well. Some facilities work especially well with the mentally ill; their patients rarely have to be hospitalized. Patients get skilled nursing care every day. Patients become good friends with each other. Many long-term care facilities are newer, and have lots of windows and amenities.

Anyway, these are just my opinions.

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Post edited by: sarahtroy, at: 07/13/2012 08:34 AM

wow Sarahtroy it is so nice to hear someone speak nicely of nursing facilities, I to work in a nursing home and the old nursing home scare gets old. We are good to our residents we laugh and sing with them, they pick on us we pick back we really do treat them like they are friends and family. When your mom becomes stable she does not have to remain at the facility she can be checked out at any time it truly is not a jail sentence. If you have to think of it as your moms life ring for stability, her meds will always be given correctly, dietary will supervise diet restrictions due to food and med interactions, 24 hour nursing staff to keep an eye on her and tons of people to talk to and things to do. you can also look into respite care, you can have a break she can see some stability and the two of you can see for sure if that is a route youd like to take. good luck to ya

Oh, cetacean, thanks for adding your input. Good nursing home staff are just as you describe, and come to care about their residents. You sound like a marvelous nursing home employee! I like the points you make about getting meds regularly, 24 hour care, dietary supervision and respite care (in the event that a skilled nursing facility (SNF) stay is short).

Often, if patients refuse meds in these facilities, the whole treatment team becomes involved in ensuring the patient takes them. For example, your mom might have a favorite certified nursing aid (CNA) from whom she'll take the meds. Or the Director of Nursing (DON) gets involved, as does the doctor.

cetacean, I was afraid of a follow-up post by someone who'd had a negative nursing home experience or was anti-nursing home. I am so glad you gave your input.

you are very welcome, It can a bit of a sensitive topic. Im a C.N.A and Ive come to understand so many things from working in a nursing home the biggest is reality isnt nearly as scary as the rumors. Just make sure you do your research before hand

If your mother continues to stay with you, I would suggest the book; "Loving someone with bipolar disorder" by Julie Fast. This book contains a lot of information on what triggers mood swings and what helps to prevent them.

I highly suggest reading the book mentioned above. It will at least help you understand what she is going through and how to respond to her.

Thanks Claude - I will order this book ASAP!!