Expert: Ivan Goldberg, M.D. - 7/18/2010

Question
QUESTION: Hello, how are you going? :-) My name is Christina and I live in Australia. My Mum has got bipolar disorder and schizophrenia and my sister has got schizophrenia. I am very lucky that I didn't get anything and my Dad is healthy too, so me and my Dad look after the other two. My sister is in a place that they call assisted living, and she hears 3 voices who all tell her what to do all day which is usually do nothing and just pace up and down all day. They also tell her to hurt herself which we all tell her not to listen to them. She is on lots of medication and has a whole team of medical people to help her, but she is getting worse instead of better. Is there anything I can do to help her get better? Also, my Mum has got schizophrenia and bipolar disorder and she always crys and gets upset, so she is going to respite for 2 weeks as her doctor said to. Do you think this will help her? Thanks heaps for your time, I do appreciate it a lot:-) Kind Regards, from Christina

ANSWER: HI Christina . . .

I don't know how much I can help you with your sister's situation as I am an expert regrading bipolar disorder. The one thing that comes to mind regarding her situation is that people with hard-to-treat schizophrenia often do weal when treated with clozapine.

MY understanding of a respite hospitalization is that it is a hospitalization that is arranged to give family care givers a respite from providing care to their sick relative. Such hospitalizations are often quite successful.

Best regards . . .

Ivan
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---------- FOLLOW-UP ----------

QUESTION: Hello, and thanks heaps for your help, I do appreciate it a lot. My sister is already on clozapine, so I hope that that will make her better one day. I was just wondering, you know how people with bipolar disorder always say they don't want to live any more and they say they want to kill themselves when their mood goes down, is it best to leave them alone, or to disagree with everything they say and tell them that everyone with bipolar disorder says that but then later they will feel better again? Thanks heaps for your time, I do appreciate it a  lot :-)

Answer
Hi . . .

People who are depressed have many hopeless thoughts that lead them to become suicidal. It is important that people who are suicidal NEVER be left alone. What I often say to such people is something like, " I know you are thinking many hopeless thoughts. Because of the hopeless thoughts it seems that ending your life is the right thing to do. While the hopeless thoughts all seem true to you it is important for you to remember that they are false thoughts that are a product of your depression While you cannot imagine things working out well, people with severe depression always get better if they don't kill themselves."

Best regards . . .

Ivan
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