How can I help my bipolar client?

Lifestyle factors which occur when someone is struggling with bipolar may well affect physical health. It is true as well that a lot of ppl with MH issues in general smoke which is a factor in physical health. The important thing is he is where he needs to be. It might be good for his psych and cardiologist to liaise with each other about treatment.

Cracked

That's a good suggestion. I'm going to bring that up.

He doesn't smoke though or even drink which is good.

It is really good he does not smoke esp and a lot of ppl with BP find it beneficial to give up alcohol so that should mean his not drinking is a bonus. Yeah cooperation between different professionals is a good idea to encourage as this means he will be getting more well rounded care

Cracked

Given that you are his main source of stability and direction during the day, I think you should ask of his family to go to his psych appointments with him, or to have separate sessions with his therapist so they can advise you how to best help him. Every person is different, every background is different. My daughter is ADHD and ODD, but I have had sessions with her shrink on how best for ME to help her, to handle her, to best guide her. Those sessions were invaluable and came directly from the therapist who knew her best. The poor guy has a lot going on right now with his health. By speaking to his doctors, you may realize he has been exhibiting signs of something that you need to share with his children in order they may help him. It could be a certain idea or a phrase he uses, it could be a certain movement he may repeat. It could be a variety of things you don't realize mean anything but his doctors or his children may recognize them as notable. My husband went to therapy sessions with me and it helped him realize what he could change/do or not change/do when my BP flairs. It was very helpful.

So far I have been going to his psychiatric appointments with him, however perhaps sessions just for me and the doctor would help too.

harrydubois wrote:So far I have been going to his psychiatric appointments with him, however perhaps sessions just for me and the doctor would help too.

Gotcha. Maybe at his next appointment, you can quietly ask the doc if a separate session for you to help him would be beneficial. The doc might say no. I'm sure this requires approval from some person (the client, the family?? HIPPA laws) so be sure to speak to the family about it as well.

Best of luck to you and your client!!

That's a good question - how does HIPAA apply to someone who is delusional?

By the way, he is extremely stubborn, proud and independent. If he would just do what experts advise him to do he would A LOT better off. But he's got to do things his way. For example, during his most recent depression, his doctor recommended ECT. He refused and stayed depressed.

Hi Harry.

I'm an RN, previously CNA, (and bipolar)... I understand how hard it is to connect with psychiatric patients. (I can relate to myself but the others are difficult to me.) Props for joining the psych field.

I think a big thing about this is that the medications do kill that exciting thrill of wanting to do some big project during a mania. Sometimes I think being depressed is worth it. This guy sounds very different from me, but I can give some limited advice. For me, first thing to happen when i'm going into an episode is sleep. Manic- don't need as much sleep, depressed, need lots of sleep. Report to RN right away. The other symptoms may follow. If you talked him into the healthy diet and gym, that's huge! Most people really don't like to do that anyway. (Bipolar aside.) Good aides know their stuff- what you learned in CNA school is fine, but being educated about illnesses doesn't hurt either. A lot of nurses may disagree with me on this, but as long as you know that you're not the one to call the shots, (let the RN or doctor do that), you will know what symptoms are important to report and help the medical team get a better idea of the whole picture.

Having a creative outlet is nice, he may want to be creative on meds, to feel that he hasn't lost that spark. Be careful about that though, (for me it can be a trigger and make me want to go off my meds again, I think the same is true for others.)

Edit: Sleep abnormalities may not be an early sign for him, but everyone has early warning signs, have to find out what they are and be really quick to nip them in the bud.

That's very interesting. Thank you. My patient was just discharged for his heart attack. He had two stents inserted through the radial arteries and he's doing very well.