Spouses of Bipolar in Active Relationships

I wanted to start a thread that might help a lot of new people but also will be good for us old-timers too. With my husband recently having to see his pdoc for some antipsychotics to stop him from an episode, I was reminded about many things we need to be aware of when navigating mental health care in America.

Let me start out with some general things (that might apply more broadly to health care) to always keep in mind:

1. (Okay, my friends on here are laughing now. I love using numbers.) Wait. Forget that 1.

A. (Hahaha. Outsmarted you guys now!) Doctors are NOT gods. You have the right to ask them why they are doing what they are doing. You have the right to question a decision they make. The doctors have the responsibility to answer your questions. Don't take them some info from "MYDoctorSUcks" or some other unreliable site. But if you have info from WebMD, NAMI, DBSA, Mayo Clinic...reputable sites, it is the doctor's duty to explain why he or she is doing things contrary to the wisdom on these reputable websites. (Often they can. Everything I read indicated I needed radiation for my breast cancer. But I was not taking into account the fact I was postmenopausal, which the web reading wasn't addressing. I didn't need radiation, thankfully.)

B. Getting an appointment with a psychiatrist feels like a real coup these days in many parts of the country. The wait can be for-evah! So I know what I am about to say seems impractical. But it is TRUE: don't be afraid to get a second opinion!

C. Make sure you know all the side effects of all the meds prescribed. Make sure you ask things like: when should the meds be taken? What happens if a dose is missed? What happens if side effects are experienced?

D. It is probably best to ask your pharmacist this next question, but you should ask your prescribing doctor first: what are the interactions between this med and the meds I am already on, the supplements (herbal or vitamin) I take, the OTC meds I take when I have a cold/allergies/indigestion?

E. Last, but not least, please do yourself (or your bipolar loved one) the favor of asking this: What are the consequences if I (or my loved one) refuses to take these meds?

Please chime in with what you have learned. I am sure I will add some more as this thread goes on. Wornout2, I hope you will have time to give us a few tips on hospitals and discharges for those who can't pay?

Great thread, married. I think the one thing I would add is to keep a log of meds, what the dr. says, dates of appts, and of course, the mood chart. I think it is very easy to forget dates and incidents when they are happening frequently. When my husband was just starting lamictal, I charted every day. I took the chart to the dr. appts and then had some solid evidence of what was going on. (our dr. is not easy to work with, we have to prove or convince him when something happens and we think we know what we need) And what married said about asking questions--do it. Make sure you are clear on what the dr. is telling you to do, and keep those questions in mind about missed dosages, things the dr. might not think of. Think about your own situation and list the things that are a problem and ask what to do. What if he is getting anxious, but not exactly having an episode? What if he says he would be better off if he wasn't around but he doesn't seem suicidal? You know the things that come up and at the time wonder...what should I do? Write them down and ask. When it comes to our dr., we came right out and asked for a prn because our dr. is concerned about the addictive nature of these meds with my husband who we think has abused ritalin. The prn (ativan) has made all the difference in preventing tragedy at our house. I control it and give it to him, although I am not against giving him one to keep with him in case I'm not around. Also, find out what to do if your SO is having an episode, what are the steps to take to keep him/her safe and how to seek out help without getting them put in jail. (this has been my dilemma) Get the dr.'s on-call number or where he can be reached in an emergency. It really helps to have a support team in times of trouble. Have a list of people/professionals who know your situation and can spring into action when something happens and you need help.

I am coming more from the angle of no health insurance. I have found that to be a huge boulder in front of a lot of people that keeps them from getting the help they need.

-to my knowledge there are free/sliding scale health clinics in all major cities in America. Personally I live in a town of about 150,000 and I am aware of at least three options for free mental health clinics

- There are programs out there that will give you meds for free. If you can't afford something tell your doctor. It does take a little while to process the drug companies paperwork. Be aware of that and ask your doctor for samples to get you by until then if you can't afford it, or to give you something less expensive. In a conversation with my SO's pdoc (who we both like very much, and is in a free clinic) he was wise to say that cost is big part of why I Rx a certain drug. It does you no good if you can't afford to refill the Rx

- I have found that if you are not married (and maybe if you are???) you need to have a release of information signed by your SO for each place you go. First visit to ANY new clinic or hospital one of the first things I ask is for a release of information form for him to sign. When you start asking hard questions I have found people quick to pull the HIPPA card on you. I respond with the ROI form and my power of attorney.

Those are the ones I can think to add...

THANK YOU times three, Riding. Great info!!!

Wife, absolutely with the mood chart. And the phone numbers! Have them on speed dial.

Be your own, or your loved one's own, Advocate! Find out all the meds that COULD BE prescribed for your loved one. Ask your pdoc why s/he is prescribing the ones s/he is and not others!