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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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My sister has been diagnosed as bipolar since she was 16.

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Hi. My sister has been diagnosed as bipolar since she was 16. She has psychosis with her episodes. Lithium and Wellbutrin have worked well for her. Sometime in the last 3 or 4 years she has thrown adderral into the mix and now off of her lithium. I don't know where her current psychiatrist is getting her medical history from. Somehow she has them convinced that she is ADHD and not bipolar. Now she is in a severe mania with psychosis and we have no access to her psychiatrist. He needs to know the truth. After talking to colleagues psychiatrists at the hospital I work at, I am a nurse, it is very bad to be on adderral when a person is bipolar. What do we do to relay this information to this dr?? It angers me that they can't follow her previous hospitalizations for her disorder and now have her on all the wrong meds. Please help. Thank you
DoctorZ :

Hello I believe I can help you with your question

DoctorZ :

I am very sorry that you sister has been experiencing these symptoms, your psychiatrist friend is right that being on adderrall, which is a stimulant can cause these symptoms of mania and psychosis with an individual that has been diagnosed with Bipolar Disorder.

DoctorZ :

What you can do is call or email her physician and say that your doctor has been experiencing severe manic and psychotic episodes since being on the adderall.

DoctorZ :

You are allowed to talk to your sister's physician about her condition, but the doctor cannot talk to you about it because of medical privacy laws.

DoctorZ :

If this physician does not listen, then ask for a second opinion for your sister and make sure it is a qualified psychiatrist to make that examination of her symptoms to make sure that she gets the right medications that have benefited her in the past. But if you still cannot have access, you can ask to talk to the psychiatrist's supervisor about your sister's case and that you are worried about your sister. Through all of this, you are making waves and they will definitely reexamine her through all of this because you have shown such great concern for your sister.

DoctorZ :

May I ask why do you not have access with her psychiatrist?

DoctorZ :

It also sounds like your sister may be having persecutory thoughts as well, so that can be added to your list of symptoms that you have observed.

DoctorZ :

In addition, many hospitals and medical groups have family relations staff that can help you with your concerns as well and relay those to her physician. Or if your sister is an active manic and psychotic state, the authorities or a mobile crisis unit can be called to assess your sister and give her the proper medications and diagnosis.

Customer: At this point if we relay this information to the dr will they try to have her come in? She is at a point right now where she is not making sense. My parents have her and her 13 year old daughter living with them and they do not have guardianship of her. Not sure how to go about doing that as well. My sister has been in and out of the er with chest pain and all these other symptoms that she has them diagnosing her with fibromyalgia as well. The er dr was concerned that she was getting her meds from two different drs she is on pamelor neurontin Wellbutrin hydroxine and adderral. My mom has not been able to access all of her pill bottles to find out all the drs prescribing. It's a mess. She thinks she is going to be a famous singer and the police are hacking in her phone. She has her daughter on adderral as well and has been managing her medical care in this condition. She has not threatened to harm herself or others so we can't call police and have her involuntarily committed.
DoctorZ :

Well one of the other looked over criteria for involuntary commitment is also gravely disabled, and I think you sister may qualify for that in her present condition because she has paranoid thoughts and is exhibiting manic behavior. If you relay this information to her doctor they may want to have her come in for an immediate evaluation, at least that is what I would do...of course I would not have removed the Bipolar Diagnosis and put an ADHD diagnosis on her too

Customer: How would we have her involuntarily committed?
Customer: All the other times we had to wait for her crash from the mania and after several attempts finally were able to get her to go.
DoctorZ :

Well there are multiple ways, you can have her go to the ER if she is willing and explain her symptoms to the ER physician. If your city or county has a mobile crisis team, that would be ideal as they are trained for this. Or you can call 911 and have an ambulance take her to the ER to be evaluated.

DoctorZ :

You can wait for the crash, but with the Adderall addition to her Bipolar Disorder that crash may not happen for awhile or may be very brief

DoctorZ :

Many cities and counties also have 24 hour local crisis hotlines that you can call and inform them of your concerns for your sister and what options you have for her

Customer: Right that is what I told my mom. I think maybe calling tomorrow to the one dr I only know of of hers and telling them the situation. Then go from there. If we tell them it is urgent will they let us talk to the psychiatrist directly?
DoctorZ :

Most likely they will allow you to leave an urgent message if the doctor is with a patient, but hopefully you will be able to talk to the doctor directly about what you are observing and your concerns for your sister. The doctor cannot talk about your sister;s medical condition and treatment unless she waived her right to privacy to you or your mother, but the doctor can listen and have her come in for reevaluation.

Customer: Ok yes good old hipaa very familiar being a nurse it's just very hard to deal with with mental disorder in adults . And she doesn't want us involved because she doesn't want to come off adderral she likes the mania high.
DoctorZ :

Yes I can imagine that she does like that euphoria and full of energy feeling associated with mania. Yes HIPPA is meant to protect the patient, but with mental health patients it can be very much a burden at times, especially in your case.

Customer: Thank u so much for talking with me I will relay the info to my mom and call the dr tomorrow
DoctorZ :

Anytime, I am always happy to help.

DoctorZ :

If there is anything else you need, please feel free to contact me at anytime.

DoctorZ :

I wish your sister and your family the best of luck and I hope she gets the right treatment soon.

Customer: Thank u
DoctorZ :

You are very welcome

DoctorZ :

I hope I provided you with excellent service tonight.

Customer: Yes u did just wish u could take over and fix the problem :)
DoctorZ :

I wish so too, I do not like when other physicians make wrong diagnoses like that and it harms the patient and their family like this.

Customer: Yep! Thanks again goodnight:)
DoctorZ :

You are welcome, have a good rest of your night as well.

DoctorZ :

Before you sign off though, I would very much appreciate if you could rate my performance in helping you so that I can get credit for this question. Thank you very much

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