Tuesday, March 27, 2018

How to Help Someone who is Acutely Suicidal

Recently, I have a family friend who is experiencing an acute mania/depression. Helping his family go through it has given me an update about how the system works  (in Ontario Canada) and how to effectively help someone who is acutely mentally ill (which applies to all people in general). 
So it started a month ago when his mom told us that he had been acting strange lately for 3 months, symptoms of mania for sure. His mom thought that he would eventually snap out of it and get better on his own. It took a while to convince her that he must receive medical intervention. Then, he started to wander on the street for most of the day, she did not know where he had been to or what he was doing. Finally, she asked us to take him to the hospital. That’s when I saw him for the first time since he became ill. Honestly he didn’t look sick, except I could tell he was no longer the soft-spoken and nice guy that he was. His mom said that he had become a different person, really angry and verbally aggressive, which definitely gave me that kind of impression.
But he refused to go to the hospital. So we called 911 on him. When the paramedics showed up he was furious and started to argue with them, some of the stuff he said was nonsense and delusional. He created a scene for sure. The paramedic told me that they had no authority to forcefully take him against his will, only the police officers could. So eventually two cops showed up, he did not resist at all this time. He went on the ambulance with the company of one of the cops.
After arriving at the emergency room, we were waiting for his turn for almost 1.5 hours.The cops were with us until he was admitted into the emergency unit. Cops came out and asked us what we think his illness is, they were not at the scene earlier, apparently they could not tell if there was anything wrong with him except he was talking in a fast speed. I think he was masking his illness in order to “escape” from the hospital. We told the cops about his strange and ill behaviours. The cops warned us by saying that he might be sent home tonight. “We have seen people who look sicker than him, and they got  sent home. There was a guy here couple months ago, his wife took him to the hospital, they did not keep him but sent him home, he jumped off the building on that night. The ones who get to stay usually look very ill, they don’t take care of their hygienes, they look like homeless people or people who are reduced to skins and bones. Unfortunately, that is how the system works, we cannot hold someone against their will, unless you go to those law divisions that process traffic violations and ask the judge to sign what’s called Form 1, you can also get that form signed by his family doctor. With this form, it gives others the authority to hospitalize him by indicating that he is not mentally capable of making decisions on his own. That way, he will be kept in the hospital for up to 72 hours. After that, an assessment will be made to decide if he should be kept for a bit longer (up to two weeks, then reassess to decide if longer)“. “ Where can we get this form at this time of the day?” We asked, it was 10pm on a Saturday night. “Unfortunately, he might have to go home tonight and you will have to come back tomorrow with the signed form. He might go home, he might, I don’t know, it depends on the doctor’s decision tonight.” There is no way that we gonna let him go home on that night, especially after hearing what happened to that poor husband and wife. After more pleads, the cops winked and said: “ you gotta tell them how severe he is. And maybe more severe than he actually is.” The cops left after that. We were lucky that the paramedics and the police officers were very patient, compassionate and helpful.
Another 45 minutes went by, a nurse came to speak to us after speaking to my friend. She asked his mom about what happened and what kinda behaviours and symptoms he had lately. Did we exaggerate the situation? Maybe, but honestly after my own struggle with mental illness, I know that a sick person’s outward behaviour only reflects a small part of what they actually have in mind, their minds are probably 10 times darker than their acts. Therefore, we were probably right on about the severity of his problems. We told the same story to the psychiatrist who came 20 minutes later. It helped when I told them how my suicide attempt put me in a wheelchair and how I wish I was locked away at the time. Thank God he was kept in the emergency room that night and for the next few days. 
For the next three days, he was staying in the emergency department, having a bed but only separated from others by a curtain. He was not medicated yet, the doctor was trying to confirm what he had and finally came to the conclusion that he was having a manic episode. I learned from the doctor that he had his first episode three years ago when he was at another city. His medical record helped confirm the diagnosis, which is bipolar disorder. His first episode was effectively treated after almost two months in the hospital, but he did not keep on taking his medications, because of severe side effects, though he had been doing well for the last 1.5 years, being off medications was like a ticking bomb, another episode would inevitable occur.
When a bed was free up on the mental health ward, he was then transferred there and he has been staying there for almost 3 weeks, he is responding well to the medication, which is a similar kind of antipsychotic medication that he took before, but it’s reported of having less side effects. His old self is resurfacing. He is about to be discharged. 
There are couple important things to keep in mind when attempting to help a loved one who is suicidal 
1.    Call 911! The chance of a person staying in the hospital is higher if they are brought in by the paramedics and the police. 
2.    When someone who is sent home right away after being seen by the doctor, it would actually facilitate their determination to commit suicide because they have now lost all hopes that anyone is able to help them, they have lost faith that their condition is treatable. When describing their behaviours, make it sound worse than you have witnessed, chances are there are many troublesome symptoms that you are not aware of. You might not know just exactly how bad they want to die. 
3.    Keep them in the hospital for as long as they are allowed. Ideally, if someone is on medications and takes them consistently, they don’t necessarily have to be hospitalized. But for any types of psychotropic medications, it takes at least 2 or 3 weeks to kick in. During that period, staying in a hospital is the only way to keep them safe. When a person is mentally ill, they usually don’t sleep at night, therefore it’s impossible for family members to watch them 24/7.
4.    Taking medications in most cases is a lifelong commitment. The medication that my friend took during his first episode was very effective during his acute state. However, when he were at the maintenance stage, he should switch to a different medication and he should have a long-term psychiatrist to help him figure out the right meds and the right dosage. Not having anyone to follow up with him regularly was a mistake.
5.    Having a mentally ill person in the family is extremely tiresome, therefore patience and unconditional love is really needed. Most importantly, being educated about their condition and monitor them to make sure that they stay on medications. It’s definitely treatable. 
To learn more about my journey and insights, read a free PDF of my story at http://xianancy.blogspot.ca
 

Monday, October 24, 2016

The Way We Think

Some people have a positive outlook in life, always hopeful and free of worries. Some people are always negative, seeing the worse in every situation. We might think it's because they are who they are, it has to do with this person's personality, character, or the experience they have gone through. It's true, maybe. But the chemical makeups in our brain can also affect the way we think, the perspectives we take, and whether or not we see a glass as half-full or half-empty. In other words, we may or may not have control over how we think.

Have you met such person, or are you that person? When you fly somewhere, you always fear that the plane is gonna crash. Or when your loved one is ridiculously late, you think that they must be in some kind of accident. If the reason or the outcome is unknown, you always think about the negative, you can't help it, you just cannot help it. That is all that you think about in your head.

I used to be like that, for the first 22 years of my life. Even when I was a child, I was lacking the naiveness of people my age. I would be so worry-sick whenever my parents had to go on a business trip. As I got older, things just got much worse. I would even lose sleep at night thinking about all the scenarios that would go wrong. I had heard all kinds of inspirational quotes, but I was incapable of thinking that way.

After being on the right medication and eventually figured out the right amount (after 2 years), I have since become a really positive person. Being optimistic is a default, it's effortless. My personality has also changed. I cannot even relate to the person that I used to be. A friend from high school reunited with me recently and she could tell the changes by just looking at "my expressions". Another thing I find it interesting is the fact that I used to LOVE to watch horror films. But now, it would haunt me for days. It's the only type of movie that I would not watch.

On the other hand, my mom said that she used to be a fearless and sassy young lady. She would walk ahead of my dad when they were venturing into an unknown territory. But after menopause, and after her health has declined because of aging, she has become an introvert, not knowing what to say in a social gathering and mildly pessimistic in almost everything. Only the fact can change her previous feeling and perspective toward uncertainties.


How to Improve Mental Health

A lot of people have tried medications, but the side effects have discouraged them from continually taking them. For others, they have "bad days" and "good days", perhaps their condition is not that severe that they probably can still function without medications. In these two cases, the only alternative "treatment" to improve their mental health is to improve their overall physical health.

When a person is already aware of the fact that they have a mental health condition, it's important to avoid drinking, smoking and taking any substances that would alter the chemical makeups in their brain. For me, I can't and I don't even drink regular coffee. It would make the quality of my sleep poorer and shallower. Often times, when a person is depressed, they tend to abuse alcohol or other substances as a coping mechanism. Unfortunately, it would only worsen their condition.

It's so trite to say, "we should drink 8 glasses of water each day, eat a lot of veggies and fruits, stop eating junk food, exercise regularly, have at least 6 to 8 hours of sleep each day, have a healthy lifestyle, etc. etc. " The truth is, they really are the keys to maintain and improve a person's mental health in a way that most people are not consciously aware of. The positive changes are slow and gradual, but once our physical body is clear of all the toxic substances and is well nourished, we will feel much better mentally. On the other hand, it takes extra amount of effect and energy for a depressed person to start making positive changes. It's easy to get pulled down but hard to bounce back. The effects are not immediate and it can be discouraging, but you gotta persist and not give up. It's worth the strive.

Friday, March 25, 2016

Mental Illness and Substance Abuse

Mental illness can be triggered and worsened by taking recreational drugs, especially if you already have a genetic predisposition that you might not know of. I heard a story of a teenage boy who used to be a happy and popular high school student. He went to a party and took two pills he didn’t even know what it was. He became psychotic for the next few days. People told him to drink a lot of water in the hope that the drug would just pee out of his system. Unfortunately, after the psychosis had subsided, he fell into a depression and eventually committed suicide. Therefore, really be careful with the choices you make in life. Drugs and alcohol abuse can also worsen a mental illness. Think about it, they can mess up a healthy person’s brain; imagine the damage it could make on a mentally unhealthy person. In addition, they can also offset the effects of psychotropic medications. Therefore, if you want to recover from a mental illness, get sober first!

Tuesday, March 22, 2016

Questions from You

Do you have to be on medications for the rest of your life?

The short answer is Yes. I always make sure I pack my medications in two different suitcases when I travel. If I skip a dosage, I would probably know right away as the pace of my thoughts will pick up at night and I am unable to fall asleep. Without a night of sleep, my heart will beat faster and I am a little bit more emotional and neurotic the next day. But as soon as I take my medications, all will go back to normal and I am myself again.

I have developed a dependency on my medications, perhaps you can compare that to an addict who cannot live without their drugs. However, I would define mine as healthy and normal. Just like someone who is born with type I diabetes, they need to rely on Insulin for the rest of their life. Having a bipolar disorder is innate and I need to rely on something extra to keep me balanced and functional. But unlike someone who has diabetes, they have to watch what they eat and change their lifestyle accordingly, when I stay on my medications, my life is perfectly normal. Right now, I am on a minimal dosage, which doesn't give me any side effects. But as to the long term consequences, I am not worry about it at this time.

Friday, March 4, 2016

Medication --- the Right Type and the Right Dosage


A lot of mentally ill person refuses to take medication or stay on a medication, they think that they are either ineffective or they are doing even more damages. This is actually true. It is very difficult to find the right type of medication that suits a particular person. The first medication I took makes me gain 60 lbs by the time I was discharged from the hospital. It was an anti-depressant medication. Two years later, I was hospitalized again for a Manic episode. It was then that I was correctly diagnosed with Bipolar Disorder. The anti-Depressant medication was actually the trigger of my Mania.

I was prescribed with Lithium Carbonate, which is a primary treatment for Bipolar Disorder. However this medication gave me severe acne to a point that my face was disfigured. It did not do any good to my mental health.

In 2007, my psychiatrist decided to put me on Epival, it is primarily an anti-seizure medication. Amazingly, after a month, I woke up one day and felt like I was different. I couldn’t explain in what way, but I was just happier for no reason. I never felt that way in the first 22 years of my life. As I took that medication more and more, I realized I finally knew what it feels like to be a “normal” human. 

Now, my personality changed, I used to be an introvert, but I am now a very outgoing and positive person. I don’t have phobias anymore and I sleep like a baby every night. My musical and artistic ability have also enhanced. I have truly reached my potential as a person and a human being because of this medication.

Though finding the right type of medication is the key in treatment, it is still not enough. The right dosage is equally important. For instance, not every middle-age female, weighs around 160lbs should be prescribed with the same dosage of medication --- everyone has a different metabolic rate. It took me about 2 years of experiment to figure out the right amount of medication for me. There was one time, my pharmacy ran out of pills in 125mg, instead, they gave me pills in 250mg. Without knowing the difference, I mistakenly took twice the usual amount for over a month. During that month, I felt so odd. I became lazy and moody, I didn’t want to do exercise and I was hungry all the time. I gained 15lbs by the end of the month. Then, my mom discovered the mistake. Within a week being back on the right amount of meds, I was myself again. Therefore, it’s important to be on the exact amount of medication that’s custom to that particular person.

Thursday, March 3, 2016

Why Is Mental Illness so Hard to Treat?


In my perspective, I think that every mentally ill person is potentially treatable. However, it is the most difficult illness to treat, for the following reasons:


1)      It is a very subjective illness. It cannot be detected by blood test, x-ray, MRI or other methods to diagnose an illness. Even the psychiatrists have a lot of limitations in knowing how each patient feels and what type of illness they actually have. Like me, I was not correctly diagnosed until 3 years after my injury.  Therefore, patients are the only ones who can access their own inner state, but most of them are too sick to even think and too easy to give up. And most importantly, they lack the knowledge and insight to help themselves.

2)      It’s hard to find the right type of medication, the right combination of medications and the right dosage. The side effects of some medications can even worsen the symptoms and make a person even more suicidal. Other side effects, such as appetite change, weight gain, acne, aloofness, etc. are big deals to most people. They could become the very cause of depression. Therefore, if one medication doesn’t work, keep on looking and trying on other types of medication. Do not give up on meds. Do not stop taking meds even if you are feeling better. My condition is treatable but I don’t think it’s curable. I’ll take my meds unconditionally every day for the rest of my life. I might compromise my chances of having my biological child, but nothing is more important than the quality of my mental health.

3)      The lack of social support is also a big problem for the mentally ill. When you are crazy and lose your mind, you really need someone to take you to a psychiatric facility and act on your behalf. But unfortunately, in many cases, when someone is mentally ill, people walk away from their life when they need social support the most. When a person lost their job, their romantic partner and other meaningful possessions during their acute state, how would they be able to feel happy again even if they are bio-chemically restored?