Tool kit for treating mental illness.
October 8, 2013 7:30 PM   Subscribe

You are familiar with what things are effective in treating someone who is bipolar, paranoid, and/or schizophrenic. Please tell me about these things. If the person is willing to accept help, what type of help are they likely to receive? If medications help, what is the nature of the medications and where could one go to learn more about them? If there are behavioral options, where can one begin to learn about these? What else is out there?

A family member needs help. It would nice to be as informed as possible about different options for help. I'd hate to be in the position of hearing from a, say, doctor something like "The only option here is _____" if there are actually other options that could be considered, too. I apologize for the question's vagueness, but I'm just looking to establish a toehold here. Coming away with a list of different possibilities would move the ball from where I am now. Thank you, MeFites.
posted by sock me amadeus to Health & Fitness (15 answers total) 3 users marked this as a favorite
 
When my son was diagnosed a few months ago, after a psychotic episode, the National Alliance on Mental Illness helped me figure out what was out there, through support groups, seminars, and courses. I highly recommend checking out your state's NAMI affiliate.

If the person doesn't want to accept treatment or simply doesn't believe they are ill at all, I have been recommended this book numerous times: I am Not Sick I Don't Need Help! by Xavier Amador.
posted by not_on_display at 7:37 PM on October 8, 2013 [11 favorites]


Wow! You've asked a huge question. NAMI is probably your best resource . It's unlikely any doctor will say that there is only one option.
posted by dchrssyr at 7:43 PM on October 8, 2013 [1 favorite]


You need to know that medicines are not one size fits all, and that sometimes it takes time and patience to hit on the right med "cocktail" to help your loved one.

You also need to know that your loved one needs support and needs to know that you see THEM and not just their illness.
posted by St. Alia of the Bunnies at 7:49 PM on October 8, 2013 [2 favorites]


Thirding the recommendation for NAMI.
posted by desjardins at 7:50 PM on October 8, 2013 [1 favorite]


I agree that this question is way too broad.

I want to caution you against relying too much on the internet or ancedotal accounts because not only do they vary widely, but people who are still "in it," for whom treatment isn't working, who are having bad side effects, and all the bad stuff tend to WAY outnumber the others, and it can be really discouraging if all you see is negativity.

I also want to say that, mileages vary, but if your family member is seeing a doctor who can only give you one single option, it is likely the wrong doctor for your family member.
posted by sm1tten at 7:56 PM on October 8, 2013


NAMI all the way. Lots of good info on treatments, resources and local support.

There are typically many different treatment options. Most of the options are going to take time, though.
posted by fluffy battle kitten at 8:01 PM on October 8, 2013 [1 favorite]


NAMI is a great place to start learning more. Generally, your relative should expect to work closely with a psychiatrist to develop a treatment plan that will involved medications as well as other additional treatments (therapy, support group, exercise/nutrition are all options). Every person is different and working through the process of finding the ideal cocktail of medications can take time. Initial side effects or frustrations should not cause either your relative and/or caregivers to lose hope in the process.

If diagnoses you list are correct, this is a situation where medication is a must. Additional treatments beyond medication can also be employed in addition based on your relative's specific needs. That may sound like, "Your only option is medication" but in a case of person diagnosed with bipolar disorder with paranoid features, and/or schizophrenia, that's the best treatment available.

It's critical that after being on the correct cocktail of medications, your relative doesn't stop taking them once they start feeling better.

Good luck.
posted by quince at 8:21 PM on October 8, 2013


quince said "It's critical that after being on the correct cocktail of medications, your relative doesn't stop taking them once they start feeling better"

THIS IS VITAL. Mental illness can be fatal. Two people close to me have died at their own hands after stopping taking their anti-psychotic medication. Medication doesn't necessarily make one feel better, it can also make one feel weird, so although there is an improvement in symptoms and behavior the sick person can still feel awful and want to stop their meds.
posted by anadem at 8:40 PM on October 8, 2013 [1 favorite]


I have found help guide to be a source of good and balanced mental health information
posted by outdoorslady at 8:55 PM on October 8, 2013 [1 favorite]


If medications help, what is the nature of the medications and where could one go to learn more about them?

I personally know of nothing that helps these conditions that isn't medication. And for the dirt on the medications: Crazy Meds.
posted by DarlingBri at 9:14 PM on October 8, 2013 [2 favorites]


Seconding Crazy Meds. That site is an absolute treasure trove of information. The guy who runs it is sarcastic smartass with this, like, aggressively unprofessional tone. But he is smart and obsessively interested in this stuff, and has compiled a whole fuckton of really useful facts (from reliable sources: published studies, official drug guides, etc) on the big name psych meds. Definitely the place to look if you want to know what to expect from a particular drug.
posted by Now there are two. There are two _______. at 9:55 PM on October 8, 2013 [3 favorites]


Seconding Xavier Amador's work.
posted by Sidhedevil at 10:13 PM on October 8, 2013


nthing NAMI and crazymeds. Also, my husband found this book to be helpful (I'm the one with bipolar).
posted by patheral at 10:17 PM on October 8, 2013


I'm sorry you are facing this.

NAMI can function as a source of support for family of persons experiencing psychiatric difficulties, but you must not simply believe that they are a reliable source of information about the phenomenon, or that, on the whole, the enterprise they represent furthers mental health.

NAMI is an organization that accepts and promotes the bio-medical model of insanity. This is not the only model, and it is probably the wrong model. It can be especially not useful for people who become psychiatric patients, both because it provides a frame of reference that can stand in the way of insight into their situation -- you have an illness, we have a medicine -- and because it leads to generic forms of treatment that can themselves be harmful, counterproductive or debilitating.

It would be comforting to think of psychiatrists as doctors like any other whose practices are supported by relatively sound knowledge. But they are not. Here is a nice review in the New Yorker of the question of the scientific status of psychiatric lore, and of the categories they use for 'diagnosis'.

According to NAMI, dissemination of the medical model results in the reduction of stigma surrounding psychiatric problems. But research appears to show the opposite; attribution of psychiatric difficulties to underlying bio-chemical causes increases the stigma. A study in the British Journal of Psychiatry on this effect is summerized in this blog post.

For a suggestion of what alternative and in a lot of ways more useful models of what is happening in a serious psychiatric episode might be, try this article's discussion of transformative psychosis or this one on spiritual emergency. They may set off all sorts of skeptical bells, but what they describe is likely closer to the truth than any narrative you'll probably hear from a run-of-the-mill psychiatrist.

(I write 'likely' because you haven't given any information about what is happening with your family member.)

If the problem does include a component of spiritual crisis, some sort of spiritual practice may be part of the solution; even if that might not be within your family's cultural horizon.

The most important thing now may be just that your family member is safe. The very powerful tranquilizers that medical model psychiatry offers can be effective for this. But long term use of them has grave physical, social and psychological consequences. (They cause diabetes, for one, and, because they are tranquilizers, impair the spontaneity that's crucial for interpersonal communication.)

Ultimately whatever is going on is something that your family member will really have to figure out for themselves. They must learn to become the moral agent here. And for this, talk therapy with a good and non-doctrinaire psychologist can be very, very helpful. If there does turn out to be any sort of medication involved in the long term, a non-doctrinaire M.D. psychiatrist is of course also important; especially one who is open to patient-driven treatment.

Good luck. And be wary. Personal creativity will probably serve you and your family member better than simply accepting the assessment of the health-care professionals.
posted by bertran at 1:43 AM on October 9, 2013 [6 favorites]


What is likely?
They are likely to first receive help in an emergency room followed by a 14 day commitment to a psych ward. They are started on medications and told they have a disease that will never go away. Then they go home and their family worries all the time that they will quit taking their medications. They have another episode and refuse treatment. They may stabilize or improve or get worse.
These are people who need a whole team of people in their lifes- social workers who can connect them with services, people to manage finances, peer support groups and recreational outlets, spiritual help, housing and job resources, meds and talk therapy. Good for you for trying to get as much information as possible. The reality is that so much of their treatment will depend on what the local resources are. Is there an early intervention in psychosis program? Are there peer advocacy groups? And the rest depends on finances / insurance. Get very familiar with the world of managed mental health care and state mental health laws.
And I hope I don't sound too pessimistic. I have a loved one with schizophrenia living in senior housing and a loved one with bipolar who is an accomplished professional with a new wife. There is so much to know and no easy answers.
posted by SyraCarol at 3:56 AM on October 9, 2013 [1 favorite]


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