Elliott, LPCC, NCC : Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.
Elliott, LPCC, NCC : Dear friend,
Elliott, LPCC, NCC : I believe that I can help.
Elliott, LPCC, NCC : First of all, bipolar disorder can disrupt short-term (working) memory but not long term.
Customer: Would memory from say the day before or several days before be considered short term or long term memory
Elliott, LPCC, NCC : Mostly short term memory. He could be having Dissociative Amnesia which may or not be related to his "condition" of bipolar or schizoaffective.
Elliott, LPCC, NCC : Is he having hallunations?
Elliott, LPCC, NCC : hallucinations
Elliott, LPCC, NCC : And do these occur when he is having manic attacks or is in a manic or depressed state or do they occur independently?
Customer: This is the first time this has happened and he seemed to be in a manic state when it first happened.
Elliott, LPCC, NCC : Did he have any medications, including antidepressants before this happened?
Elliott, LPCC, NCC : Has he been diagnosed with anything before?
Elliott, LPCC, NCC : How old is he?
Elliott, LPCC, NCC : Has he used any illicit drugs to the best of your knowledge?
Customer: No, he doesn't use drugs but does drink alcohol
Elliott, LPCC, NCC : Did he drink much right before this incident?
Customer: He remembers having two drinks but I'm not sure if he would clearly remember how much he drank since he doesn't remember parts of that day and night since he seemed manic
Elliott, LPCC, NCC : Alcohol sometimes causes memory loss, and so this is something to consider. It can also cause hallucinations.
Elliott, LPCC, NCC : Has he been depressed? Is he suffering from any stress or trauma or major worries?
Customer: He says that he snapped that night. Yes , he is dealing with issues concerning his sexual orientation.
Elliott, LPCC, NCC : I do not think, first of all, that he has schizoaffective disorder, which is often confused with bipolar disorder with psychotic features. Schizoaffective is more of a psychotic disorder with elements of mood disorder (either depressive or bipolar) but the hallucinations and mood changes do not occur together.
Customer: So, bipolar might be a possibility?
Elliott, LPCC, NCC : He is under tremendous pressure because of his sexual identity issues and perhaps also has bipolar disorder, which, during a manic episode will disruptive to his thought processes (racing thoughts) and cause lack of focus, and in extreme cases cause hallucinations.
Elliott, LPCC, NCC : Is he prone to reckless behavior (including spending, driving, drinking, sex)? You may not be privy to his private life, of course.
Customer: I think he could be. I think I won't be too shocked if the diagnosis is bipolar disorder. It is just difficult waiting for a diagnosis and treatment to begin. He is in the hospital voluntarily and that is a good thing. I don't know how long they observe someone before they will diagnose him.
Elliott, LPCC, NCC : Be careful that he is not misdiagnosed with Schizoaffective. He has not other history to indicate that he has a psychotic disorder, but psychotic breaks in depression and in bipolar, particularly, are more common.
Elliott, LPCC, NCC : What were his hallucinations about?
Customer: He told his brother that he will now have to tell if people are real or not.
Elliott, LPCC, NCC : And what did he mean by that? Figuratively or literally?
Customer: I think he meant literally. I should mention that he has an uncle with schizphrenia
Elliott, LPCC, NCC : Blood uncle?
Elliott, LPCC, NCC : That doesn't mean that he has inherited it. He could also inherit tendency for bipolar, or may just have had this break because of all of the stress on his life. Not knowing his own "identity" puts into question whether he is real or not, in a certain sense.
Elliott, LPCC, NCC : What are they giving him now? Antipsychotics or mood stabilizers?
Customer: No, just something to sleep
Elliott, LPCC, NCC : And does he seem his old self now?
Customer: No not yet. He is talking about the hallucinations a lot.
Elliott, LPCC, NCC : He saw people and could not identify if they were real or not?
Customer: It sounds that way
Customer: To me that would make me think of schizophrenia and that is why I am so worried
Elliott, LPCC, NCC : He has a memory of those feelings but it not in a hallucinatory state now, I take it?
Customer: I think that is correct.
Elliott, LPCC, NCC : Then he is past it, he remembers it, and it shocks him that he actually experienced this.
Elliott, LPCC, NCC : That does not sound like psychosis to me.
Elliott, LPCC, NCC : I would be very wary of having him diagnosed with either of those two disorders, and then being put on heavy-duty drugs.
Elliott, LPCC, NCC : I strongly suspect that this hallucination was associated with stress and anxiety.
Customer: Okay good. I agree that I want to make sure that he gets the correct diagnosis, especially since they know about his uncle. I think that if he is diagnosed with either of these conditions then we will at least get a second opinion. Thanks so much for your help, you have been wonderful
Elliott, LPCC, NCC : I believe that you should find a therapist who specializes in traumatic stress. You could find someone at www.psychologytoday.com and enter state and city, then go to the refine search list and look for traumatic stress.
Customer: Thanks so much, I will do that.
Elliott, LPCC, NCC : "Shop" carefully as all professionals are NOT the same. Even psychiatrists.
Elliott, LPCC, NCC : I shall keep your family in my prayersl.
Elliott, LPCC, NCC : You are very welcome. Warm regards, XXXXX NCC, CCMHC