[lokiez]

I am working with someone who is having mania episode as she went off medication.
Now it has been a month and half since starting medication but mania is not really coming down.

So i wanted to check if medication is not working or stronger dosage might be required.

I feel that after medication started mania is not getting worse but behaviours picked up in manic episode are not really stopping. Is this normal or some counselling will needed to stop those behaviours.

Who are you to this manic person? Shouldn't the psychiatrist be consulted?

If the person's current medication(s) isn't/aren't working, then I'd think higher doses or additions or changes to the medication(s) should be made. This should be up to the person's psychiatrist. The last resort, in some cases, could be ECT. I think in the case of severe mania, therapy has only very limited benefits. That's just my personal opinion as a patient whose been manic several times. I'm not a doctor or therapist. They should be consulted on this.

Quitting meds is not a good idea. I think that for many people with bipolar disorder that it is easier to control mania when medications are already in place rather than none at the start. Some bipolar medications require time and dosage/cocktail experiments to work.

[xxenigmaxx]

She's on the wrong meds then. Meds work within a week. It doesn't take 2 to 3 months for meds to start working like it's usually said here. Have her psychiatrist start a new med.

[lokiez]

Medication was given by Psychiatrist itself. So she was on medication and doing well for almost 2 years before she went off medication.
Now at the peak of manic phase, we managed to start same medication again but the mania phase is still on after a month.

So wanted to know about other people's experience i.e. If manic phase has triggered then higher dosage is needed to control probably ?

Who is "we"? Are you just a family member or friend? If so, I strongly recommend that you NOT play doctor! Even with medications prescribed by a doctor in the past. If you are a doctor, it would seem totally ridiculous and the sign of a quack that you'd be asking these questions to bipolar disorder forum members. A doctor (preferably a psychiatrist) should be consulted. If you care about this manic person, get them proper help. Maybe take them to the hospital ER.

[tecomsin]

Sometimes persistent mania can mean the dosage should be increased, and sometimes it means another medication should be added or used to replace her current med. It is not unusual for dosages of medications to change over the course of bipolar illness.

What med(s) and dosages is she on?

[Wander]

Can she get into a pdoc ASAP? Or present at emergency? Professional action is needed. We are all different so no one here can really give you an answer pertinent to her situation.

[Travelinglady]

Yes, if it's the right meds at the right levels.

[sophiebunny]

The only way to treat mania is with medication. You seem genuinely caring and concerned for this person. You should encourage her to contact her psychiatrist ASAP and let him evaluate dose adjustments. You can help by continuing to support her and her treatment. She's blessed to have someone who cares about her, not everyone does.

[luvyrself]

She might have to be hospitalized under the psychiatrists care.

[fern46]

Your friend might consider hospitalization to break the cycle. The meds can be adjusted there under consistent care which might be needed at this point. If that seems extreme, many hospitals provide intensive outpatient programs that allow patients to receive care during the day and then go home at night.

I hope your friend is doing OK. As a friend, I would encourage you to help her seek the help she needs. Have hope that things will get better once she gets help, the right meds and dosages.

[lokiez]

Thanks all for Inputs.
One of the major challenges have been medication compliance. Now that she is taking medicine, tweaking and changing is tricky.
I don't think she will be ready for hospitalization and i don't think i can force unless it's a threat to life.

I am working with Psychiatrist, so let's see how it goes.

[luvyrself]

Originally Posted by lokiez

I am working with someone who is having mania episode as she went off medication.
Now it has been a month and half since starting medication but mania is not really coming down.

So i wanted to check if medication is not working or stronger dosage might be required.

I feel that after medication started mania is not getting worse but behaviours picked up in manic episode are not really stopping. Is this normal or some counselling will needed to stop those behaviours.

—-could you please tell us what type of environment your workplace is and whether you have any senior staff to carry some of the burden?

[lokiez]

My workplace can be quite hectic at times but they do support me when i need. I am trying to keep a balance.
It my mother and me who support her.
Here in India, i am not finding lots of resources to get support but i am exploring.

[luvyrself]

Who is the person with mania? A family member? Are you talking about being a caregiver in your home? How old is the person with the mania? How old are you? I think w need a better picture of the whole situation.

[lokiez]

Yes its a 32 year old family member and i am 40.
I am taking care of her along with my mother at home.

I am basically looking to create a setup which manageable and sustainable. Have been working with Psychiatrist and several Psychologists.

She is a difficult person to counsel , so counselling part effectively comes to me.

[~Christina]

Meds can only do so much. Self care and the “ want” to find stability must be part of her felling more stable. Or it likely to fail.

[lokiez]

I agree Christina and that is the journey. Once person starts taking care of themselves then job is done.
One of the reason i feel people go off medication is that they feel its the circumstances or the other people who are causing the pain rather than any illness.

[luvyrself]

Loki, I thik you would get better advice more on target if you put a little paragraph on your computer fully describing the situation that you can cut and paste into a thread here, or else put it into your signature. To give proper ideas, we need :Your familiy’s ages and that you are the caregiver yet working, the diagnoses of each,what measures and help you are receiving,and what you are currently doing for the problem in the thread.
HUGs, your buddy in Phoenix
I think most of us should do this when we are asking for help because the situation would alter our responses and make them faster and more on target.