Tuesday, April 26, 2011

Another Milestone!

Today marks the 6 month point since Mary's last inpatient stay at the hospital. Yay! We are praying that this continues and we won't see the inside of a psychiatric hospital for very long time.

Saturday, April 16, 2011

We've Come A Long Way Baby...

One year ago right now I was chasing my daughter down the middle of the street in our neighborhood, praying that no cars would come by. At the same time, I was on the phone with a 911 operator trying to explain the situation... I have an 11 year old bipolar child who is trying to run away from home and I need help transporting her to the hospital. This was the beginning of a very long day, a very long week, and a very long year. I am so thankful that this morning my daughter woke up smiling and happy. She is not suicidal, nor is she considering running away from home. She has a fun day planned with friends, we have a new medicine to try for the anxiety that rules her thinking, and the outlook on the future looks a little brighter. Is she completely healthy and stable? Not by a long shot! She is still all over the board as far as emotions. But at least for this very moment we are in a much better place than we were a year ago today. Thank you God!!!

Wednesday, April 13, 2011

Thoughts on Perception & Thinking Errors...

This week at our tdoc appointment, our wonderful doctor gave me a hand out that she had put together regarding the perception and thinking errors that bipolar people, children in particular, struggle with. She took much of the information from a great book entitled The Bipolar Handbook for Children, Teens, and Families and condensed it down to two pages. As we were discussing where Mary is right now emotionally (she is ALL OVER THE PLACE!), I could really see where these errors in her thinking process are having a dramatic effect on her. Here are just a few things we are seeing...

Gets stuck: runs into a problem and is unable to figure out what to do because can't visualize the next step. This leads to getting very upset or giving up... feeling hopeless. I see this often in Mary when she encounters a problem. It doesn't matter how I try to break down a step by step solution for her, she can't visualize past what she is feeling/seeing right now. This leads to the next one...

Negativity: difficulty with cause, effect, and stepwise thinking. It is hard to visualize or predict what will happen in the future. If feeling unsuccessful, assumes that it is always going to stay that way because unable to visualize how to succeed. This is a real area of struggle right now. It is hard to find joy in the situation when you feel like you are always going to be a failure, you are never going to learn this, life is always going to be hard, etc. This negative self talk only serves to make her feel more hopeless. It is like trying to fight darkness with darkness.

Intrusive thoughts: There is a failure of the mental gate to keep important thoughts in and unwanted thoughts out of the mind. This makes it hard to concentrate or follow conversations. Sometimes these unwanted thoughts get stuck or keep bombarding the mind over and over like a broken record. These thoughts are extremely difficult to control and result in strong emotions which appear suddenly. These intrusive thoughts are fueled by the negativity that she is feeling towards herself.

Leaky Interpersonal Boundaries: Hard to tell where he/she stops and other people begin- unable to distinguish their own thoughts and feelings from those of others. This is a huge one that Mary is struggling with right now. If someone is sad, then Mary is sad, but it doesn't just stop there. Mary takes that sadness and multiplies it by a hundred until she is feeling scared, hopeless, and overwhelmed. The same way with anger. If someone is angry with another family member, Mary takes that on and compounds it to the point that the people involved have become suicidal in her mind. Worrying about disappointing people is another area that she is struggling with. If she feels like someone is disappointed in her, she becomes disappointed in herself... cue the negative and intrusive thoughts... you see the cycle?

Over-thinking: Carrying assumptions/conclusions far beyond that justified by information. Exaggerated way of thinking. This also comes into play with the leaky interpersonal boundaries. If she perceives that someone is just a little bit sad, then she over thinks it to catastrophic levels. If she perceives that someone is even a little disappointed in her work, she over thinks it to the point that everything she does is a disappointment. And because she has some trouble interpreting social cues at times, a lot of what she takes on herself are just that... assumptions. She assumes that because she gets a C instead of an A that she has disappointed everyone. That is so totally not the case, but she can not be convinced. Again this leads to the negative and intrusive thoughts.

It saddens me that these perception and thinking errors can have such a profound effect on my daughter's everyday life.

Monday, April 4, 2011

Breaking the Silence

Sorry for the long silence. I have thought many times about sitting down to write, but really haven't had much to say. Well, that is not really true. There is always lots to say, but so often it is the same old, same old. We continue with our daily ups and downs. Spring is in the air and with it the mania that typically accompanies it.

We are fast approaching the one year anniversary of Mary's first inpatient hospital stay. I have to confess that the date looms huge in my head. As the day gets closer, I find myself comparing this year to last year and previous years before that. I find myself fully prepared to have to do it again, and yet praying that we don't get to that point.

Overall this year is much different than last year. I think we have a better grip on the cycling with her current medications, and that a year of maturity makes a huge difference in Mary's ability to cope. But I am also aware that while she is a very "happy manic" right now, that can change in an instant.

There is also the need to have blood work done... it has been six months since her levels were checked last (during her second inpatient hospital stay) and it really needs to be done again. Of course her reaction to that was "absolutely no way, not doing it!" After that she proceeded to tell the pdoc that she is the worst doctor ever and then went to hide on the couch with her head buried under the cushions. She threatened to stop taking her medicines if that was the reason she has to have blood work done. The pdoc was very gracious and let her rant. When things had calmed down and we were in the car on the way home, I was not so gracious. I let her know in no uncertain terms that to stop taking her medicine without a doctor's approval and oversight would kill her. Thankfully she understands that and told me she was just frustrated and does not plan to stop taking her medicine. Phewww!

Anyway, back to the blood work... we are trying to come up with a good plan to sedate her enough not to care about having blood drawn, but not so much that it would be considered conscience sedation. We don't want her to have to spend hours being monitored at the doctor's office or take any unnecessary risks. Since sedatives make her sleepy, and we don't want her to miss school because of it, we will be having it done over a break from school or right after school lets out for the summer. In the meantime, we will try and figure out what a good dose of sedative is on an empty stomach, first thing in the morning, starting at the very lowest dose and working up slowly from there.

Mary continues to love her new school. We are so thankful for the opportunity to have her there and for all the wonderful people in the school who love her and accept her just the way she is. What a blessing from God!!! I know that having her at this school has played a huge role in helping her cope both with the death of her grandfather as well as the spring mania. There are plans to partner with a program called the Arrowsmith program next year for children with learning disabilities. If anyone has heard anything about this program, please let me know. It looks like it could potentially be a great thing for Mary.