Friends, Family & Carers Forum

[Louise]

My 17 yr old son has recovered remarkably well from his psychotic episode in October. If he stays on this medication ( which he is fine with) for a year, he may never have another episode. Last week the psychiatrist was so happy with him, he lowered his dose and said he can start driving again. I guess I relaxed a bit too much on hearing this: for 2 nights in a row I forgot to remind my son to take his tablet. Last night also, I think we both forgot. And unfortunately I have noticed he is slightly manic. Just little things I have noticed: he is more outgoing,expressive in his face, jerky and sudden in his movements, and dipped fruitcake in his lettuce soup, saying they went well together. I am wondering if this will settle a bit back to normal if he doesnt miss any more tablets...or is this a sign he could develop full-blown mania again? And should I tell him that I have noticed him behaving a little differently...or wait to see if it settles or develops? Any advice appreciated. Cheers ( His diagnosis is Bipolar 1, he has had mania and psychosis but no depression )

[NikNik]

Hi @Louise 

I'm so glad to read that your son has recovered very well. That's excellent.

While I can't give advice as to whether this will move into full blown mania or if the symptoms will disappear after he takes his medication, what I can say is that you are doing an amazing job at being on top of looking out for your son.

We all forget our medication at some point in time, it's part of life. This has happened under such a controlled environment with such great support from yourself, and the outcome will be useful down the track to reflect on, and inform how things are managed if something like this pops up again.

I have seen in these forums some techniques carers use when the person they care for isn't doing so well. For example, when the person they care for is well or when symptoms are not severe, they make a bit of a check list, which is created together. In your situation this would mean sitting down with you son and working out a list of changes both you and him notice when he is moving into mania.

Once this list is set, a care plan is created together on what will be done if either of you notice those changes listed are taking place.

The list gives you something concrete to refer back to and is designed to help start the conversation eg: 'hey I'm noticing that you're showing some things on the list (use examples), how are you feeling about this? Have you noticed any changes?'

I think you could definitely start a conversation with 'We both forgot your medication last night... how are you travelling?'

Is he comfortable seeing his psychiatrist? If so, if things get worse over the next couple of days, perhaps you could suggest to your son a  'check up' is in order?

Some doctors take calls about questions like this. Perhaps it's worth calling his/her office to see if they can advise?

Does anyone else have a strategy or different perspective how to manage these types of things?

[Hobbit]

Hi @Louise ,

Welcome to the forums!!

I have read your post, and I can hear your concern. I think it's really good that you want to address this before it might possibly escalate into something. It shows me how much ou really love your son.

I think  @NikNik 's advice is great - seeing if you can get something concrete in place such as a care plan that you can both refer to on equal terms is a terrific idea.

Have you thought about calling the psychiatrist for some advice? Your son seems happy to see him (or her) and perhaps you could make another appointment soon?

WOuld anybody out there have some advice they can offer @Louise ? @Alessandra1992 @kristin @Rick 

Hobbit.

[Rick]

@Louise 

Hi Louise,

It's very good to hear that his medication is effective. It often is with this kind of disorder. So that's just just.

Nik offred really good strategies you might want to consider. The thing to remember is that both carer and the person dealing with the sypmtoms work together to make a recovery.

It is not at all unusual in my experience for missed meds to have an impact on the condition. It's fantastic he's improving but your doctors advice of the type of med and the dose and frequency are important to follow. The psyche is the expert in this case. 

I will will say that you have been a really positive force in your kid's life and this is rare and wonderful! You seem to have the typre of rellationship where you can be frank and ernest. Now might well be a good time for that.

Now that you are aware that missing doses may have an adverse effect I think the kind of chart Nik suggested is a great way to head this off in the future.

Alot of MI management is recognising triggers and planning for them in the future.

I wish you hope and grace.

Rick

[Louise]

Thank you all for your kind support and helpful suggestions! I think NikNiks advice regarding conversation and putting together a care plan with my son is excellent and I will do that sometime over the next few days. Thankfully he seems to have settled back to normal as he has resumed his medication! But it is a good opportunity to talk with him about it all.( I just need a day or two to recover from long hours at work recently) Thanks again , and best wishes to you all xx

[NikNik]

That's great news @Louise !

Please come back and let us know how the care plans goes. It's really important for us to create these with our loved ones, and I think a lot of people would benefit from hearing how you go!

Nik

[Louise]

Just an update.

My son was surprised to hear that I noticed changes in him when he missed his tablets 3 times in 1 week but he at least believed me. He said that it was probably  temporary symptoms due to adjustment such as anyone would experience when ceasing medication or quitting smoking for example. He didn't think he would have gone on to develop full-blown mania. I accepted his opinion though privately I disagree. He didn't think it necessary to develop a Care Plan. But I did at least mention that if those symptoms had continued, one option would be for me to ring his psychiatrist...and did he agree that would be a good idea? And yes, he agreed with that happily enough ( probably mainly because he doesn't believe it will ever happen). 

Anyway, I have been reminding him every night to take his tablet and he complies readily, and is going really well in every respect. This is excellent, bearing in mind that this is a lower dose than he was taking for the first few months. If all goes REALLY WELL, maybe at the end of the year he will be able to come off medication entirely (CAREFULLY).

He is a great kid, but he is 17 and occasionally if I give him too much advice regarding exercise etc, he  warns me that he will make his own decisions and plans. I have to allow him to develop independence. This is a tiny bit frustrating because he actually does need me to remind him to take his tablet EVERY night, because he NEVER remembers. (There's no use setting an alarm on his MB phone to remind him because it's either switched off or uncharged. He is a very absent minded person)

Anyway, because his prognosis is very good, I don't mind supervising his medication just for this year. Perhaps after that it won't be necessary ever again. Then he will be free to develop complete independence. 

If, years down the track, he does happen to have another episode, maybe he will be less absent-minded by then and able to remember his medication unaided. But that is too far in the future to think about now I suppose.

Anyway, I'm very grateful that he is doing so well and has an excellent prognosis. The hospital staff and psychiatrists have been excellent, and he has no serious side-effects to the medication.

Perhaps others can find encouragement in this good news.