fearful

[MomofBipolaradult]

My daughter is 36 and is bipolar. She attempted suicide two weeks ago and I am having trouble sleeping and am fearful that she will do it again. Thirteen years ago she made a similar attempt and has only had ideations since then that have been sucessfully monitered with medication. However, in December her husband of 5 years left her and she has been spiraling ever since. She has stayed on her medication but seems to be just barely making it from day to day. She is a beautiful brilliant woman and I am not ready to have her leave our family. Does anyone else have any similar input. This is constantly on my mind and my husband (her stepfather) is getting fed up with my fearfulness.

[Natalie]

Can we have some more details? Was she hospitalized? Did they check to make sure that the levels of her medication are appropriate? Is she talking to a therapist on an ongoing basis? All of these things would increase the likelihood that she gets back to a more stable situation.

[MomofBipolaradult]

In response to Natalie, my daughter was hospitalized the evening she took an overdose of pills, and alcohol. Once the emergency room treated her with charcoal ingestion, they released her to the Behavorial Mental Facility. When I saw her a few hours later they were waiting to evaluate her for a 51/50. They did check her blood but kept her on her medication (excuse the spelling) effexor, topamax, and abilify, she also takes ambien for sleep and lorazapam for anxiety as needed. She has her first therapist appointment since the hospitalization on Monday morning and says she is very anxious about that. She has had such bad experiences with therapists in the past.

My hope is that she can truly participate in therapy. This is an area where she has never followed through for very long. Her Psychiatrist is a constant and medication, but therapy always ends up with "they aren't helping me." She was a therapist for a few years before this disease became debilitating. She is now on complete disability and seems to have some signs of agoraphobia and her anxiety does not even allow her to go to her doctor alone.

She is so bright that she can usually tell a doctor just what she wants them to hear to allow her not to get too anxious. I know if she can get past this that the therapist could be the missing link to help her back to a better quality of life. She has quit drinking since the episode and has not been alone since. She says that she thinks this has delivered her - and she is over her husband, etc. However, I have learned over time that what is said today may indeed not be true for her tomorrow, so I always encourage, but am always a bit anxious that she might start drinking and end up trying to take her life again.

Thank you for your response.

[Guest ASchwartz]

Dear Momofbipolaradult,

Thank you for the additional information about your daughter.

After years of experience in working with people with Bipolar Disorder I have learned that, in addition to the medication, psychotherapy is important.

But, what is meant by psychotherapy?

The ordinary "talking therapy" will not help your daughter.

What she needs is a combination of therapies:

1. Psychoeducation: in this the emphasis is on education. Your daughter needs to learn about her illness and how to control it. This means that she needs to learn the types of stresses and worries that put her in danger of having a manic or depressive episode. She also needs to learn to recognize the symptoms.

2. One of the major findings in the treatment of patients with Bipolar Disorder is that, in addition to medication, Cognitive-Behavioral Therapy is enormously helpful in preventing future relapses. In CBT people learn to modify their thinking so that they can avoid a relapse. I know people (not patients, but friends) who have gone through this and found it enormously helpful.

Your daughter needs to find a Clinical Psychologist fully trained in the use of CBT.

What do others think?

Allan

[donnytree]

Dear Momofbipolar adult,

Your daughter is so similar to my 30 year old bp sister. She is so smart, she can manipulate the doctors and figure out what they want to hear and tell them. She is bright and funny and creative anyway, its just so sad to see her like this.

I don't know if it's similar with your daughter, but my sister refuses pschotherapy, she is in complete denial of her illness. It is so hard for our family, its comforting to know that other people deal with the same issues, it feels so isolating dealing with a bp family member, and it is so hard to find help and information. Finding a good therapist is so hard, and finding one that actually connects with your daughter is even harder. I wish you all the best, and if you ever need to talk please feel free to.