My husband had some break thru episodes while taking his meds but he was taking his meds and then going out and drinking alcohol and smoking pot. Just taking meds isn't enough. They have to change the lifestyle as well and not enough sleep, illegal drugs, alcohol, to much stress and to much caffeine can trigger episodes.
My husband has done miraculously well while taking his meds. He has suffered some damage we believe, since his full manic episode, but has come so far and is able to hold down his job and many people don't even know he has bipolar unless they get "close" to him or hang around long enough to notice things. But he is a loner, outside of work, so he is able to pull it off. He has had some hypomania, while medicated, though. It is fairly extreme at times, but his particular case is hard to treat. He is sort of like a hair-trigger...too much of this and he is super depressed, or too much of this or not enough of that and he is hypomanic. He has been fairly balanced for quite awhile now, running more on the hypomanic side for most of it. But it is manageable. His pdoc says I need to pay close attention and recognize when he is cycling too up or too down and then he takes a PRN med (if he will take it at the time...dratted hypomania!) and it calms his brain. So far, so good. One of our dealbreakers is that he must ALWAYS take his meds. He's only bucked me a few times and was definitely cycling in hypomania at that moment. His pdoc says breakthrough episodes can definitely occur and I need to realize that possibility.
My husband's pdoc is very careful about med changes....always slowing getting him off one med before putting him on another. And making sure he has PRNs to help stop any cycling from becoming an episode.
My husband had what we NOW know was an episode in his 20s. At the time, they didn't diagnose him. They called it a nervous breakdown, which is not useful! (I wonder how much of this was what the doctors actually told him and what his parents told him.) I married him in his late 40s. He had one prolonged manic episode that was several years (only punctuated by cycling "down" into hypomanias) and one prolonged depressive episode he is still climbing out of.
12/10/2013 07:31 PM
Posts: 88 Member
Re: med changes,
I think everyone reacts differently but my neighbour got his meds changed and went fully manic. The mania ended when he stole a car and raced down the highway and crashed. He was admitted to the psych ward. Took years to stabilise him.
12/10/2013 08:02 PM
Posts: 11200 Group Leader
@whathappnd.....that shouldn't happen, with a good pdoc. If a person has to completely come off one mood stabilizer before getting on the new one (which sometimes happens), there should be close monitoring, lots of PRNs (not just Ativan but PRNs of things like Zyprexa or Risperidone), and hospitalization, if need be. Something went horribly horribly wrong in your neighbor's case.
Edited to add: I know that in the real world (versus the ideal world), this does happen sometimes. But if everybody is doing what they should be doing, a person should not have a manic episode during a med change, and if they begin to cycle up and PRNs won't stop it, they need to be hospitalized.
I think we know so many dysfunctional stories here that we forget that many people (like the GLs on our BP groups here) actively manage their BP and will chart their moods, watch their sleep, go to therapy, call their pdoc if there are any issues, and go in-patient if they need to.
If our spouses are not at that level of self-awareness and management of their BP, we need to do all we can to help them get there!
Post edited by: marriedtoit, at: 12/10/2013 08:31 PM
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