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Penny Rayas, MFT
Penny Rayas, MFT, Therapist
Category: Mental Health
Satisfied Customers: 395
Experience:  I have 20 years experience in the mental health field
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I apologise for the length of this email.In 2010 my then 20

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I apologise for the length of this email.In 2010 my then 20 year old daughter started hearing voices telling her she was a criminal, and she kept trying to hand herself in to the police. She became a danger to herself, and after assessment by a mental health nurse was admitted to hospital under section,and was diagnosed with Treatment Resistant Schizophrenia, as she did not respond to 3 types of anti psychotic meds. She is now on clozapine She came home to live with me and her dad. We had lots of support, as mental health outreach workers came out to her 5 mornings a week. They involved her in activities such as going to the gym, and all seemed to be going well.
However she started buying bottles of wine while we were at work,her drinking increased, until she was finally readmitted to hospital following an overdose. She got access to her medication,took a whole week's worth, plus paracetamol, bleach and cider. Her medication was recommenced, but without an antidepressant as this time they had caused her mood to swing to manic. Again we had lots of support, again she started drinking, hiding bottles in her room. 5 months later she tried to jump off a bridge on to a motorway. Thankfully the police were called, and she is safely back in hospital. She is still taking clozapine, has been started on a different antidepressant, and is having psychotherapy.
The psychiatrist seems very positive, although she has mentioned ECT as a very last resort. I really don't want this, and would appreciate your views on it.
My main question is,how we can help my daughter when she comes home. Can you see a positive outcome to our situation. Your views would be greatly appreciated. Thank you

Hello there, thanks for asking JA. As a dual diagnosis specialist I beleive that you daughter needs a program that will be a dual diagnosis program. I am also wondering if her diagnosis is correct and she is has bi-polar with psychotic features. If she gets manic she may be missdiagnosed. How is her thought process? schizphrenia is a thought disorder as opposed to bi-polar that is a mood disorder. Does she start to drink when she is manic? Usually bi-polar people start to overspend drink and are grandiose when manic. What happens before she gets to that state? ECT is a good method of controlling depression and not what it used to be 20 years ago. I think who ever is treating her needs to focus on her using alcohol and providing recovery services. Is she attending AA meeting? When people are dually diagnosed they have to treat both the drug alcohol and the mental health problems. Also the suicidality most of the time is a result of over-drinking. It is important that your daughter gets and stay sober as drinking leeds her to be suicidal. Does she have family therapy? That can help also. The way to help your daughter is to ask her to go to AA meetings and also go to Alanon meetings yourself. Make sure that she stays in recovery and in therapy. Ask her to sign a release for you to stay in communication with the therapist. You have set strong and loving bounderies.

The most times she tries recovery from mental illness and drugs and aclohol the move likely she is to be successful. Don't be overly controlling or overly accomonating. That will help you. Ask her to participate in family therapy as mental ilness affects the family and so does alcoholism.

Let me know if you have any question. It looks like she is in the right type of medication.

Penny Rayas, MFT and other Mental Health Specialists are ready to help you
Customer: replied 3 years ago.

Thankyou for your reply. My daughter has never been manic, apart from one time whilst in hospital when her antidepressant dose was too high.

We are hoping she will come home soon. We have very good family support, and will have mental health support workers with her 3 hours every morning, plus a nurse calling every afternoon initially.

The main problem as you say, is the drinking. She is normally ok for the first month, then starts buying and hiding bottles of wine. This is difficult to monitor when my husband and I are both working, but we will percevere.


It is very encouraging to hear that she has a good chance of recovery as my husband and I were beginning to wonder if this 5 months at home, 2months in hospital with a different suicide method every time, cycle was ever going to end.




You are wellcome I am very happy to be working with you.

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