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Thursday, March 8, 2012

Dire Straits with Full-Blown Bipolar Mania

About a week ago a friend in Oregon called me for some advice.  She was very concerned about her brother.  He unexpectedly showed up at her house in a full-blown mania.

Yes, we're talking all the good stuff.  He had delusions of grandeur, nonsensical ramblings, tangential references to God, and frequent, bizarre ranting about things from his past (presumably unresolved issues).  Along with the manic thoughts there were other tell tale signs like racing thoughts, fast/pressured speech, hyperactivity, agitation, pacing, confusion, and the like.

My advice was straightforward: (1) call 911 immediately, (2) explain to them that it is a mental crises so they bring in the mental health team, and (3) work with him to get either a voluntarily or involuntary hospital admission.  

As expected he was found a danger to himself or others and ended up in a 5150 (involuntary hospitalization).  I didn't get specifics about what happened.  I can only imagine.  

This was my first involvement in a mental crisis situation from the perspective of a concerned person trying to help a family dealing with a mental health crisis.  Prior to this my experience with mental crises was about me getting the 5150!

The hospital health team say he is slowly improving but the psychiatrist called for an additional two weeks of hospitalization.  They want more time for the medications to take effect.  Since he objected to the longer stay a mental health court will be assembled to ascertain whether he is okay to be released or should stay longer.

My experience with these mental health courts has been interesting.  Twice I found myself in a 72 hour involuntary hold for acute mania.  And both of those times the psychiatrists attempted to keep me an additional two weeks.

Well, I would have none of that, objected the physician's advice, and had the mental health court convene.  I did this twice and I won both times!

In each case I had already been treated for "blatantly" acute mania in the three days prior.  This caused my mania to subside enough for me to do my thing for the court.  I put on my "I'm okay" face, act mild mannered, acknowledge the behavior that got me hospitalized, express my concerns that I'm okay and do not need additional hospitalization, and answer questions from the judge.

As I said this happened twice, once in 1997 and again in 2002.  Each time the court was convinced I was able to take care of myself and should be released!  Yay, good for me, but I really wasn't fully treated, especially in 2002.

I don't know what the court's assessment of his condition will be.  If he can keep it together for 15 or 20 minutes and say the right things, then it's likely he'll be let go.  But if manic thoughts creep in during court he may be unsuccessful.  I am curious.

The family wants him hospitalized for another two weeks.  I can see why based on what they told me about his madness.  He (as with most who are involuntarily hospitalized) loathes the idea of more psych hospital time.  He probably feels "fine" according to himself but has not been fully treated for the acute mania.

I hope my experience with mania and involuntary hospitalizations provided information that was helpful to them.  It is terrible the family has to deal with the insanity of his bipolar illness.  It was good for me to experience the "other side" of mania, from the family's perspective.  

I've now seen a glimpse of what I put my family and friends through during my manic episodes.  I don't like it.  I am fully committed to never getting full-blown manic again.  It's simply to destructive and dangerous.  


  1. Hi.
    I´ve been in hospital about 10 times. Sometimes 14 days, couple of times 3 months. (When I was really bad condition.) At first I hated to go hospital but now I know myself when it´s time to go. Only call to my doctor and he makes it posssible. It´s a big step to me that I know when I need a hospital. That I dont need anyone to say that now you must to go. It´s easier to accept to being in hospital when knows that really needs it. Right now Im deeply depressed, tired, anxious. I´m in "daytime" hospital. Nights Im at home and 6 hours a day Im in hospital. it´s a good to me and specially for kids. They suffer so much when Im in real hospital and it takes weeks that we meet each other. And when Im in hospital Im usually so bad condition that its better that kids don´t meet me. But I like your blog Jeff ;). It helps me a lot. T: Päivi

    1. Hi there, good to hear from you! It is really good that you know when it's time for inpatient care. I'm glad the outpatient (daytime) hospital is working for you. I did that once for two weeks and it certainly helped. I'm very pleased that this blog helps you! It is good to hear. Take care.