to half hope bipolar goes the same way as homosexuality?

[Mitchy1nge]

when homosexuality came out of the DSM

In America there does seem to be a big thing to medecate teenagers, with big pharmacology companies heavily investing in some would say with not the best intentions. Wasn't there talk of the kids who carried out college massacres were or had been on a similar drug?

Homosexuality is not made different by any of these because it is not a 'condition' to be treated in the first place

but lots of things in the manual are not made substantially different by any of those things (meds, techniques for reducing anxiety) either - eg autism but most people agree with their inclusion

was it paroxetine breakingdad or some other SSRI? I bet it was one of those

Of course you can define 'normality' so finely that any deviation is a mental illness, but this isn't really about that is it. We're not talking about forcibly drugging people who are mildly different in their views.

Mitch, you say you were hospitalised. Do you think the doctors should have acted differently? Could they have said 'well it's just your way - everyone is different' and walked away?

uh . . . no, I really don't think the best alternative to depriving someone of their liberty is walking away and leaving them to die of malnutrition or whatever, no

somewhere between those absurd extremes there is plenty of space for supporting and seeking to understand and help people within the context of their lives, there is a role for education about relationships, financial and housing help, psychological/psychosocial support, we have home treatment teams now which can be great, for another if someone can sit and do the work with the person affected by bipolar mood swings a lot can be done to prevent relapse

I guess treatment is going to be on a case by case basis but what happens if a person refuses to accept treatment?

I went along with her plan(I hadn't read up on it much, though in back of mind had the thoughts of jack nicholson in one flew over the cuckoos nest) as she said she had spoken to her doc to come off her lithium and it was ok.

When in fact she had convinced a locum GP that she could come off them without any other interventions. Leading to a going manic and having to lose weeks and her job to come back down again (this was the second time this had happened and in the same fashion). Which with loaded parents she was able to do but if you were of normal means just losing your job would be a nightmare etc.

I think she could have done with some counselling or other support with her lithium as her parents were so stifling and put so much pressure on her. Her father definitely had mh problems as well but I dont think had ever properly addressed them and set a bad example.

I don't think anyone should ever be compulsorily treated, we should have moved far beyond that by now and have the resources to educate and motivate people to make their own choices

But..... Some people are just too poorly to make an informed choice because they are too ill to do so. They need someone to help them reach a point where they can make choices. Some people will still need to be protected because they are a danger to themselves or to others.

I dont agree that treatment shouldn't be 'compulsory' for some people.

I was a voluntary patient on a psychiatric ward (although I was strongly advised to go into hospital by the psych assessment tram, and think they may have sought a 72 hour section if I had not agreed).

While I was in there, I met some vey, very unwell people who were frankly a danger to themselves. People suffering from severe psychosis, delusions, paranoia and suicidal thoughts. I doubt many of them would have been alive if they hadnt been sectioned and treated, in some cases against their will. Distressing, but true.

I have been sectioned twice. Although I was far from happy about it at the time, it was the correct course of action as I was very ill and wanted to drive home. If they had let me out I could have caused a major accident and killed someone as I was not fit to drive.

not sure where you are that has all these resources and staff to do the education but mental health services in the UK are in crisis

and people need to be sectioned and treated for their own safety

I think it's more preventable more often than we know at the moment, and it should be a priority for us to know much much more not only about preventing people from becoming a danger to themselves or others in the first place but to make that less serious when it does happen without depriving them of their liberty or any other basic human rights

we already know from local and regional patterns that these aren't accidents of our biology or brain chemistry, predestined breakdowns that our environment has no influence over

I'm in suffolk Gordy

and it's not exactly a money saver, waiting for people to be unable to care for themselves and then sectioning them at a cost of £thousands a week

ghosty, sorry, not Gordy

Has anyone ever told you about what happened to lead to your hospitalisation?

well on one occasion it was caused by complying with treatment, taking antidepressants that triggered hypomania and worsened my mood cycles for what seemed forever

Mitchy do you think the problem is that there aren't the MH systems in place to manage peoples conditions properly. Blanket drug choices for people with certain conditions?

I get the impression the choice of drugs is fraught and they can have different results with different people.

How does that feedback loop work - is it up to the patient to go back to report what they are feeling or are there scheduled meets?

YABU - my mate's bipolar and has it really under control the whole time I've known her, but she's told me stories of how she had an extended stay in a mental hospital and she thought she was being told things by Jesus...

How does that feedback loop work

it goes:

pt - am experiencing x,y,z (not always adverse) effects of drugs

dr - it is not the drugs it is your disorder

Oh, also my gran was an unmedicated bipolar sufferer for years and thought she was being given "missions" and being spied on by the milkman and her GP and that there were cameras everywhere watching her (this was before CCTV was everywhere, and my mother witnessed her pulling silly faces at the "camera" in the Dr's waiting room that was actually an intercom).

If walks like a serious mental illness, quacks like a serious mental illness...

mitchy have you read "Cracked" by James Davies or "Doctoring the Mind" by Richard Bentall? I think you'd find them both interesting. The material about anti-depressants in particular is fascinating.

Im not really sure how you can say treatment shouldn't be compulsory for some. No amount of education and guidance is going to help when someone is in a mania phase or paranoid delusion. The whole point is to try and protect them from themselves.

Many bipolar sufferers never experience psychosis, though @outtahell. Again, it is a spectrum condition.

Re: the feedback loop. That must be so frustrating, Mitchy.

I havent found meds that work for me yet, but have been lucky in that the psychs I have worked with have always been totally influenced by my feedback on how a particular med has worked for me and been willing to trial different things. I refused quetiapine because it slurs my speech and gives me disturbed vision, for example, and the psych accepted that I wasnt going to take it anymore. No arguments.

I also refuse lithium because I am concerned about long term side effects and dont think mania is my main problem (I 'only' really get hypomanic. Depression is the more debilitating aspect of my BP).

I guess that willingness from the HPs to accept my views on my own medication might change if I was sectioned, though.

Do you follow the blog, Sectioned? If not, please have a look. There are some interesting pieces on forced treatment.
Xx

I can remember a housemate who had some mh problems, was just doing volunteering he was terribly posh, talked in quite a paused manner, and to me it seemed he had a financial safety net. He complained about his psychiatrist 'telling him off' for cannabis use not taking his condition seriously, (he'd got 'lost' in Amsterdam and hit by a tram and broke a rib).

Obviously the relationship between patient and doc wasn't working what do you do?

grays you seem to think it's inevitable that a certain number of people will just have these episodes every now and then and that there is nothing we can do either to prevent them or reduce their severity when they do occur and so compulsory treatment/detention/sectioning is a necessary evil, much like slavery or prostitution, nobody really likes it but

we find local and regional clusters of some of the more serious mental health problems - like canard says - seems legit to infer from those that there are social and environmental contributory factors to address before we can accept 'these things just happen'

will look up that blog and the book recommendations, thanks

(generally most of the time am sort of ok with taking lithium because, you know, evidence base and if I believe the documentation of my own history then it's not doing me any harm, but obviously would prefer not to)