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Suggest treatment for bipolar disorder

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Posted on Tue, 12 May 2015
Question: I have an extensive list of symptoms my fiancee is facing and we cannot seem to get a straight answer. Her doctors just add, adjust, or change her medication. I am calling them all symptoms, but it may be multiple things. They are:
-severe depression, anxiety, adhd, memory loss, severe chronic fatigue, chronic constipation, severe selfishness, explosive anger, loss of empathy, loss of self accountability, and trouble urinating completely.

There may be some I am missing, but we suffer from these daily. It is beggining to effect our childrens lives. I am have and cannot find anything specific that could link all of these.
doctor
Answered by Dr. Chintan Solanki (33 minutes later)
Brief Answer:
possibility of bipolar disorder or personality disorder

Detailed Answer:
Hello,

Thanks for writing to us.

I can understand your concern.

You have described some of diagnosis and some of the symptoms.

Severe Depression, Chronic fatigue and ADHD are diagnosis from psychiatry point of view.

Explosive anger, loss of accountability and selfishness go in favor of possibility of Bipolar disorder which also includes depression and and ADHD symptoms.
If these symptoms are there since many years without major disturbances in life there is possibility of borderline personality disorder.

For any diagnosis confirmation in psychiatry, proper history from patient as well as relatives and detail mental status examination are required and these should be done by a psychiatrist in person.

I need clarification.You mentioned in beginning that she is your fiancee and at last effect our children lives. Are you married or not? Do you have children?

And you also wrote that we suffer from these daily.Since when are these there? So have you consulted psychiatrist? If yes what is diagnosis according to doctor?

Problem of chronic constipation and trouble in urine might be some physical problem or side effects of medicines. Both problem required physical examination and necessary investigations.

Anxiety can occur in many psychiatric problem.

Memory loss should be evaluated. In depression forgetfulness is common symptom but there is no actual memory loss. If severe memory disturbance is there, MRI brain should be done.

Chronic fatigue can also be presentation of depression.

Please provide answers of above questions and also narrate her symptoms with examples so I can give more comments.

I will be happy to help further.

Regards,

Dr.Chintan Solanki.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Chintan Solanki (15 minutes later)
We are not married, but we do have two children together. It is effecting their lives because there are days where she forgets to feed them lunch while I am at work, or does nto brush their teeth. She does not interact with them. She lets TV and social media consume her. She falls asleep while I am at work, and I have come home and my kids have been climbing on the counters, or getting into her purse (where she keeps her medication)

She has not and will not talk to a psychiatrist. She does not believe talking to anyone can help. She has become reliant on medication to barely function. She sleeps 12-14 hours a day normally and then spends the majority of her day sitting on the couch due to all the symptoms.

Her family doctor is the one diagnosing all these disorders and I have looked up the medications and they all have some sort of negative interaction with another. She has been on diferent medications and when they don't help, her doctor ups the doseage until he can no longer do so, then switches to something else. I have begged her to find someone else, but she has not.

She has been so depressed that she has asked me to take her medication out of the house so I could go to work because she was worried she would hurt herself. On Christmas Day she thought she was having a heart attack and went to the hospital and it was anxiety. She take 4-5 hydrocodone 7.5 a day on average (6-10 hour period) and she says the pain is still unbearable at times.

If we have an argument, she becomes explosive and I try to calm her down to talk like adults but she almost reverts to child like behaviors. mocking, ignoring, screaming, etc.

I am really at a loss of what to do for her.
doctor
Answered by Dr. Chintan Solanki (13 hours later)
Brief Answer:
Evalaution by psychiatrist is must, possibly she is addicted to hydrocodone

Detailed Answer:
Hello,

Thanks for more information. Sorry for delayed response.
I can understand your painful and helpless situation.

She is taking 5 hydrocodone per day. This is not required at all until there is specific physical indication for pain. By chance some doctor has prescribed her tablets and she has become addicted to the same.

From your narration it seems that she needs indoor psychiatric management for proper evaluation and treatment.

Her symptoms of excessive sleep, impaired self care,not caring children, remaining in couch and against TV suggest severe resistant depression(more likely) or negative symptoms of schizophrenia.

She can be treated with electro convulsive therapy(ECT).

You forgot to mention that since when she had such problems. If they are after pregnancy only it may be postpartum psychosis.

You should make her visit a psychiatrist by herself or forcefully according to prevalent medical laws or you can ask psychiatrist for home visit.

Hope this answer will help. Feel free to discuss further.

take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (3 hours later)
Thanks for your response. She was diagnosed with depression when she was a teenager. And she has had some of these symptoms most of her life, such as the lack of empathy, reverting to child like behavior, selfishness, and anger. It has become prgressively worse since we have had our children.
doctor
Answered by Dr. Chintan Solanki (1 hour later)
Brief Answer:
Evaluation of her IQ is also needed

Detailed Answer:
Hi,

Thanks for follow up.

As some of the symptoms are there during her whole life, possibility of some mental retardation might be there.Her IQ(Intelligence quotient) should be checked. If her IQ is below normal in range of 70 -90, these symptoms are mostly due to the same.

Symptoms worsening after children suggests possibility of long term psychotic disorder.

I am sorry that without taking her personal interview I can not comment about her confirmed diagnosis.

If you were from XXXXXXX I may help you to refer you to some known doctor. But you are from USA so I can not help in that manner.

In conclusion she needs indoor management at mental health care set up.

All the best and wish you that she will have recovery.



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (19 minutes later)
Thank you
doctor
Answered by Dr. Chintan Solanki (14 minutes later)
Brief Answer:
welcome

Detailed Answer:
You are always welcome.

If feasible please give your feedback and rating before closing the query.

In future if you wish you can contact me directly on this site with following link

Http://bit.ly/drchintansolanki

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Suggest treatment for bipolar disorder

Brief Answer: possibility of bipolar disorder or personality disorder Detailed Answer: Hello, Thanks for writing to us. I can understand your concern. You have described some of diagnosis and some of the symptoms. Severe Depression, Chronic fatigue and ADHD are diagnosis from psychiatry point of view. Explosive anger, loss of accountability and selfishness go in favor of possibility of Bipolar disorder which also includes depression and and ADHD symptoms. If these symptoms are there since many years without major disturbances in life there is possibility of borderline personality disorder. For any diagnosis confirmation in psychiatry, proper history from patient as well as relatives and detail mental status examination are required and these should be done by a psychiatrist in person. I need clarification.You mentioned in beginning that she is your fiancee and at last effect our children lives. Are you married or not? Do you have children? And you also wrote that we suffer from these daily.Since when are these there? So have you consulted psychiatrist? If yes what is diagnosis according to doctor? Problem of chronic constipation and trouble in urine might be some physical problem or side effects of medicines. Both problem required physical examination and necessary investigations. Anxiety can occur in many psychiatric problem. Memory loss should be evaluated. In depression forgetfulness is common symptom but there is no actual memory loss. If severe memory disturbance is there, MRI brain should be done. Chronic fatigue can also be presentation of depression. Please provide answers of above questions and also narrate her symptoms with examples so I can give more comments. I will be happy to help further. Regards, Dr.Chintan Solanki.