My life partner has Bipolar ii

I don't know if Mr D ever got the message on that one @Faith-and-Hope as he slid into major depression. But I think you are right, similar but different.

I gather that if a patient notices they are starting to do things which could indicate a switch to mania that they can seek early intervention (we have not been in that situation as yet). I believe it takes a bit of experience and insight to be able to do this.

We are getting snippets of insight about some things @Former-Member ..... but it has been a long, hard road to achieve even that much, so I have settled for settled ..... if we can keep things settled enough and only fight the essential battles, there are aspects of insight that will have to come with time and enlightening experiences I think, most of which I have little power over.

Medication (and the side effects we see our loved ones struggle with) is another thing to contend with in BP.

Mr D allows me to be fully involved in his treatment and I do try and ensure I do not take from his dignity or self-governance in this process. I do keep an eye on meds (as requested by treating team post attempt).

I am very mindful that treatment is keeping Mr D in remission and the meds are life saving, without them, having nearly lost him already, his prognosis would be very poor.

I have found that as a carer, suppporting Mr D with communication and advocacy has been necessary.

Mr D found it difficult to talk to the pdoc about side effects such as constipation and sexual dysfunction; I needed to do this. He does not understand much about the medical side of things and when he brings up issues at home I ask if he would like me to support him in bringing things up with the treating team and I am guided by him in relation to this.

There are a number of mood stabilisers out there so if one is not tolerated well, there usually are other options available to try. I have found documenting meds, doses and response has been helpful. Speaking openly and respectfully to the treating team is important especially if our loved ones are finding a medication difficult. Articulating the symptoms that are a problem can guide the pdocs as to a suitable alternative.

Understanding benefit v risk, not being afraid to ask questions, ensuring routine monitoring is scheduled and openly communicating concerns are all things we can do as carers as we support the ones we love.

@Zorro

be interested in knowing what other things are in have bipolar 11 @Former-Member

Mr shaz had decided yesterday that we needed more work , to advertise more , he does have days like these

Depression.

This is not a good place. Feelings of hopelessness, worthlessness, the inability to enjoy things, lack of energy and activity, not wanting to get up or go out. Suicidal thinking (medical term = ideation) can creep in which can deteriorate to having a plan (medical term = intent).

A feature of Bipolar ii is that patients can spend a lot of time being depressed and if not adequately treated, they are at risk for the serious consequencs of this disorder.

This is why having a treatment plan and a safety plan is best practice for management of a patients mental health. Having a holistic approach to wellness with appropriate lifestyle interventions (not just medication) makes a difference. This can include exercise, doing meaningful activities, if the patient cannot work (or can only work part time) are they able to volunteer? Do they have a hobby - is there somewhere social where they can enjoy it having company?

As a carer, noticing when signs of depression emerge and encouraging the patient to follow their safety and treatment plan can make a difference. Sometimes lifestyle changes and ramping up of self care can avert deterioration. However, if things continue to worsen a pdoc visit might be be necessary. They may be reluctant to go, but being able to say that in their treatment plan they agreed that if a,b or c happened, they would make an appt with the pdoc and one might need to push the point with this. Meds may need tweaking either temporarily or permanently.

It is well documented that collaboration with the carer leads to better outcomes. We need to report any signs that indicate a patient is losing touch with reality (medical term = psychotic), this may require more aggressive treatment.

Mr D had psychotic depression and the mix of being suicidal and delusional was not a good one. His last attempt was poorly thought out and he ended up with a permanent orthopaedic deficit. Recovering psychologically from this is still a work in progress.

Some of the things I have learned about depression:

1. There is s spectrum of depression from mild to severe.

2. If a patient starts showing signs that depression is looming or worsening, putting into place measures that are documented in the treatment plan can halt a spiral down.

3. Sometimes early intervention is not possible - the plunge into deep depression can be rapid in some patients.

4.If there is any suicidal ideation, let treating team know. When intent is there, immediate help is required.

There is heaps more to this topic and I soon hope to talk about how I initially didn't cope and how I learned to cope and matters relating to involuntary treatment

Thanks for sharing your experience. This is beautifully insightful.

@Former-Member

Love reading your work! Sorry you and Mr D had to go through so much suffering though.

But your writing is always very spot on and informative.

Thank you!

I don't like to admit it but in the last 2 years I have also suffered from 'depressed mood' which is stepping stone to depression, so I try to monitor myself.

Hope you are well.

Grasshopper3

good afternoon @Former-Member, @Grasshopper3, @Determined, @Faith-and-Hope

sorry I did not expand my meaning last night , very tired and drained

mr shaz has put locks on all the windows and checks them 2 or 3 times before going to bed -- OCD

the other one is when he was seeing traphy -- they were try ing to get him to use assertiveness as he would always say YES to everything , did does not want to upset anyone , so the other day was a yes day , o now we have this big job now to do , but as time passes and bipolar2 set in , by the time comes I will be saying sorry but we are unable to do the job

@Grasshopper3