Whether to seek hospitalization or family care?

There was a time in my life where I lived in the same city as my sister. For a period of about 7 years my sister invited me into her home and volunteered to help administer meds when I was in the midst of what I call a mini-break. I feel like this treatment time in her home was instrumental in the prognosis of my illness. I was able to hang out with family even when I was severely ill.

In more recent years, I have come to understand that in Europe home treatments for mental illness are more popular than here in the States. I don’t thoroughly know why that is. But I do know it takes a village.

The progression of my illness since about 2008 using clozapine has basically stopped the occurrence of these mini-breaks but there may be a time when I bump the meds up for a particularly rough day. This is generally in step with my doctor.

The relative stability on clozapine beginning in 2008, however, was preceded by a time of hospitalizations about twice a year after my daughter was born. This was about 2004 to 2008. Prior I had had a period of hospitalizations from 1986 to 1988.

Do you think those who have severe behavioral health concerns/break-through episodes should be treated in the hospital or by a family member who is educated about treatment protocols, medications and the general course of the illness? What do you think about hospitalization versus family care? What are the benefits of each? What are the drawbacks?

My Sojourn through Bipolar Illness – Managing Anxiety Then and Now

My daughter was born 16 years ago when I was 40 years old.  She is the light and the delight of my world, yet her birth marks a turning point in my illness particularly as regards my experiences of anxiety.  As a parent, my experience of anxiety has quadrupled or more over the years of being a parent. 

In years prior to the birth of my daughter, everyday life felt relatively normal between breaks with breaks or mini-breaks coming every six months or so each year.  After the birth of my daughter this scenario was replaced by a low to medium to sometimes high level of generalized anxiety all of the time.  This generalized anxiety now persists as my benchmark or my norm with little or few break-down episodes.

While I no longer have episodes that land me in the hospital or at my sister Jane’s house twice a year, I do maintain and live with a generalized sense of anxiety all the time.  In many ways my illness has migrated from severe to partially severe breaks every six months to living with anxiety on a regular basis.  The anxiety may also be the by-product of mixed moods – or experiencing mania and depression simultaneously.

The good news is I have become better at policing my environment and know those things that trigger my anxiety:   fears of safety, not being sure the house is locked or secure, not knowing the location of important things like documents in the safe or prescription medication, big parties where there is an emphasis on alcohol and drinking…. In many ways it feels like my bipolar illness has migrated toward including a combination of Obsessive Compulsive Disorder and Generalized Anxiety. 

But, I am not the doctor and as far as I know I am still diagnosed as having bipolar illness… 

As a parent as discussed, I tend to be hyper-focused on safety concerns for my daughter as well as for my family.  I tend to be extra vigilant about little things like crossing the street or being in a venue where alcohol is served or being aware of predators on the internet or elsewhere.

I also appear to have some short-term memory problems that I associate with a high dosage of meds over the years and/or over-active brain synapses.   These short-term memory issues continue to present challenges to me particularly in the workplace.  At times, I am challenged with finding a place for everyday things like a wallet or keys or cell phone.  It is also difficult for me to keep track of things of my daughter’s like phones, laptops, keys, etc. Each of these things has to have a specific place or I will become anxious in the not knowing.  The not knowing again is tied with the short-term memory challenges. 

These short-term memory issues have turned me into “a checker.”  Before leaving the house, I check routinely that the stove and oven are off and that other appliances are unplugged.  I have developed a checking routine for various appliances and doorways before leaving the house.  This level of “checking” feels important for me because of the memory issues but drives my husband and my daughter crazy.  

In general, I would say that the general anxiety that I experience currently presents my largest challenge in the management of my life including my role as mother to my sixteen-year-old daughter.  The anxiety is something that I face every day.  Being overly sedated so as not to feel the anxiety is one approach.  I am hopeful, however, that the medication I have been taking for the last 10 years will allow me to address that generalized sense of anxiety.  Perhaps also, this anxiety simply is tied with being a parent and all the worrying about things that that role entails.    Perhaps also this anxiety is due to unresolved issues of potential child abuse when I was six.

Prior to my daughter’s birth, I managed my condition with a combination of lithium and tegretol for ten plus years.  This was my regime when I had the mini breaks every six months or so that were treated with Mellaril and Haldol.  Now, I no longer have those mini break-through episodes, but I do have a sense of generalized anxiety a lot of the time.  The generalized anxiety appears for now to be the trade-off for no longer having the mini-breaks.   Managing through this generalized anxiety is my current mental health challenge.     I am hopeful as I get through to the other side of child abuse as a six-year-old, these anxiety symptoms will abate markedly.