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My 56 y.o. g/f is in hospital again for mania/psychosis. Unlike another many times in, this CT scan showed brain atrophy. I'm alarmed. She has been taking Depakote for a yr -- as now doctor forced her to stop Lithium, due to longterm use & Stage 2 kidney damage. Thus no more lithium.
But Depakote along w/ Ativan & Seroquel are being used at does of 2000mg/day Depaktoe. 800mg acute dose of Seroquel/day to knock down the mania/psychosis. But it is the CT scan showing atrophy that worries me most. She had her mom's sister die in '90s of Parkinsons. Her dad's sis died recently & was Bipolar. Her 53 y.o., younger brother, I think has confirmed Bipolar & is wheelchair bound w/ MS now too.
She is genetically lined up for problems. The doc who told me of the CT scan said it shows brain shrinkage & atrophy possible consistent w/ early med-induced or other dementia onset?
This terrifies me, let alone the Bipolar itself which (is beyond bizarre & erratic at times) was treated off & on til about '98 -- when she has been mostly on meds since. She is complaint at times but often goes off meds due to lbs gain worry.
Just wondering if anyone else has had this type experience? She needs an MRI to rule out more definitive things too. I still think there's far more than just Bipolar at work here.
My only experience comes from the devastating effects of the medicines given to a close friend of mine who was diagnosed as bipolar, and the extensive reading and research of medical literature that I did at the time. I came to the conclusion that in her case, the treatment was worse than the condition. Antipsychotics have been linked to brain atrophy. Once the musical chairs of of prescriptions begins it can often be difficult to tell what you're dealing with, an illness or effects of a treatment.
Last edited by Deserterer; 09-21-2020 at 09:04 AM..
She has been thru this 5x at least, w/ me in 22 yrs. Back & forth. She is still on daily; 2000mg Depakote & 800mg Seroquel & an anti-anxiety 1mg 3x/day. Been on Synthroid for 22 yrs too at .88mcg Levotyyroxine. It is so hard this genetic disorder.
She has been thru this 5x at least, w/ me in 22 yrs. Back & forth. She is still on daily; 2000mg Depakote & 800mg Seroquel & an anti-anxiety 1mg 3x/day. Been on Synthroid for 22 yrs too at .88mcg Levotyyroxine. It is so hard this genetic disorder.
In my opinion its incorrect to call "bipolar disorder" a genetic disorder at this stage. Genetics may play a role but genetics play a role in everything human. The genetic component of the condition is far from being pinned down, and nobody is claiming it's the whole story. There is no genetic test, no way to look at someone's DNA in isolation of other factors and say "yup, this person has or is going to have bipolar disorder". It also leads to fatalistic outlooks and approaches to treatment. Telling patients who suffer severe depressions that they have an incurable genetic brain disease without any diagnostic pathology proving it is nothing short of cruel if not criminal. One doesn't have to be very imaginative to understand how that kind of "diagnosis" can adversely effect the depressed patient and others in their lives.
There's too much going on in her brain/head that it'd take Neurologists & Psychiatrists & others to eval it. We think Axis 1 is: Bipolar 1. But it could have shades of grey like Schizoaffective, etc. She even thinks she has is Schizophrenia at times, she says to me. I have no clue.
It can present w/ rather bizarre behavior the nurse just told me on tele; like wandering halls/pacing to 'exercise/lose lbs', talking to self, speaking in 3rd person re herself, agitation, irritability, fast manic speech, loose associations, jumping topics to topic, confused/lost, pressure speech, rambling, etc. She also has a UTI being treated w/ antibio's orally obtained while at reg. ICU til transfer to Psych. hops.
So...Needed in addition to meds; CBT counseling, Body Dysmorphic Disorder/anorexia/bulimia/purging food help & a huge need thus for intense therapy/counseling -- as it is causing on & off of meds -- due to her belief of lbs gain on the meds.
On & off non-compliance due to that or feeling depressed thus stops meds cold turkey or 2-3x's the dose as needed or 'prn in her mind'!
SSRI use to blunt appetite or jack up mood to almost manic, etc, etc. Also, a possible Axis 2 personality disorder yet undiagnosed. Cluster of Histrionic, Narcissistic or Borderline even??
You see the messy as heck, & need for a staff of docs, & this total chaotic plight?
ALl this & not to mention the CT brain scan atrophy, need for MRI's, possible dementia or Alzheimer's -- & early onset due to meds or genes or who knows what??
Even Sig Freud would quit this patient I'm afraid. Imagine living a normal life worrying daily of what/if/how something may occur? Not easy folks take it from me.
Any MD/DO Neurologists/Psychiatrists on board I need help -- or Psych nurses or PhD Clinical Psychologists,
I was a med student in 1st yrs over 20yrs ago too myself, but had w/draw after 1 yr-- as couldn't handle her & all this & med school?
No way!
Last edited by movintime; 09-22-2020 at 01:43 PM..
They have an article on the front page which quotes a Yale study claiming the shrinkage is from inflammation. They also have a list of nutrients they recommend and articles like success stories.
Articles on inflammation
-Is your brain on fire - Recommend maintaining sugar, plant flavonoids, and glutathione( 1 , 2 )
-Brain Inflammation
-The best doctor approved supplements - They recommend curcumin, Omega 3s , and butyrate for inflammation. Lack of omegas and b12 also causes brain shrinkage. Be sure to take a full spectrum vitamin E to keep the omegas from oxidizing. 2-4 grams of omega3s is good dosage, I prefer liquid so you know if it is spoiled.
Curcumin is a tricky supplement, there are many formulations and hard to know which one is most effective. Longvida was developed specifically for brain inflammation and has the most research. NOW supplements has version of it called Curcubrain.
There's too much going on in her brain/head that it'd take Neurologists & Psychiatrists & others to eval it. We think Axis 1 is: Bipolar 1. But it could have shades of grey like Schizoaffective, etc. She even thinks she has is Schizophrenia at times, she says to me. I have no clue.
It can present w/ rather bizarre behavior the nurse just told me on tele; like wandering halls/pacing to 'exercise/lose lbs', talking to self, speaking in 3rd person re herself, agitation, irritability, fast manic speech, loose associations, jumping topics to topic, confused/lost, pressure speech, rambling, etc. She also has a UTI being treated w/ antibio's orally obtained while at reg. ICU til transfer to Psych. hops.
So...Needed in addition to meds; CBT counseling, Body Dysmorphic Disorder/anorexia/bulimia/purging food help & a huge need thus for intense therapy/counseling -- as it is causing on & off of meds -- due to her belief of lbs gain on the meds.
On & off non-compliance due to that or feeling depressed thus stops meds cold turkey or 2-3x's the dose as needed or 'prn in her mind'!
SSRI use to blunt appetite or jack up mood to almost manic, etc, etc. Also, a possible Axis 2 personality disorder yet undiagnosed. Cluster of Histrionic, Narcissistic or Borderline even??
You see the messy as heck, & need for a staff of docs, & this total chaotic plight?
ALl this & not to mention the CT brain scan atrophy, need for MRI's, possible dementia or Alzheimer's -- & early onset due to meds or genes or who knows what??
Even Sig Freud would quit this patient I'm afraid. Imagine living a normal life worrying daily of what/if/how something may occur? Not easy folks take it from me.
Any MD/DO Neurologists/Psychiatrists on board I need help -- or Psych nurses or PhD Clinical Psychologists,
I was a med student in 1st yrs over 20yrs ago too myself, but had w/draw after 1 yr-- as couldn't handle her & all this & med school?
No way!
Speaking from personal experience again, there is probably very little you can do for her other than be supportive and care. But at the same time you can do things for yourself, and its very important that you do so. Not to be overly pessimistic (I don't believe in giving up) but its probably best for you to at least acknowledge possibility of a poor outcome and prepare yourself for that mentally and develop a support system and plan for yourself just in case things don't get better for her. It is extremely stressful and you have to think of yourself too. That isn't selfishness, its just self-preservation.
In my case, after doing everything I could think of to support and help my friend (who was married, and not to me) short of outright meddling in her life, I had to put some distance between us to preserve my own mental health because it became clear there was little hope of a good outcome. As it turned out, I wasn't wrong.
I know it is always a risk but nowadays even life in general is a risk. So I guess, 'tough times don't last only tough guys do!', was what I was always told playing hockey & in life in general. Time to buckup & face it head on!
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