Expert: Libby Bonner - 9/15/2004

Question
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Dear Sir, Hi! Thankyou once again for your great reply. Sir, the homeopath residing in states is not at all charging a penny and a quick responder. I know he is trying seriously for her. Its just that I have not yet seen much results.

She is still having her menses, is just 32 yrs old. But you are right I have often noticed her to be having a touchy mood usually just before. But not always. And she mostly has backache and bodyaches before occurance. Whenever tense or about to get tense, I see that she informs about body ache, or just either left or right side in pain. She has had a disturbed childhood, as parents got divorced when she was very young, so she kept on switiching between two, father was good to her but then she lived with mother who has never had love for her children the way mothers do, she also got married to a guy who also used to maltreat all the kids. So this has also put some good effect on her mind. I have also seen her school reports when she was around 13-14 yrs where teacher wrote to guardians that she is often seen sitting separate and not mingling with other kids.

Sincere regards sir, I really appreciate.

Faisal


Followup To
Question -
I had send a follow up reply...which I again paste as below. Thanks a lot once again Sir.

Dear Sir, Thanks alot for your emotional support and guidance. Your suggestions have been great. I will look for the books mentioned. I doubt the legal system here is not as protective as is in the states. Surely the situation would have been much better if I were there too. Sir, I will seriously look into all that you wrote and would like to stay in touch with you. I just read your email and would also visit the webistes you mentioned. Sir, Do you think the homeo medicines would be effective in this case. I have one doc who is online treating her all the way from States and is quite hopeful. Just asking on the basis of if you have ever had any feedback.

Thanks alot once again. You have been great and doing a great job by being a support to others you dont even know for no personal interests at all.

Regards

Faisal.




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Followup To
Question -
Dear Sir, Thanks alot for your emotional support and guidance. Your suggestions have been great. I will look for the books mentioned. I doubt the legal system here is not as protective as is in the states. Surely the situation would have been much better if I were there too. Sir, I will seriously look into all that you wrote and would like to stay in touch with you. I just read your email and would also visit the webistes you mentioned. Sir, Do you think the homeo medicines would be effective in this case. I have one doc who is online treating her all the way from States and is quite hopeful. Just asking on the basis of if you have ever had any feedback.

Thanks alot once again. You have been great and doing a great job by being a support to others you dont even know for no personal interests at all.

Regards

Faisal.



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Followup To
Question -
Dear Sir, Thankyou for your reply. I live in Pakistan. The doctor earlier who prescribed to her was a psychiatrist but she did not know. She says very strongly that she will not take any antipsychotic medicines. May take if told that the medicine is homeopathic. Yes books in english are easily available. Yes I can have access to weltrained psychiatrist. I really aappreciate your reply. Regards

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Followup To
Question -
The problem which I would like to share with you is about my wife. She has psychological problem. Earlier she was diagnosed to be having a Bipolar Disorder and later another doctor said it is Schizophrenia.
The problem with her is that she has become negative minded. People talk positively and she takes it negatively. When she doesn't like something, she may leave the party immediately. Then keeps on shouting and screaming for 3-4 days and hates that person. That person may not even take a guess what was wrong he or she had said. If I try to explain at this stage, she gets more hyper and starts shouting at me, if again argued at this stage, she gets violent, then she has to be handled like a child.but still when she realizes what she did was wrong, she never says sorry or admits. Once she had misunderstood someone's statement, I tried to explain, then she thought I am favoring others not her, and then she left the house and started shouting at them in front of the whole neighborhood. She could get so hyper that may even kill a person.

when in a good mood, she is very good nature wise, likes to give gifts to the people she like, help them etc. In initial meetings, she is very polite but if the frequency of meetings increases, then I am always sure that something will happen, whether it be her friend, her family, my family, neighbors etc.

Only beginnig last year, she had started taking allopathic treatment, risperdal 1mg daily.used it for 3months.had somewhat improved but initially saw no results.then she left it because of the side effectsspecially sedation and moreover she doesnt agree that she is sick. now she doesn't want to use allopathic medicine for this again.I am giving her homoe medicine , whihc she takes but not so good results as yet. She also has pain in body usually and it was for this reason that she agreed to see with me adoctor who gave her risperdal not telling its a psychotic medicine. We have one child whose seven plus now and is very much effected by her such nature.
Please advise if you can be of any help. Please note that she will not take sedative medicines. She is teaching motessori students now and also drives.

Answer -
Will answer fully later today, but I have questions: in what country are you [it might tell me something about services available to you] and can you easily buy English-language books?  Do you have access to well-trained psychiatrists  --  and what type of doctor prescribes for her?
Answer -
[Here is a note I came back and added after my long answer.  I did not mean to imply that there is anything wrong w/ any doctor who has diagnosed her.  Getting a correct psychiatric diagosis is a matter of trial and error, sometimes, since there are no laboratory tests for mental illnesses....and since patient behavior sometimes varies between one appointment [to the doctor] and the next.  So it does not dismay me that she have been given different diagnosis.  And, as my long answer implies, getting the right medicine and the right dose also is a matter of some good guessing and observation.  --- This of course complicates your situation, since we have your wife who wants NO medicine but may, to be truly helped, have to endure the long delays that often accompany: finding the diagnosis; finding the medicine or medicines, and the doses.  How much simpler if we could get her agreement to be treated and then get the right diagnosis and only a  single medicine immediately!]
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Addressing the issue of illness denial.  Get the book by Amador called "I am not sick; I don't need help."  He says that some people ARE denying but that some quite honestly believe themselves to be well.  But regardless, his point is to forget arguing with the pt about whether or not they are ill.  Find any grounds on which they are willing to take the medicine they need and let that be the reason.....and leave aside the whole issue of illness.

For instance, at some point your wife's job will likely be in jeopardy.  Then the question is: if you take this medicine [to control anger, perhaps] you will be able to keep your job.  Or - you will be able to continue to have contact with your child, continue in your marriage if you take medicine.  Find the things that matter and use them as the reasons for the medicine.

Apparently you have seen her angry and violent enough to be afraid - for yourself or for others.  Until and unless her unpredictable violence can be controlled, you are at genuine risk.....and you should take any and all appropriate protective measures.  [Like, I am sorry to say, giving some thought to leaving the marriage for awhile.]  I think by now you know some of the things that will always upset and provoke her and - whether her actions and behavior are right or wrong - you would do very well to take an agreeable attitude toward ANYTHING she says when she is violent, as a self-protective measure.

Then there is the central point:  what is her diagnosis?  Without a correct diagnosis, there can be no correct treatment.  It's possible, for instance, that she is schizoaffective, having some of the characteristics of both bipolar disorder and schizophrenia.  [I am acting now as though getting her into treatment isn't a problem, just in order to give you information.]  I wish I could tell you that there are effective drugs without side effects, but that's not true....and most of the appropriate drugs have noticeable and somewhat unpleasant side effects:  she would be likely to want to stop taking most of the effective drugs.  [I wonder what we can conclude from the 3 mo on risperdal.  Maybe nothing, or maybe: she didn't do better because another similar drug might have worked better, but it could also be that it didn't work better or sooner because either the dose should have been raised at some earlier point OR that risperdal is not a drug ever used for her true diagnosis - whatever it may be.]

Here is the likeliest thing that would happen here in the US, in your situation.  The husband might or might not leave and the wife would eventually get so crazed and sick that she would do the sorts of things that would either get her jailed or put into a hospital.  And it's not unlikely that that's how your story will go.  --- What we have not talked about is your laws there, and here.  Here, if the family is willing to have their sick relative get even angrier at them, SOMETIMES a court of law will order a patient into the hospital on the basis of evidence submitted by the family or doctor: the court will order the patient "committed."  [Committed to treatment.]  OR, alternatively, the police may simply agree that a person is 'a danger to themselves or others' in which case, esp is the person is making a big public disturbance, the patient  is put into hospital for 72 hours of observation, during which the decision is made to admit and treat the patient  or release her.

So my next piece of advice is to consult with the doctor and with a lawyer to see what legal choices you may have.

In difficult situations like yours, it is so helpful if family can listen to others who have faced similar problems.  Here, there is NAMI, www.nami.org.  There is a similar international organization, I hope present in Pakistan, that helps patients and families involved with the serious mental illnesses.  
www.world-schizophrenia.org   They definitely deal w/ all of the mental illnesses.  If you could find anyone in your own country w/ whom to talk or email, it would be so helpful.  That organization, by the way, has a wonderful free book on schizophrenia that you can ask for.  Title is "Rays of Hope."

Another book that I would like to recommend is by Woolis:  "When someone you love has a mental illness." It is about the practical aspects of family life w/ a mentally ill person.  It will cover communicating in ways that are clear and non-angering, and it also covers setting limits on the behavior of persons who are ill.  There is also a section on dangerousness.

The other and obvious thing to say, which you appear to know, I think? - is that you cannot reason with a person who is irrational.  If she continues to be unmedicated, the best steps to take would be to limit social contacts, perhaps, and to see that those with whom she will have regular contacts [closest family, perhaps] have read the book by Woolis and understand how to deal with her.

It's very important for you to get in contact w/ other families...I hope that will come about.  They will understand you and your situation.  Probably one of your biggest problems right now is that your family and friends all have many different ideas about what's wrong and what should be done and, probably, even whose 'fault' this is.  Until she can be on medicine, or the situation is resolved in some way, be strong in your own understanding of the truth of the problem - and politely let others with differing views know that you are not needing their advice right now.  Find allies, and don't be further upset by unwanted, wrong-headed advice.

How have I helped you?  Not at all in the ways that you would wish, I'm afraid.  The fact is that adults who are mentally unbalanced and who wish to remain that way are usually able to.....despite the wishes of loved ones, until some disaster finally comes.  So - get the books if you can and make what use of them you can; get in contact w/ the online organization; talk to the doctor and a lawyer....and then think about what is possible; what is likely; what your daughter's needs are.

I hope a good solution will arrive soon, and I am terribly sorry not to have a miracle to offer you.  These are such difficult and sad situations, and I do know how stressful and anxious you are right now.

Go in some of the directions I have suggested as you try to find solutions.  Please feel free to write again.


Answer -
allexperts says there is still a question waiting, from you...but I am reveiwing all our material and don't see anything, from you or me, that is new.

Do you have a question pending to which I have not replied?  If so, apologies, and please re-submit.
Answer -
Thanks for re-sending.  I'm terribly sorry to have kept you waiting - I must have clicked the wrong thing and my answer didn't get to you...

I have some positive feeling about homeopathy but many reservations about its usefulness for mental illness.  My greater concern is that this is an unknown guy on the Internet, and I hope he is not cheating you and charging you huge amounts of money.  Or making big promises.  As I had written in the email that didn't get to you, I would be glad to look his site over if you wish.  I do have a medical background of sorts.....

As long as this treatment doesn't cause harm, and given that you have a resistant patient, you have few other courses open to you right now .  And so I guess I would continue on.

But I would certainly pursue any and all other options that we have discussed.  

One thing I hadn't suggested might prove helpful at the point where she seeks, or is forced to seek, psychiatric care: you could keep a careful 'log', a brief written record, of her behavior day by day.  You might see useful patterns yourself....and it would have future value to a doctor in trying to get an exact diagnosis quickly.

Let me also ask quite a frank question.  Is your wife pre-menopausal?  Do her symptoms worsen at ovulation and/or just prior to or duing menstruation?  [A log will help you know, if you don't already.]  If everything is worse at these times, perhaps you can have an influence on how much social interaction occurs at these times, when her behavior is likely to worsen - keep her from others as much as possible.

There is also the related question of whether she has premenstrual syndrome, PMS.  [She could have PMS and a mental illness, or either alone.]  Treatment for PMS is still not very good, despite its widespread occurance...but perhaps do some research online about PMS and see if that advances your options any.

This time I will click correctly and it will be on its way to you.

Answer
From your new information, I suppose one might consider Post-traumatic Stress Disorder.

Don't know what about the body pain/s.  If they have been ingored by family [you!] maybe some sympathy and special attention would be good......but you don't want to be accidently teaching her to use "pain for gain" esp if the 'pain' is maybe real, maybe not.

She might feel better to talk of some of the past distress w/ someone - a qualified someone free of whacky ideas - but I don't know who in Pakistan.....unless that schizophreniz-world organization can either link her to other or you to therapists.

You must have physical therapists there?  What if her regular doc referred her to some physical therapy for these pains.  Then she would be given some exercises to do and might then be taking some responsibility for her wellness.

I must go - no time even to -re-read.