Monday, May 16, 2011

Advice For A Family Re: Their Over 18 Type 1 Child & Self Destructive Bipolar Issues

Well, today's post was going to be a Diabetes Blog Week Round Up and how fantastic Diabetes Blog Week was. Then I received the following letter early this afternoon from a Diabetesaliciousness reader and my Diabetes Blog Week post will have to go up tomorrow, because a DOC family member needs our help - BIG TIME.

Please read the following and if you have any advice or words of encouragement for them, comment or email me at Kellykunik@gmail.com and I'll pass your info along. Thanks DOC~
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Kelly - Please post this letter on your blog!

Does anyone in the D.O.C. Have experience with a young adult (and according to the law, legally independent of parents) who struggles with both bipolar issues and type 1?

Particularly with regard to situations where the swings of bipolar are such that self destructive behavior is involved.

Self destructive actions beyond but including even rudimentary type 1 care.
Any references to expert help, or experience with legal proceedings that may facilitate loved ones intervening are appreciated.

Thanks In Advance,

Stuck Between a Diabetes Rock & A Bipolar Hard Place ~

8 comments:

Wendy said...

I'm sure they've been through this before, but my understanding is that if someone is deemed a threat to themselves or others, they can be detained (not necessarily jail -- could be a ER visit or a hospital admission) without permission.

It comes down to who is doing the evaluation and whether they determine that the individual is capable of making their own medical decisions.

Beyond that? I have no idea.

Vivian said...

That is a tough one. My heart goes out to this family. I will dig around and see what I can find. Sending lots of love and prayers.

The Kimlers said...

I don't know much about this as if he is mentally incapable of providing the correct and needed care for himself as he is an adult. I work with people suffering with a Mental Illness in Iowa. And, ironically I have type 1. I don't have any clients with both, but I do know, that if there is a threat to him and his safety, or life, and his parents think he needs a higher level of care, rather it be to a residence, 24hr home placement, or some type of community living with supervision the best and first way to get them stabilized with his medications and treatment compliance, the best thing is to have him committed. This would require a written statement stating why he is a danger to himself or others, what medications he has been on and then a quick court meeting is held. Just because you commit someone does NOT mean they go to Jail. It just means they receive the services in which they need. I hope this helps! Good luck!

Penny said...

I feel for their dilemma. I have a daughter with autism and a daughter with Type 1. I would enlist the help of a neurological psychologist who can help identify treatment which might include medication for bipolar. I do believe in many instances the brain chemistry is off balance and can be righted again with the appropriate meds, which in turn, may lead to a more balanced approach to diabetes management. First the bipolar, then the diabetes. Just my two cents.

Beta Bandit said...

I guess I would recommend:

1. Ongoing therapy with someone who is familiar with both Bipolar disease and Type 1.

2. Close management of symptoms and medication management for bipolar.

3. If he's an actually threat to himself (as in going to harm himself), he could be admitted, to start an intervention.

4. Is he living at home or away? Is he depending on parents for funding? If so, I'd cut the funding unless he moved back home.

5. Like diabetes and general depression, you can't take care of one without the other. Both issues need to be addressed-- preferably the Bipolar control of symptoms before diabetes.

Lee Ann Thill said...

I'm not sure that I can add much more to what's already been offered, and there are too many unknown variables to give more than general suggestions. While he is a threat to himself for not managing his diabetes, whether or not he is a threat to himself from a legal standpoint is iffy. He would need to be an imminent danger to himself (or others) in order to be committed, and being reckless with diabetes management, without a pattern of DKA or loss of consciousness isn't going to be enough. Even being committed is pretty limited though. I worked on an acute in-patient psychiatric unit for several years, and very few people who came though were there on commitment because they only do that in extreme cases. Commitments are only 72 hours, so long enough to assess the patient, not the insight-oriented treatment with a trusted therapist that this person sounds like he needs. If he were committed, and received treatment recommendations, but didn't follow through, which sounds like a possible scenario, it's not like he can just be committed over and over again. He has to be willing to engage in treatment.

I know the system is very frustrating for families of people with mental illness - I see that time and time again when the family is invested in the patient's well-being, but the patient isn't. I wish I could offer something more substantive. My best suggestion, based on the short letter, is for the parents to find themselves a family therapist who will be in a better position to make recommendations. Even if their child won't engage in therapy, they need the support and they need someone to help them deal with this complicated situation. The family can also get support through NAMI: http://www.nami.org/
I can't stress the value of building a relationship with a family therapist though. If this turns out to be an ongoing or recurrent issue, the family will need that guidance from someone who understand how medical and mental health issues are family problems, not individual problems. The day might come when they've exhausted other options, and they have to let go and let their kid make bad choices, which is a horrible position for a parent, so having that professional support will be imperative if other courses of action don't result in the changes they want to see. Hopefully a family therapist can help them implement a strategy that will result in change before that though.

Anonymous said...

Where do I begin...I am T1 with bipolar 2, and I was only diagnosed with the bp 4 years ago. I've had T1 for nearly 30! As child, I remember gorging myself on various foods for no reason. I would get such a rush from "being bad" and seeing how much I could get away with. My parents thought I had an eating disorder, but since the bp diagnosis, A LOT of questions were answered and things started to make since.

I high school, out of nowhere, I just stopped taking my shots and went into serious DKA, nearly a coma...at the time, I had no idea why I did something so dangerous. There are a myriad of other instances where my judgement regarding my health and well-being was less than desirable...especially into college and even still, some recently.

For anyone, I think education is the best weapon, for the patient as well as loved ones. Having a knowledgable team of doctors (including a psychiatrist for meds), support groups and regular therapy is a must.

I'm 34, married with one child and still have some instances where my mind goes haywire and I wonder what's going on in my head...the difference now is I know myself a little better and have a better grasp on mental health in regards to my physical well-being. It's been more of a trial and error process. I understand, too, that it will continue...again, education is the best tool anyone can have. I hope this little bit of insight has helped. Feel free to contact me at any time at erinkeenright@yahoo.com

Erin

The Kimlers said...

To add something to my first comment. 1. For Iowa when you are committed, (and this would mean for BP) being a threat to himself, or others, not complying with medication, treatment, appointments or being contacted by family, whoever is the one checking up on him, AND they have a concern for his health and safety. I would imagine he has a psychiatrist already, as they would also have to agree that he is not following through with the plan and then after commitment would begin building a larger team of therapists, social workers, family therapists and so on. You are committed for a longer period of time, and once you are found or picked up from your residence they don't take you to jail here, they'd take you to the hospital.
As far at T1, Lee Ann is right, unless he is also in DKA, not compliant with medication and is in serious need of diabetes management and insulin, solely on the T1, nothing can be done. Hopefully this helps.
The point here is though, this young man needs some medication attention and support staff that are going to work with him for the multiple symptoms he is having. Treatment with doctors, therapists, possibly day treatment of some kind might help him. Having a mental illness does not make him or label him as needing to be detained, but more in need of the correct and appropriate psychiatric and medical care. Hope that helps!