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MN Psychiatrist
MN Psychiatrist, Psychiatrist
Category: Mental Health
Satisfied Customers: 792
Experience:  Physician for 17 years, adult psychiatrist for 13 years working with a wide variety of patients.
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How do you communicate with someone who is going through a

Resolved Question:

How do you communicate with someone who is going through a manic stage of a bipolar dissorder?
Submitted: 2 years ago.
Category: Mental Health
Expert:  MN Psychiatrist replied 2 years ago.
Hello, I am a psychiatrist.
I'm sorry you are struggling with this. Bipolar disorder really complicates things, to be sure.
I could best help you if I made sure that I understood what you meant by "manic." This might sound odd, but even though it means one thing to us who work in mental health, it sometimes means different things to different people. What do you mean by "manic?" Do you mean she is hyperactive, abnormally happy (without reason), not needing sleep, not wanting sleep, having tons of ideas race through her head as fast as she can think of them, or that she is getting grandiose, spending a lot of money (by her standards), etc.?
Also, if you can tell me more about the situation in general, it would be helpful.
Customer: replied 2 years ago.

yes, by manic you have hit the nail on the head. She can't even keep up talking with her thoughts at times. Yes, in her past relationship, I am certain, ended because there was no money left. Yes, she would be up until past midnight and up at 4 am.

 

To complicate things, she added Baileys to her coffee, smoked pot, and because of her disorder (phantom pain?) visited the ER many times and they enabled her.

 

She takes Zolof (sp)

Expert:  MN Psychiatrist replied 2 years ago.
This is helpful information.

It can often be considered impossible - for all intents and purposes - to try to talk to a manic person. Not only can you not get a word in much of the time, but they are in no mental state to register what you say, let alone process it. If she is like this, if you cannot get anywhere with her, or you cannot get her to a doctor who will treat this, you may have to call EMTs to take her to evaluated by a psychiatrist. Mania can be dangerous; not just in terms of buying things like crazy, but in terms of risky behaviors and/or constant physical activity that can result in a dangerous breakdown of muscle tissue.

It is not uncommon for bipolar patients to take an antidepressant (such as Zoloft). However, it is dangerous for bipolar patients to take an antidepressant without also taking a mood stabilizer (such as lithium, Depakote, Abilify, Lamictal, etc.) at the same time. The reason is that without a mood stabilizer, an antidepressant can elevate a bipolar patient's mood up out of depression and all the way into mania. In fact, this is how some bipolar patients are diagnosed; they are put on an antidepressant for what is thought to be regular depression, and a week later they are buying all kinds of things. Antidepressants are often used in bipolar disorder to help the depression phases be adequately dealt with; often a mood stabilizer alone cannot keep a bipolar patient from being depressed.

With this in mind, if all she's taking is Zoloft, please notify her doctor immediately. You may have to take the Zoloft away from her, but do not do this without discussing it with her doctor.

This won't fix the whole situation, but it's a start. Does it make sense?
MN Psychiatrist, Psychiatrist
Category: Mental Health
Satisfied Customers: 792
Experience: Physician for 17 years, adult psychiatrist for 13 years working with a wide variety of patients.
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MN Psychiatrist
MN Psychiatrist
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792 Satisfied Customers
Physician for 17 years, adult psychiatrist for 13 years working with a wide variety of patients.