[motherofthree]

I have a 10 yr. old daughter who has been diagnosed a Manic Bi-polar over a year ago. She takes Depakote and Zoloft everyday and now she is having paranoia, and hallucinations. She is now taking Abilify. She has lost ALOT of weight since starting her meds and the Abilify seems to aggravate it even more. She has isolated herself and has no friends as "Everybody is talking about me" and she even had CPS called on us because "ROB" (one of the many voices in her head) told her to say horrible disgusting things about us. Thank god they dropped all charges and with her psychiatrists help we have made everyone at school aware of her illness. Is this normal for a Bi-polar child or are we dealing with something even more frightening? We are concerned that she is now starting to listen to the voices and do what they tell her to do. She has never been hospitalized yet and I am wondering when do we hit rock bottom to admit her ourselves. PLEASE!!! any help or advice will be greatly appreciated.

[InACorner]

i have no idea...but i care...good luck, Welcome to PC....im sure alot more of people will write who have more experience...but all i can offer you is a cyber hug and support and nice listening ear...hope thats ok

((((motherofthree)))

perhaps hosipitalization at least just to get her stable might be wise? I mean...it couldnt hurt...it can only keep her safe from putting herslf or someone in danger in this very fragile time...

[Psychotic_Phil]

Psychotic manic depression is not uncommon. What it requires is an anti psychotic like Abilify until the psychosis stops. Unlike schizophrenia or a psychotic disorder the psychosis appears within mood symptoms. If it doesn't and has lasted at least two weeks, then your daughter is schizoaffective and not bipolar. The difference being that schizoaffective is a combination of schizophrenia and bipolar. Of course, there are different forms. Some forms are more like schizophrenia with a mood component, some are bipolar with a strong psychotic component. I would recommend ruling out schizoaffective disorder in the case of your daughter. Psychiatrists once labeled me with bipolar disorder only to find later that I have some form of schizophrenia. I think that you won't have to worry about schizophrenia in your daughter's case however. Like I said, rule out schizoaffective illness. And if the Abilify doesn't work (believe me it doesn't work for A LOT of people, like me for instance) try some other anti psychotic. I'm on Geodon and feel much better than on Abilify or Risperdal. I wish you and your daughter all the best.

[motherofthree]

she has heard "voices" ever since we seeked out help which was over a year ago!!! Can I offer this diagnosis of schizoaffective disorder to her psych. doc without him thinking I am a know it all mom? She is gettting worse as well as the paranoia. Thank you for your info. You are much appreciated.

[Psychotic_Phil]

I would simply suggest to the doctor that she might be schizoaffective, and that it should be ruled out. I don't think you'll look like a know it all. You want what's best for your daughter and therefore she should be diagnosed correctly so as to treat the illness correctly. If she is getting worse, also talk to the doc about switching anti-psychotics. Abilify, like I have said is crap.

[spiritual_emergency]

Hello MotherofThree:

This is what I see going on...

First of all, there's your daughter. Something is going on in her life and we could call it "this" or we could call it "that" but it all adds up to a heavy plate for a 10 year old.

Then, there's you. You have two other children to care for, a home, you may have a marriage you have to tend, possibly a job (or even two), co-workers, bills, probably some aging parents, and on top of that... a ten year old daughter who's not doing well. It's easy to see why you're stressed out.

Now, I'm going to return to your daughter. Just a couple things I noticed...

... She has isolated herself and has no friends as "Everybody is talking about me".

... with her psychiatrists help we have made everyone at school aware of her illness.

I think if I was 10 and everyone at school was aware of my illness, I'd feel like everyone was talking about me too. I'm certain you can identify with this, after all, you're a grown-up and you found it painful and hurtful to consider that other people might be talking about you too. What I'm wondering is, who does your daughter have on her side -- "Rob" perhaps?

It may be helpful for you to know that Between 70 and 90 cent of people who hear voices do so following traumatic events." What I'm also wondering is what was going on in your daughter's life before all this started?

You note that some untrue things have been said. I'm going to assume that they hinted at some form of abuse occurring in the home. No doubt, you love your daughter very much and this is why you found such statements to be hurtful. But that doesn't mean that she might not be feeling abused or even have been abused. Sometimes, the language of those who have been traumatized comes out in a distorted state. Again, this goes back to what may have been going on in her life previous to all this beginning. Environment can make people crazy and that doesn't mean just one's home life but rather, their entire environment -- friends, family, school, etc.

Something else you mentioned was that your daughter was on three different kinds of drugs. You need to educate yourself as to the full range of those drugs because some of them can produce hallucinations and delusions, particularly once you start mixing them up. You also need to understand that very few studies have been done on psychiatric medications and children -- for all intensive purposes, your daughter is a guinea pig for the pharmaceutical industry. There is no means possible of assuring you that these drugs will not have a negative effect upon her developing body, including her brain, because no one really knows.

You also noted that you were hesitant to appear to be a know-it-all mother. Let me remind you that psychiatrists are not gods, they are humans and like all the rest of the humans out there, some of them are very good, some of them are downright horrible, and all of them are fallible. You need to become a know-it-all mother because no one is going to love your kid like you love her -- not even a psychiatrist with a string of letters behind his or her name.

Overall, my suggestions -- which you can take or leave as you see fit -- are...

1.) Educate yourself. It's very tempting to believe that someone else has the answers -- the psychiatrist, the doctor, the pills, the hospital. If someone else has the answers that lets us off the hook for discovering them for ourselves.

2.) Examine your daughter's life, as much as possible from her perspective. Psychosis nearly always contains a triggering incident.

3.) If at all possible, remove her from her school environment where she is very likely exposed to shame and humiliation on a continual daily basis. Options might include home-schooling, enrolling her in a small, private school, or even, just letting her stay home. She's ill and troubled and the school environment might not be helping at this time. If possible, there might even be someone within your extended family who could take her in, if only through the day.

4.) Find her an advocate, someone who can be on her side and understand her life from her perspective. Recognize that you may not be capable of providing this to her even if, as her mother, you feel you should. Recognize also that a relationship with a psychiatrist is also not likely to provide this to her. As a general rule, most psychiatrists in this culture dispense pills. They do not engage in talk therapy. I suggest you get her in to see someone who will talk to and with her -- someone who goes by the label of "psychologist, therapist" or "counsellor".

She has never been hospitalized yet and I am wondering when do we hit rock bottom to admit her ourselves.

And what then? How will your life or hers be any better if you put her into the hospital?

[motherofthree]

You have opened my eyes to alot of things and I am grateful. Everything seems so jumbled all the time. Thank you.

[spiritual_emergency]

You are most welcome MotherofThree. I can appreciate that you must be feeling overwhelmed and frightened by this situation, but I'm also going to assume that what you most want is for your daughter to be well.

I'm also going to pass the name of a doctor to you who might have some additional insights for you. His name is Dr. John Breeding and he has a number of videos on youtube that directly address the matter of hallucinations and psychosis. You will likely find it informative to invest 20-30 minutes in watching them.

In addition, Dr. Breeding also has a website called The Wildest Colts Make the Best Horses. That site was created to address the issue of children and ADHD but you may find a great deal of material there that applies to your daughter's situation as well. I noticed that Dr. Breeding also has an e-mail address listed at that site. It's possible that if you contact him, he might be able to recommend some doctors or other resources in your area that will be beneficial for your daughter.

The following video may also be informative...
<blockquote>
This is a difficult video to watch because the brave individuals who came forward to testify (and agreed to have their testimony recorded on video) lay bare very personal details of their lives that led to them being “bombarded by drugs,” rather than receiving other forms of support and therapy that would have been more appropriate. Particularly egregious examples are the multiple reports of people who were severely medicated as children or teenagers, rather than being rescued from severe physical, emotional, and sexual abuse at home and in school.

If anything, these heart-rending stories remind us of the danger of solutions looking for problems. With today’s growing arsenal of psychotropic medications, marketed heavily by the pharmaceutical industry, it is all too easy and tempting for physicians to turn to masking symptoms or controlling behaviours through chemical interventions, rather than helping an individual with underlying causes of personal turmoil.

Watch the video, and think carefully about the effects of being

</blockquote>

Best of luck to the both of you.

[spiritual_emergency]

Also of note...
<blockquote>
What Does "Off-label" Mean?
Based on clinical experience and medication knowledge, a physician may prescribe to young children a medication that has been approved by the U.S. Food and Drug Administration (FDA) for use in adults or older children. This use of the medication is called "off-label." <font color=red>Most medications prescribed for child mental disorders, including many of the newer medications that are proving helpful, are prescribed off-label because only a few of them have been systematically studied for safety and efficacy in children.</font> Medications that have not undergone such testing are dispensed with the statement that "safety and efficacy have not been established in pediatric patients." The FDA has been urging that products be appropriately studied in children and has offered incentives to drug manufacturers to carry out such testing. The National Institutes of Health and the FDA are examining the issue of medication research in children and are developing new research approaches.

Source: Children & Psychiatric Medications

<center><hr width=100% size=2></center>

A new article in the Archives of General Psychiatry asserts that diagnoses of bipolar disorder in children and teens up to 19 years-old increased 4,000 percent between 1993 and 2003. ...

According to one press account, one of the study authors is even critical of the diagnosis of bipolar disorder in youths. I am, too, since there is very mixed evidence on whether it even exists in kids younger than about 12. This issue was recently taken up by Australia's ABC radio. Here's a transcript.

But whatever one makes of the diagnosis itself, I think the psych researchers who have been pushing this paradigm for unruly children should be ashamed of themselves. That's because the treatment paradigm of mood stabilizers and antipsychotics has barely been studied in children and teens, and has not been studied at all long-term. The injuries that can be caused by these drugs are well known. And to judge by what I glean from places like the bipolar groups on MySpace, it appears that these treatments are not proving to be effective in long-term use. And clinicians and researchers are well aware of this. My own view is that most of these drugs are not acceptable for long-term use except in extreme cases.

You'd think that should argue for some caution in the psych world and maybe some introspection about what it is that is apparently making America's youth (and adults) so much screwier than in 1993. But there's little except for silence on that front, and nothing but bloviating from the defenders of the faith at Harvard. No one is asking why they aren't making anyone well much less making them whole.

Source: Bipolar Diagnosis is Up, Up and Away

[Gemstone]

I think spiritual emergency has made some really good points here. I think you really need to find out what is going on with her.

These medications may be effecting her negatively. When I was a child (at around 12) I was dx'ed with depression and started on antidepressants. I had a negative response to the antidepressant and I became manic and suicidal and I was than dx'ed with bipolar 1 and started on a lot of other meds. Those meds made be groggy and drunk so I was dx'ed with add and given a stimulant to go along with all the sedatives.

In my case I was being severely abused and was very dissociative. I was depressed, but no amount of anti-depressants would have fixed me.

I'm not suggesting at all that your daughter is being abused. I'm just saying something else may be going on here. I would really recomend getting her in to talk therapy in addition to seeing the psychiatrist.

[Gemstone]

And either switching schools or getting her out of school into home schooling is probably a good idea too.

If the other students are aware of her illness I'm sure she is being teased. Children can be very mean to anyone who is even slightly different.

[pachyderm]

</font><blockquote><div id="quote"><font class="small">Quote:</font>
spiritual_emergency said:

3.) If at all possible, remove her from her school environment where she is very likely exposed to shame and humiliation on a continual daily basis. Options might include home-schooling, enrolling her in a small, private school, or even, just letting her stay home. She's ill and troubled and the school environment might not be helping at this time. If possible, there might even be someone within your extended family who could take her in, if only through the day.

</div></font></blockquote><font class="post">

I think spiritual_emergency has offered very fine advice. I would only suggest, if you think you can, to investigate the school situation first, before going to other options. This might include asking your daughter about what is happening there.

[Swedish]

Hi!

I am really sorry your daughter has to go trough such horrible things at such a young age. I have had two psychosisis and I have some input. First of all - if she has paranoia (as I had) she thinks it is real. It is real to her. So she will act like it really happens. So, what would you do if you were really followed, everyone talks about you (in a mean way) and you thought you were going to die? You would avoid everyone, make sure the talking stops (by not saying anything to anyone), not leave your house/room, etc. So her not having any friends and being alone is a complete "normal" reaction (to her). I had very little contact with people when I got paranoid and I think that is a good thing. If you do not want to spend time with anyone, why should you? Also, when you are that sick and hear voices, I had so much input in my brain, my brain went on overdrive and minimizing the input made me fell better, I couldn´t even watch TV or read papers. Also I missunderstood information people gave me - if someone said "I am fat" - I thougth that was code for them saying to me "you are fat", so if I were you I would try to avoid to say anything mean about anyone in her precesence. I am sorry to say there is not a "cure" for psychosis in terms of medication, antipsycothic drugs are just taking away some of the symtoms. So all you can do is to "wait for it to pass". My first psychosis took a couple of weeks, the other one lasted for more than 6 months. I did however trick a lot of people into thinking that I was over it earlier by acting normal. It is really hard for people around the ill person to know when it stops ... Once you are over it you can talk about what happened, how not to make it happen again and what triggered it. In the middle of it it is really hard to know what is true or not (I made up a lot of things wich i thougt was true at the time). So I do not think it is wise to try to bring up any issuses about her being abused or so when she is still in the middle of her psychosis, because there will not really be easy for you to know if she is telling the truth or not. It is however wise to figure out if you have any history of mental illness in yours or your husbands family, some of it is probably genetic (science think). I do have that in my family. Try to give her a quiet and calm surrounding until she snaps out of it. Take her out of school if neccesary (no grown up would work in that condition). And ask her about what the voices in her head says, talking about it makes them less scary and she´ll be less likely to follow stupid advice from them. And tell her you love her a lot. And encourage her to paint or write or do other creative things to express her feelings, sometimes putting words on emotions makes them less intimidating. A lot of people with mental illnesses end up in really creative jobs, thats how I earn my living. Good luck! I really feel for you and your family.

[motherofthree]

I am trying to get her into ,actually the whole family into therapy ASAP. I am trying to keep the stress factor low for her but at the same time how do you function a house hold in utter complete silence? She came home today early from school b/c she had a panic attack over what "Rob" said to her (voice in her head). He told her that he was killing me and her father in our sleep (I work nights and sleep during the day while they are at school). She said she tried to ignore him but he started out as whispering, taunting her and then because she was trying to ignore him he continued to scream at her wile also using cursing language calling out to her. SHe said "He told her these things and when she ignored him he started yelling at me saying, ***** do you hear me? I am killing your %#@&#! mother!!!! I know you love her so." Then he laughes." Her school counselor called me and told me to come get her after she tried to calm her down for over an hour. I picked her up from school and she was a wreck. She was sweating and shivering at the same time. Her eyes were huge and she was very fidgety. As soon as we got her home all she wanted to do was crawl in bed with me and hold her tight while I sang and prayed with her. She cried herself to sleep. Help!! What else can I be doing? I though about pulling her out of school for good but I have not a clue about how to home school nor do I think it would be good for her as I think she would need the social interaction.. She has her good days where she plays with other kids but then she can have really bad days like today. What do I do? At what point am I supposed to inform her doctor of these episodes? Thanks and I appreciate everyones opinion and support in this matter.

[motherofthree]

I am not sure if I have mentioned this but my daughter actually "sees" Rob and recently we have developed another friend. This one is Dianne. My daughter says she is the nice one. She also sees her and my daughter says her and Rob will often argue with each other about how Rob is being mean and what not. Dianne reassures my daughter but my daughter states that Rob must have done something to Dianne because she has not seen her recently. What is this?

[spiritual_emergency]

<blockquote>
A few article excerpts that might provide some insight for you...

<blockquote>

She came home today early from school b/c she had a panic attack over what "Rob" said to her (voice in her head). He told her that he was killing me and her father in our sleep (I work nights and sleep during the day while they are at school). She said she tried to ignore him but he started out as whispering, taunting her and then because she was trying to ignore him he continued to scream at her wile also using cursing language calling out to her. SHe said "He told her these things and when she ignored him he started yelling at me saying, ***** do you hear me? I am killing your %#@&amp;#! mother!!!! I know you love her so." Then he laughes."

<hr width=50% size=2>

Like most multiple-voice hearers, Longden says one voice was dominant. “He was demonic, and had a visual manifestation of a huge grotesque figure swathed in black. His threats were graphic and violent. The other voices, which were less clear, would back him up.”

...

Longden began to recognise her voices as a representation of unconscious feelings of self-loathing. This helped her to fear them less. “If they were metaphorical, it stood to reason they couldn’t have any control in the external world,” she says.

...

The psychiatrist encouraged her to talk back to them. “I began to question them, and their replies gave me great insight into my subconscious feelings - enormously helpful in my therapy - and then I started negotiating with them. Sometimes I’d say to the dominant one, ‘I’ll only talk to you after EastEnders,’ and he’d agree!”

Three years on, Longden is off medication. She says she’s happy, and is studying for a doctorate in clinical psychology. Although her voices sometimes return, she feels in complete control of them. “I see them as useful - almost like a stress barometer. My mum’s clue to feeling stressed is a migraine; mine is the voices.”

Dr Rufus May, a clinical psychologist, says the aim of getting people to connect with their voices is to enable them to incorporate them into their daily lives so they are not distressing. “Voices themselves are not a problem; it’s people’s relationship with them that’s important. So, rather than voices being something that we should avoid at all costs - the traditional psychiatric view - we should be trying to get people to face them, understand them and work with them.”

...

He even talks to his patients’ voices himself. “I ask the person to tell me verbatim what each voice is saying. I’ll ask questions such as, ‘How long have you been in Mary’s life?” and ‘Why did you come along?’ Sometimes, they’ll tell me something about the person they themselves are unaware of. After all, we’re dealing with the subconscious here.”

Source: How I Tamed the Voices in My Head

See also: Redefing Hearing Voices

<hr width=100% size=2>

I am not sure if I have mentioned this but my daughter actually "sees" Rob and recently we have developed another friend. This one is Dianne. My daughter says she is the nice one. She also sees her and my daughter says her and Rob will often argue with each other about how Rob is being mean and what not. Dianne reassures my daughter but my daughter states that Rob must have done something to Dianne because she has not seen her recently. What is this?

Is Schizophrenia 'Split Personality'?

Yes . . . and No! Imagine, if you will, that a 3-levelled house represents the structure of the psyche. The top floor, consisting of various linked rooms, represents consciousness, in all its bustling, interacting complexity. Immediately below is the cellar, which represents the personal unconscious, or dark 'shadow' side of the personality. The lowest level, the basement, is the oldest part of the house and contains dim, godlike and archaic figures, personifications of what Jung called 'archetypes', universally occurring, powerful energies and forms of behaviour and thought, which make up what Jung called the 'collective unconscious', and which often take on mythological, religious, semi-human, divine, animal or natural forms. What we call 'split personality' involves the conscious personality forming split off, distinctly separate personalities, so it's as if the upper floor rooms become completely isolated from each other, their doors all locked.

With a schizophrenic split, or fragmentation, however, it's as if the house's floorboards (foundations of the conscious personality) are split, or shattered as invading archetypal figures from the basement rush up to inhabit, or displace the upstairs (conscious) inhabitants. As Jung notes, whereas the healthy person's ego (conscious self) is the subject of his/her experiences, the schizophrenic person's ego is (therefore) only one of several subjects. The nature of the schizophrenic 'split' (which I've called 'split subjectivity') in other words, arises from the splitting of the archetypes of the collective unconscious into a multitude of figures that invade, or usurp the weaker and far more fragile conscious personality. It's a bit like a swimming pool trying to contain the ocean!

[b]Source: What is Schizophrenia?

[spiritual_emergency]

<blockquote>
I included your quotes and the article excerpts above to give you some possible insight into what may be going on with your daughter. Bear in mind, I'm not a professional, but I am someone who has gone through what would be called psychosis in this culture. Also, please don't let the word "schizophrenia" frighten you -- think of the word as a means of describing forms of psychosis that haven't yet been resolved.

Psychosis can be produced in any number of ways. My own definition (and experience) is that psychosis is produced when one's sense of self-identity (what's sometimes referred to as the ego) is worn down, fragmented or shattered. It's worth noting that one's sense of self identity goes through transitional states of growth where it may already be "a little thin". For example, between the stages of life we call adolescense and adulthood, there is a stage of transitional vulnerability. Stress, trauma, loss -- these are also life experiences that can produce a weakening of the personality structure. Psychosis occurs at the point that the personality structure is weakened to the extent that aspects of the unconscious / subconscious begin to "leak" through.

In many ways, this is comparable to a dream state. For example, if your daughter's experience occurred in her sleep and she woke up frightened, we would call it a nightmare. Because it occurs during the day, when she's wide awake, we call it psychosis. Likewise, if your daughter had had a nightmare, you (or someone else) might talk to her and discover that the nightmare was not a random event but rather was related to life circumstances in her "ordinary" world. So too, psychosis can be related to life circumstances and if these are addressed and resolved, thereby strengthening the personality structure once more, the psychosis resolves itself naturally. That's my experience of psychosis.

I'd like to say more but I've got to get ready for work. Hopefully, others will add the insight of their own experiences to this thread and that will help you develop a clearer idea of what you can do to help your daughter.

[spiritual_emergency]

One more thing, MotherofThree... Here's a link to an article that might provide you with some more specific "professional" insights as to what you can do to help your daughter.
[*] Guidelines for the Treatment of Psychosis: Dr. Loren Mosher

[gardenergirl]

Hi motherofthree,
It sure sounds like you've got a great deal to manage in your family. I hope you're doing your best to take care of yourself, too. Remember what they say on airplanes before take off: you've got to put on your own oxygen first, before helping anyone else. And I'm glad you're working to get the family into therapy. That's an excellent idea.

I looked up Depakote in the drug reference I use on my PDA, Epocrates. Psychosis and hallucinations are listed as possible serious reactions to the medication. Use of this med in pediatric populations requires extra caution. It's possible that the psychotic symptoms could be related to the Depakote, especially if those symptoms didn't start til after that was begun. Also, I'm concerned that someone with a diagnosis of bipolar disorder, particularly a child, is taking Zoloft, an antidepressant. Folks with bipolar are more likely to respond to SSRI's with increased mania than those with unipolar depression. So it's possible that Zoloft if contributing to her symptoms by increasing her mania symptoms. As someone above stated already, I think, psychotic symptoms can come with mania.

I realize this suggestion would mean another task/burden, but you might want to consider getting a second opinion or other consultation about her medications. Or talk to her doc if the doc is receptive about these symptoms, when they started, and if they could be related to the meds. I can understand your concern about appearing to be a "know it all" mom, but again as I think someone above said, these days consumers are becoming more and more educated about health and healthcare. I think doctors are getting used to this, and many appreciate it. If you approach it within the frame that you (and your daughter) and the doc are equal partners in treating her, and show respect for what he brings, I think he or she is likely to show respect for what you bring to the team. And if not, it's another data point to consider when deciding if you want to continue with this doc or not. That framework is a requirement for me when working with docs. If they can't work WITH me versus working AT me, I don't tend to go back to them.

Good luck. I'm glad you reached out here. It's a great place for support and information.

Take care,

gg

[Swedish]

Hearing voices and seeing stuff that is not real does not mean she has scizophrenia. Voices and hallucinations can be very intimidating, maybe giving them names is making them less intimidating (I never named mine)? First I thougth they were real, even to other people. I would hear someone shouting outside the window and i would go there and check who it was. When I realized noone else heard it I started thinking it was dead people trying på communicate with me, some of them nice and some of them mean. Now after the psychosis I have a theory that it was my subconsious talking to me. It is important that she talks about what they are saying and why she thinks they are there. What is her theory? It is important that she realizes that she is sick and that she experiences things that other people cannot see/hear and that it will pass. It is hard to describe what it is like, but it feels like you are waking up in a dream, you do not know that the dream is not real. My shrink says that you can interpret the experiences like you interpret a dream.

[spiritual_emergency]

<blockquote>
gardengirl: I looked up Depakote in the drug reference I use on my PDA, Epocrates. Psychosis and hallucinations are listed as possible serious reactions to the medication. Use of this med in pediatric populations requires extra caution. It's possible that the psychotic symptoms could be related to the Depakote, especially if those symptoms didn't start til after that was begun.

That's terrific that you looked up that info for MotherofThree, and it's good for her to know. I was quite surprised myself to discover that sometimes the drugs that are used to treat psychosis can actually cause psychosis. However, I did want to ask if you could provide a source of the quote. It's possible you already did ("PDA, Epocrates") and I simply didn't understand.

Also, I'm concerned that someone with a diagnosis of bipolar disorder, particularly a child, is taking Zoloft, an antidepressant. Folks with bipolar are more likely to respond to SSRI's with increased mania than those with unipolar depression. So it's possible that Zoloft if contributing to her symptoms by increasing her mania symptoms.

I think what concerns me most is the pattern of escalation and worsening of symptoms that Gemstone shared as part of her experience...

When I was a child (at around 12) I was dx'ed with depression and started on antidepressants. I had a negative response to the antidepressant and I became manic and suicidal and I was than dx'ed with bipolar 1 and started on a lot of other meds. Those meds made be groggy and drunk so I was dx'ed with add and given a stimulant to go along with all the sedatives.

In my case I was being severely abused and was very dissociative. I was depressed, but no amount of anti-depressants would have fixed me.

There is always a human element that too often, gets overlooked in the neurology of theory. I've spent the last few years talking to people who have gone through an episode of psychosis and in every instance there was a triggering factor. Sometimes, it's one that's easily resolved such as recreational drug use; other times it's more complex, such as trauma. What all of these people seem to need is first of all, a place of safety -- they need a safe environment. The second thing they need is to be with people they can feel safe with. Often, this is family members or friends, sometimes it's a professional -- the "rank" doesn't seem to be near as important as the empathic human connection. The third thing they seem to need is to express what they're going through, to "get it out" of their system...

<hr width=100% size=2>

<blockquote><font color=191970>An Interview With Dr. John Weir Perry</a>

<center><font color=red>"...85% of our clients (all diagnosed as severely schizophrenic) at the Diabasis center not only improved, with no medications, but most went on growing after leaving us."</font></center>

O'C: In your book The Far Side of Madness, you describe how at Diabasis - the home for "schizophrenic" individuals which you set up - they could comfortably get into their visionary process in a totally supportive atmosphere. What are the necessary conditions to enable a person to go through the experience of madness and be renewed by it when they come through, as you put it, on the far side?

PERRY: That's a question with many facets! The first one, which we touched on briefly toward the beginning of this conversation, was about the conditions that are set up around such an individual. What we did at Diabasis was specifically to set up what we hoped would be the most ideal, least toxic (smile), least damaging environment for a person in the visionary state.

First off, this means a home. You need a place with friendly, sympathetic individuals who live there. These people have to be companions, have to be willing to listen and not be frightened and not be judgmental about it, and not try to do anything to anybody.

One has to let the visionary process unfold itself spontaneously. Under such conditions, to our surprise, we found that our clients got into a clear space very quickly! We had started out with the notion that we would surely be in for alot of bedlam with all this "madness" going on, but actually the opposite was true! People would come in just as crazy as could be on the first day or two, but they'd settle down very soon into a state of coherency and clarity. Often, when I would come in for a consultation at the end of the week, I would see someone who had been admitted in a completely freaked-out state just a few days before, sitting at the dinner-table indistinguishable from anybody else; sometimes I couldn't tell if this was a new member of the staff, or one of our clients. The calming effect of a supportive environment is truly amazing!

It's a well-known fact that people can and do clear up in a benign setting. Actually, they can come down very quickly. But if some of our cases had gone to the mental hospital, they would have been given a very dire message: "You've had a mental breakdown. You're sick. You're into this for decades, maybe for the rest of your life!" and told "You need this medication to keep it all together." I am quite certain that if some of our clients had been sent to the mental hospital, they would have had a long, long fight with it. The outcome of their stay at Diabasis, however, was that their life after the episode was substantially more satisfying and fulfilling to them than it had been before!

O'C: Would the determining factor then be the person's realisation that she is in a non-ordinary state of consciousness - i.e. a state which, although very different from that of the people around her, is in fact completely natural and good - and that the hallucinatory imagery carries a symbolic meaning, which pertains primarily to the inner reality, rather than to the outside world?

PERRY: You said it! The tendency, as you suggest, is to concretise all the symbolic stuff and believe there are enemies out there, and that the walls are wired, that there are people with guns at the window, and subversive political parties trying to do things, or that one is being watched because one is the head of some organisation and everybody knows it. All of that is a mistaken, "concretistic" tendency to take too literally things whose correct meaning is actually symbolic.

So yes, the therapeutic goal is to achieve that attitude which perceives the symbolic nature of the ideation which belongs to the inner reality. Now the inner reality is real! It's very important to grant it that reality, but not to get the two realities mixed up. That's the trick! Actually, for most people it's surprisingly easy. Certainly, the more paranoid a person is, the more difficult. There is a certain paranoid makeup, a style of personality which tends to focus on the objective world around. It's what we call an attention style. It is difficult for such people to see the inner meaning of their visions. On the other hand, the average person tends to go along with the inner journey and to realise - well, they do need to be reminded - but once they're reminded, they tend to quickly perceive that it is a spiritual test, or a symbolic test, and not the actual end of the actual world.

The second condition needed for a successful outcome of the "schizophrenic episode" is not just a benign surround, but also some people who can relate to the visionary process in a sympathetic way. I believe very strongly that it's not just enough to have a benign community around such a person: the thing that really makes the process move and reach its conclusion, is an intense relationship with one or two people. Sometimes with a man and a woman, who may play a symbolic role like two parents, or like the opposites, which can be taken care of in this way.

Bringing the whole supercharged process into a relationship seems to make it bearable, containable, manageable. Of course, some people go through it alone. They tell me this is highly painful, very frightening. But if one has a therapist or counsellor to whom one can relate the experience, one need not suffer a whole lot once the process gets underway. There will always be some tough moments, nightmarish times, bewilderment. One wonders what the dangers are, whether there are evil forces out there. But through these weeks, somehow, the prevailing mood is actually one of buoyancy. At Diabasis, there was a general atmosphere of jocularity. People would be joking around, having fun, playing music and dancing and humming tunes and painting...

O'C: Yes, in fact wasn't that part of the design? You had all sorts of ways for people to communicate their experience and externalise in through various forms of art?

PERRY: The whole environment was organised into various "spaces." One of these - a very important one - was called the rage room. This was sound-proofed and padded, for the individual's own protection, and we put things in there that they could whack to pieces like old cottons and mattresses. But the door was not locked, it was not like the padded cell in the mental hospital, where the person is isolated against his will... We set it up so that if a client was having strong feelings of rage, he or she could share it with a staff member, particularly the counsellor or primary therapist, and thus deliver it. This was found meaningful. The anger is a very important part of the growth of the ego, you see.

We also had the opposite: a room for quietness and meditation. This was equally important, for integrative purposes. We had an art room, but I must say, people didn't seem to spend much time there (chuckle). These so-called "sensitive personalities" were all hanging around the dining room table, doing water-colours or modelling in clay, and giving creative expression to some of the imagery inside their head. We also had a sand tray and figurines for sandplay therapy. It works like a dream: you set up a dramatic scene, move the figurines, tell a story. This avenue of expression is easier than painting. It's very dreamlike, so it hits the visionary state very well. We also had poetry...

Another thing we provided was a variety of body movement sessions, dance and martial arts, with skilled facilitators. And finally, we had interviews at least three of four times a week, for an hour and a half to two hours each, with the primary counsellor/therapist. But really all of these creative outlets put together became part of the interview itself - verbal expression combined with image expression in these various media.

Now throughout all this there was nothing scheduled, nothing mandatory. It was all informal. We'd just respond to things as they came up. Our only house rule really was "No violence to property or persons!" The clients could dash out nude into the street if they had to; we didn't like it, but they did! You see, we wanted them to be in this house of their own free will. They had to realise their own desire to belong in the house, and they did.

So this whole approach is essentially one of releasing, rather than suppression. We allowed everything and encouraged its expression - not toward chaos, but toward communication! Communication tends to order. This is a most important point in psychiatry, but the common opinion is that it is very dangerous... When you actually do it, however, you find exactly the opposite is true: people get over their preoccupations very quickly. The whole point here is to deliver the visionary content to somebody and to be able to appreciate its symbolic relevance to the inner process of personal and social renewal. Once it's delivered, the process keeps moving by itself. It's really unfortunate there is so much misunderstanding about it all. The truth is really very simple.

Source: An Interview With John Weir Perry

See also: Mental Breakdown as Healing

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[gardenergirl]

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spiritual_emergency said:
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gardengirl: I looked up Depakote in the drug reference I use on my PDA, Epocrates. Psychosis and hallucinations are listed as possible serious reactions to the medication. Use of this med in pediatric populations requires extra caution. It's possible that the psychotic symptoms could be related to the Depakote, especially if those symptoms didn't start til after that was begun.

That's terrific that you looked up that info for MotherofThree, and it's good for her to know. I was quite surprised myself to discover that sometimes the drugs that are used to treat psychosis can actually cause psychosis. However, I did want to ask if you could provide a source of the quote. It's possible you already did ("PDA, Epocrates") and I simply didn't understand.

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I use the software "Epocrates", a drug reference database, on my pda. http://www.epocrates.com/ It's very handy, is cross-validated via multiple sources, and is updated at least daily.

gg

[spiritual_emergency]

<blockquote>
gardenergirl: I use the software "Epocrates", a drug reference database, on my pda. http://www.epocrates.com/ It's very handy, is cross-validated via multiple sources, and is updated at least daily.

Whoa, that is a handy little tool! Medication wasn't part of my experience so I have very little background in that area. Many others I've spoken with however, have identified medication as being personally helpful to them. I'm all for people making use of the tools they find personally beneficial but I'm also very much in favor of informed consent and when it comes to medications, side effects, interactions and the like, a tool like Epocrates can be very helpful. I think a link deserves to be added to the recommended links section. Thank you for sharing it in this space.

[Swedish]

Hmm, I am also concerned by the facts that the child is taking antidrepressants. Does she have a psychosis and a depression at the same time? That is (i think) unusual. I had a psychosis and after that I had a depression. When i was in my psychosis I wasn´t really depressed. Especially people who have borderline and have manic phases that turns into psychosis are not supposed to take antidrepessants. Maybe it is correct for her to do so? When i was depressed I could hardly get out of bed and didn´t eat anything. She seems to go to school and so on, but maybe it is different degrees on depression ...

I would definately get your daughter in therapy.. not just giving her drugs.