Urgent need to convince my sister that she needs care - first manic episode

LegacyUser

One of my sisters seems to going through what must be a manic phase, her first. It's a bit scary, and as uncomfortable as I am saying that it's a manic phase, I'm working from the definition I found on the aware.ie site.

---

The symptoms of ELATION are:

• F eeling - elated, enthusiastic, excited, angry, irritable or depressed

• E nergy - great energy, 'never felt as well', over-talkative or over-active

• S leep - reduced need for sleep and marked difficulty in getting off to sleep

• T hinking - racing thoughts, pressure in the head, indecisive, jumping from one topic to another, poor concentration

• I nterest - increased interest in pleasurable activities, new adventures, sex, alcohol, street drugs, religion, music or art

• V alue - excessive and unrealistic belief in one's ability, or having grandiose plans

• A ches - never tiring, being unaware of the physical symptoms of illness such as asthma, having muscle tension at the back of the head or round the shoulders

• L ive - thinking that one can live forever, taking reckless physical risks or, if angry or distressed, feeling suicidal

If 5 or more of the above symptoms are present for more than 2 weeks, it may be a manic episode, and professional medical advice must be sought.

---

She has the first 6 symptoms and also is spending wildly as well as being very very irritable when anyone tries to talk with her that something might be wrong.

She did go and see the doctor, mainly to get us off her back about it, but the doctor told her that she need treatment/care and now she thinks that we filled the doctors head with lies, somehow.

We are at our wits end and this is putting serious strain on the physical and mental health of the family members living closest to her.

What I'm asking for is people that have been in this situation, as a carer or a patient, to tell us what might work at this stage. How can we get her to seek care when she doesn't seem to hear what we are saying?

Doing nothing is not an option, she is often getting herself into unsafe situations.

Elessar

You cannot help someone who does not want to be helped. All efforts in this direction will be fruitless.

I don't mean to sound bad, but have you looked into sectioning? I don't know how the process works, but if someone is bad enough, they can be "sectioned" and forceably removed to a mental hospital. This may only be in cases where the patient is a danger to themselves or others though.

Xiney

I've had my mother involuntarily committed to a mental health ward twice, the first time I was just 14 so you don't really have to know what you're doing She was manic both times. Unfortunately, she's in Canada, so the protocol is different there and I don't know exactly how it works here.

However, I would say that contacting your sister's GP and asking for advice would be the best thing to do. They will be able to advise you on who to call in order to get your sister into care. Manic episodes (as I'm sure you've googled) are especially difficult for people experiencing them to get treatment for because they see absolutely not reason to - they feel GREAT! They don't realise how destructive their behaviour is. So they really do need to be put into care involuntarily a lot of the time, in order for them to come down from their mania and realise they needed help.


From Citizen's Information:

An application for the involuntary admission of an adult may be made to a registered medical practitioner by a spouse or relative, an authorised officer, a Garda or any other person. An authorised officer is an officer of the Health Service Executive (HSE) who is designated by the Chief Executive Officer of the HSE for the purposes of making such applications. Spouse does not include a separated spouse or a spouse against whom an application or order under the Domestic Violence Act has been made.

The following people may not make an application:
• Anyone aged under 18
• An authorised officer or Garda who is a relative of the person concerned or that person's spouse
• A member of the governing body (not including a member of the HSE) or staff of the approved centre concerned
• Anyone who has an interest in the payments to be made to the approved centre
• Any medical practitioner who provides a regular medical service to the centre
• The spouse, parent or other close relative of any of the people specifically mentioned above.

The person applying must have seen the person whose admission is sought within the 48 hours prior to making the application. If the application is being made by 'any other person', the application must include a statement of the reasons why it is being made, the connection of the applicant to the person whose admission is proposed and the circumstances in which the application is made.

LegacyUser

I've looked into that option a little and we've talked a bit about it in the family, but it's such a violent step that it scares me how much it could hurt the trust between us. In fairness, it doesn't scare me as much as how she could hurt herself at the moment, but if there were ways of getting though to her that might work, other things we could try.

For example, it might be zany, but the thought crossed my mind of all of us (family) in a room with a counsellor/facilitator/doctor of my sisters choosing, and us telling her what we were worried about and her having to talk to us all instead of playing us off one another as she is at the moment. Now the problem with that idea is that she would just storm out after two minutes, but are there other interventions like that which are not as violent as committal, but might work with someone in a mood like she is?

Xiney

Without knowing your sister I can't say for sure, but I know my mother would have never gone into care voluntarily. It was the only option open to us.

If you want to keep trying to get her into care voluntarily then I would still suggest going to her GP and asking for advice. But as I said before, people experiencing mania are completely in denial about their need for professional help. They are often delusional to the point that any attempts to convince her she needs help may be just as damaging to the trust between you as forcing her to go to hospital. It's never going to be an easy, "oh yes I can see what you mean, I'll get help" kind of situation because that is completely orthogonal to her current problem.

chuci

i work in a children's ward in a hospital and parents bring there kids into a&e and then they get admitted and get evaluated by child psychcologist's and social works have a chat with the family for support etc. I don't always agree with this as it takes up an acute bed in a children's ward, but if you have no choice and the family are are their wits end then it might be an idea. as for the trust thing I'm sure in the future your sister will thank you a lot more for helping her when she needed it rather than letting it get worse.

Greenmachine

Not easy for anyone here to say if it is in fact a Manic episode however if it is, it will need a qualified diagnosis, some observation and of our course some first person report. The best way forward for this is by the sounds of this is for her to be admitted for some closer observation. It is understandable that you don't want to section her but bear in mind that it may be nessesary and if needs be someone has to amke that call. Is there anyway that maybe she would be determined to say prove there is nothing wrong with her. Thta everyone else is cxrazy by say talking to a doctor in The ER.

bSlick

ScaredBrother wrote: »

One of my sisters seems to going through what must be a manic phase, her first. It's a bit scary, and as uncomfortable as I am saying that it's a manic phase, I'm working from the definition I found on the aware.ie site.

---

The symptoms of ELATION are:

I don't get it, what is so bad about your sister being elated? Elated means very happy, so what is so wrong with her that you are thinking about getting her involuntarily committed?

Oh The Humanity

Oh OP, that is so sad. I think you will have to look at getting her sectioned temporarily as she sounds she could be a danger to herself.

The red flag there is that she thought that yourselves had put ideas into the doctors head. That suggests a little more than mania/hypomania but of course medical opinions are needed.

You can get the community nurse involved and he/she will support both yourselves and your sister.

She sounds quite 'up' so I would err on the side more of over-reaction then underreaction. I know you are worried about breaching her trust but she is not herself at the moment and could do a lot more damage than just embarassing herself.

All the best.

Frelance

My best friend went through the same kind of thing your sister is experiencing. I cant really advise you on what the best way is to help her but if it she refuses to get treatment then you really must seek help. Commiting her can't be ruled out.

V alue - excessive and unrealistic belief in one's ability

This was the most worrisome trait in my friends behaviour. He started driving at excessive speeds/dangerous overtaking. He was a danger to himself and others.
He knew himself something was wrong and thankfully agreed to get treatment.
Does she drive? it can manifest itself in pretty wierd ways so you really need to keep an eye on her.

LegacyUser

bSlick wrote: »

I don't get it, what is so bad about your sister being elated? Elated means very happy, so what is so wrong with her that you are thinking about getting her involuntarily committed?

I understand the question, but I want to stay anonymous for her sake, so am cautious to give too many details.

I want her to be happy. She's a very fake happy at the moment.

She's out almost every night, at some club, generally with a new bunch of friends, which last a few weeks. She flits from circle to circle of new friends and her old friends have been hurtfully flung off. Constantly changing temporary boyfriends, I'm afraid she's going to end up in the wrong situation with the wrong person and get seriously physically hurt. I'm scared for her.

She has changed from being a mature, prudent person, into someone short tempered, arrogant and careless. Another big change is the amount of money she's spending. Literally thousands on things that she would never have bought at any previous stage in her life.

Guilting family members into doing things with her - such as going to parties with strangers, because if they fear they abandon her that she'll be alone and unsafe.

marthaclark

This is so hard for me to read because I feel like you could be the brother of one of my friends who is going through the exact same thing.

Could you get her to go to another doctor? (Maybe without you speaking to the doctor first?)

If the doctor diagnosed, and she refuses medication, I don't see how you have any choice.

The risks to her safety are far too severe.

My friend is most likely suffering the same thing, and is self medicating with drugs, (specifically xanax, marijuana and cocaine), alcohol and completely unsuitable men who probably also have mental health problems.

I would rather see someone I cared about sectioned than have to regret not doing anything about it.

I know this is a horrible, horrible situation but if your sister is anything like my friend, she is putting you through the mill and lying to you from all angles.

If that's the case, she's leaving you with no other option.

LegacyUser

http://www.mhcirl.ie/Mental_Health_Act_2001/Service_User_Information/Your_Guide_to_the_Mental_Health_Act_2001.pdf

The above booklet explains in detail the whole procedure involved in having someone admitted to hospital involuntarily.

There are over 2000 involuntary hospital admissions each year in Ireland, so most GPs will have a working knowledge of the system and should be able to advise your family on the best course of action if this is necessary.

Good luck.

sam34

OP, you need to get your sister assessed medically.

step one- talk to a gp.
ask about making an application to have her assessed under the mental health act. there is aform you will have to fill in - gp should have this form.

gp then has to see her within 24 hrs. dont worry if she wont go to gp, he has to see her so he will do a house call if necessary.

then he signs his form, and she'll be brought to hospital for psychiatric assessment and further treatment.

if your sister is manic, she will have impaired judgement and reasoning, and thus wil be beyond rational counselling/talking. also, the likelihood is that she will deteriorate further without treatment. manic episodes generally do not resolve spontaneously.

she needs treatment, and as she will not get it for herself, she needs her family to seek it out for her.

good luck, hope things work out ok.

sam34

chuci wrote: »

i work in a children's ward in a hospital and parents bring there kids into a&e and then they get admitted and get evaluated by child psychcologist's and social works have a chat with the family for support etc. I don't always agree with this as it takes up an acute bed in a children's ward, but if you have no choice and the family are are their wits end then it might be an idea. as for the trust thing I'm sure in the future your sister will thank you a lot more for helping her when she needed it rather than letting it get worse.

i odnt understand your point here - are you suggesting taht someone with an acute psychiatric illness is less deserving of an acute hospital bed than someone with a physical illness???

people with mental illnesses need acute inpatient care at times, just as those with various physical illnesses do. just because they dont ahve a visibky broken leg/seizures/whatever does not mean they are not in need of acute care

LegacyUser

I have had to get a friend committed a number of times when he went manic.

It is the strangest situation to have to deal with , certainly the first time.... the second, third and fourth time just start getting annoying.

Firstly, get her credit and bank cards from her and hide her car keys. Get it done - she;ll thank you for it later.

I think your friend has to maybe go a bit further off the rails though for her to see, when she eventually returns to normal, that you were doing her a favour.

I caught my friend;s last attack before it got fully blown.... I started picking up some signals but he was very sneaky as he knew that I basically had the power to get him committed... I said it to him straight "I think that you're having a manic episode and that you need to see your psychiatrist". I called the Shrink and told him what was going on.... he prescribed pills and I made sure he took them. He had convinced his folks he was fine -I knew him too well to believe him at that time. Luckily this time we were able to keep him out of hospital.

And remember, she will return to normal. It will be fine once it is dealt with swiftly.

Then you need to get her to see someone regularly and get the right medication for her to control the swings... My friend is on a new pill which he says works better than any of the previous one which gave him spots and made him feel numbed...

I hope you have family support and support from other friends as it will take it's toll on your own sanity for a while. Spread the load if you can... you may need to take breaks from her craziness if a while.

As for sectioning being violent: sometimes it has to be done for their sake... best of luck with this. Having had to deal with it again with a friend last year, I understand what you are going through.