[wonderbread]

Hi,

I'm a frustrated caretaker and trying to help a person all I can.
Does anyone know much about distinguishing overlapping disorders... or are they ever clear cut? I am caring for one who is displaying a lot of BPD symptoms, both manic/and or depressive, and yet has been having aural hallucinations and is extremely paranoid and delusional. This person also has shown extreme anti-social tendencies since late teens.

Other recent odd things to note, the person mentioned seeing a visual hallucination this morning (purple hue over everything) and is at times holding a hand erect/to the side in a strange posture, sometime for minutes at a time. Anger/irritably is prevalent, and mood swings are the order of the day. Eyes are usually darting around, or off to one side, anywhere but on the person being spoken to. I've noticed the eyes to be fixed and glassy before a mood change. Also, anti-social tendencies are still alive and well (person is almost 50 years old now), but this may swing to religious preoccupation the next moment.

Next Psych visit is tomorrow, I'm doing the best I can to note everything I can, they have this person on Lithium/Zyprexa/ & Xanax, but something is seriously wrong. Any thoughts?

Thanks

Wonderbread

[Perna]

I don't think distinguishing overlapping disorders would be very helpful to you? I'd look for "degrees" in behavior and try to note everything between med changes/visits to the psychiatrist? Maybe make up some sort of chart of behaviors and give them a marking each day so you can see what is "worse" and what improves, based on different medicines or food or activities, etc.

[wonderbread]

I see, I am new to this altogether. I thought that is the diagnosis were crystal clear, then the medications could be perfected, and the person could get some relief.

I just was told during the first inpatient stay that they would be most likely returning a few more times before they were "better". I imagined a hospitalization to be like a surgery, they would be weak and not themselves for a while, then as good as new afterwards.

I've been reading abnormal psychology books, since the physicians seem to differ on what is the problem. I just wish I knew how to help. I did find a suggestion, like yours, to make a journal of sorts on the schizophrenia.com page.

Other than this, I only knew to make a family history from three different sources to show the extent of mental illness in the family. I also accompanied them to the psychiatrist and raised the issue of psychosis being a problem. When the psychiatrist asked the person I'm caring for about it, all was denied. I was then asked for details, and I casually mentioned that there was a belief that Amalek had invaded the government and healthcare system. The Psychiatrist then asked them what this individual thought of this... the answer? "Amalek needs to be destroyed!"

So a lithium check has been ordered, and a higher dose is pending, Zanax will be changed to Clnopin pending test results, and the Zyprexa has been cut in half and a more effective Anti psychotic will be used pending test results. I don't know what else to do at the moment, as I have to wait for the test and it's outpatient Friday.

Meanwhile, this individual refuses hygeine, sleeps 2/3 of life or more away, eats compulsively, makes irrational decisions, stays confused/dazed starts 10-15 new project in whatever few waking hours are left. Stealing property, lying, angry, irritable, explosive outbursts, sad moping spells... Every time I think all has been covered someone adds to it or I observe more. Cooperation is in very short supply. The only light is an outpatient day program is in the works, this may help in all aspects.

Thanks for your response

Wonderbread

[Perna]

Mental health isn't at all like physical, no way to get inside someone's head. A lot of it is trial and error as you're seeing with the different meds, and even then they may give some help but not complete and/or the "cost" (lots of medicines for small amount of benefits) can be high and one never knows if the side effects of the medicines (excessive sleeping, for example) are causing problems or if it's the "original" problem the person has.

The biggest help you can give is to take care of yourself well. I'm glad there will be a day treatment program. But if you get overwhelmed or depressed, etc. it's harder to be of help to someone else. I does sound like "Amalek needs to be destroyed!" :-)