Hacker News Reader

Comment by denton-scratch | Hacker News Reader

My GF is diagnosed bipolar, and had a breakdown before Christmas and got sectioned. I didn't see her at that time, but the behaviour that she describes sounds mildly psychotic.

She was home by the end of February, on a mood-stabiliser, an anti-psychotic, and a minor tranq.

She's off the minor tranq now; she'll be taking the mood-stabiliser until she dies, and it's not much of a problem.

But the anti-psychotic is troublesome. It makes her sleepy, so she needs a nap every two or three hours. It makes her shuffle around, a bit like a drunk; she used to run several miles daily, but she can't do that now. And she's gaining weight. I hope the shrink weans her off the anti-psychotic soon; I don't think she needs it.

> But the doctors kept her on tranquilizers anyways.

That sounds wrong to me. Tranqs are horribly addictive (meaning the withdrawal is horrible and dangerous) - even minor tranqs. You need to get off them within a few weeks.

IANAP.

View on HN

Thanks for your response. Sorry to hear about your GF's experience. "Sectioned"... .. . Mental Health Act -> you're in the U.K.?

> she'll be taking the mood-stabiliser until she dies

"Mood stabiliser" is a marketing term. My friend was on a "mood stabiliser" until the 2nd to last time she escaped. She didn't have those pills with her when she hopped the fence, so she couldn't take them when she was in hiding at my place. She was perfectly "stable" without the drug, so they dropped it from her treatment program at the next visit & she felt better.

> But the anti-psychotic is troublesome. [...]

Whitaker points out that psychotic patients who do the best are those who are never put on anti-psychotics. Those who do second-best are those who are taken off the anti-psychotic promptly. Those who do the worst are those who are "maintained" on anti-psychotics indefinitely.

Random link to Whitaker's organization: https://www.madinamerica.com/2017/05/psychiatry-defends-its-...

>> But the doctors kept her on tranquilizers anyways.

> That sounds wrong to me.

I refer to anti-psychotics as tranquilizers, because Robert Whitaker points out that the drugs that got re-labeled as the first generation anti-psychotics were originally used as tranquilizers. Maybe this doesn't accurately reflect how today's patients are told about the medicines they're given, but it's better for being dismissive of their inappropriate use.

> I hope the shrink weans her off the anti-psychotic soon; I don't think she needs it.

You're almost certain to have help with this: look for a psychiatrist for a second opinion, someone with experience with tapering patients off psychiatric medications. Let the guy know that you're advocating for your GF, and are prepared to complain to licensing boards/etc...

I may have been overly-aggressive in my personal efforts. No one cared, but I don't know that a softer, gentler approach might've been more effective.

Since this is all sort of new for you, I'm happy to read your questions and see if I have any insights for you. I've been at this for almost 6 years... You may also find my comment history useful. hth. :)

Yes, "sectioned" as in Section [x] of the UK Mental Health Act (I hadn't realized until just now that there's more than one section of the Act that you can be detained under).

> I refer to anti-psychotics as tranquilizers

If I've got you right, that's what I call "major tranquilizers", e.g. haloperidol and chlorpromazine. I think they:

- Make you fat

- Cause you to start rocking

- Take away all the interest from life

"Mood stabiliser" is actually a new term for me; it used to mean simply "Lithium", in my book. Lithium also makes you rock, if you take it long-term. It does seem to work, in the sense of preventing episodes. The GF is on a mood stabiliser called Depakote.

> Random link to Whitaker's organization

OK, so they're ranting specifically about US prescribing practices, the DSM, and the US drug industry. They're focused on anti-psychotics. I think the system here is less crazy than in the US; although they're severely understaffed and under-funded, UK mental health services aren't in the pocket of Big Pharma.

I'm also concerned about anti-psychotics - especially long-term. My assumption is that they gave her an anti-psychotic because her behaviour at the time she was admitted was chaotic, she posed a risk to herself, and they wanted to prevent a relapse when she was returned to her own home. I've never known her to manifest delusions or hallucinations, which as far as I'm aware are required indicators for a diagnosis of psychosis.

I'm a bit suspicious of the bi-polar diagnosis; she doesn't suffer from wild mood swings or extended periods of depression; she just gets agitated, and jabbers. She says she hasn't had a depressive episode for 20 years. She's as honest as the day is long, and although she's told me some far-out things, they all turned out to be true when I checked; so I believe her. I can't find a medical description of bi-polar that matches the behaviour I observe. And it's not clear to me that the different kinds of "bi-polar" are really different kinds of one thing.

My own ad-hoc definition of bi-polar is "psychological condition that responds to Lithium".

> Let the guy know that you're advocating for your GF, and are prepared to complain to licensing boards/etc...

I've met her shrink, and members of her care team. It would be premature to say "I'm advocating..." - I'm keeping an eye on her treatment. I believe they mean to get her off the anti-psychotic, but not the mood-stabiliser.

I'm her BF, not her carer. I don't police her taking her pills. If she starts going off the rails, I'll give them a heads-up; I imagine I'll be the first to notice. If I eventually have to stick my oar in over her prescriptions, then I will; but for now, I trust her care team (and so does she).

So I see my role as basically "support".

> You may also find my comment history useful.

Thanks, I'll take a look.

> "Lithium also makes you rock, if you take it long-term.

My other friend called me up recently to tell me that she'd just bought supplemental lithium. She thought she was bipolar and needed more lithium. 12 hours later she called again, sobbing: suicidal. I told her she shouldn't have taken the lithium, and that it would probably wear off. She searched and found adverse symptoms associated with her supplement. I don't think she'll take that one again.

> The GF is on a mood stabiliser called Depakote.

That's what my friend was forced to take. She's been off it for nine months, and doesn't miss it.

Another response to my comment, from /u/eliasmacpherson, gets into orthomolecular psychiatry and "histadelics" (histamine, allergies) as an important causative factor in "mental health problems". That thread might be really valuable to you as well: https://news.ycombinator.com/item?id=27993001

> OK, so they're ranting specifically about US prescribing practices, the DSM, and the US drug industry. They're focused on anti-psychotics.

The essence of Robert Whitaker's books, Mad in America, Anatomy of an Epidemic, and Psychiatry Under the Influence, is that Psychiatry got idealogically-captured by the drug industry, and how psychiatric drugs arguably take episodic conditions and make them chronic.

Whitaker's initial forays into "mental health" was when he looked into Prozac as a reporter for the Boston Globe (newspaper). The trials for Prozac found that it makes some patients suicidal. The Germans FDA-equivalent wouldn't approve it...

Whitaker's organization spotlights more effective approaches to treatment.

> So I see my role as basically "support".

Often times it's hard for patients to notice how adversely affected they are by their medications, but the doctors thinks the medications are working fantastically even though the patient would have gotten better anyways, with just time and a normal diet. Followup visits are opportunities for injecting additional perspective... "What are you going to talk to the doctor about today?" might be a useful question to ask.

Thanks for your comment.

Reply on news.ycombinator.com