Delusions and Bipolar Disorder: Helping a Loved One - Psychiatry

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Delusions, obstinacy, bipolar disorder?


Hello, doctor.
My father had a history of depression and bipolar disorder several years ago.
His condition had improved over the past few years, but recently, due to significant work-related stress, it seems to have relapsed.
However, he does not believe he is ill and refuses to seek medical attention.
Recently, he has fallen victim to multiple scams, despite being aware of the tactics used by fraudsters.
He continues to believe that a beautiful woman from abroad wants to come and marry him, which seems to resemble "erotic delusions." Each family member has tried to persuade him, but it has been extremely difficult.
I would like to know if this situation qualifies as a delusion and how we can help him.
Is medication treatment an option? Are there any over-the-counter medications available at the pharmacy that could help?

Jane, 20~29 year old female. Ask Date: 2022/09/27

Dr. Qiu Junda reply Psychiatry


Hello.
If there are signs of an episode, regardless of whether there are delusional symptoms, prompt medication treatment should be initiated (over-the-counter medications are not appropriate).
You can contact the hospital where you previously received treatment for an appointment.
If the individual refuses to seek medical attention, family members can discuss possible options with the physician (such as prescribing tincture medications) to stabilize the condition as soon as possible.

Reply Date: 2022/09/27

More Info


It sounds like you are facing a very challenging situation with your father, who appears to be experiencing a resurgence of symptoms related to his previous mental health issues, specifically bipolar disorder and possibly delusions. Understanding these conditions and how to approach them can be complex, but it's crucial for both your father's well-being and your family's peace of mind.


Understanding Delusions and Bipolar Disorder
Bipolar disorder is characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). During manic phases, individuals may exhibit increased energy, reduced need for sleep, and impulsive behaviors. Conversely, depressive episodes can lead to feelings of sadness, hopelessness, and a lack of interest in activities. Delusions, particularly in the context of bipolar disorder, can manifest as false beliefs that are strongly held despite evidence to the contrary. In your father's case, his belief in a romantic relationship with a foreign woman, despite being a victim of scams, suggests a delusional thought process.


The Role of Family Support
Family support is vital in managing mental health conditions. It’s important to approach your father with empathy and understanding. Instead of confronting him directly about his delusions, which may lead to defensiveness, try to engage him in conversations about his feelings and experiences. Express your concerns without judgment, and emphasize that you care about his well-being.

Encouraging Professional Help
While it can be difficult to convince someone who does not believe they are ill to seek help, it is essential to encourage your father to see a mental health professional. You might suggest a general check-up with a physician, framing it as a routine health assessment rather than a mental health issue. If he is resistant, consider seeking advice from a mental health professional on how to approach the conversation.


Medication and Treatment Options
In terms of treatment, medication can be an effective way to manage symptoms of bipolar disorder and delusions. Mood stabilizers, antipsychotics, and antidepressants are commonly prescribed, but these should only be administered under the guidance of a healthcare professional. Over-the-counter medications or supplements are generally not effective for treating serious mental health conditions and could potentially interfere with prescribed treatments.


Crisis Situations
If your father’s delusions lead him to engage in risky behaviors or if he shows signs of severe distress, it may be necessary to seek immediate help. This could involve contacting a mental health crisis line or taking him to an emergency room.

Building a Support Network
Encourage your family to be involved in your father’s care. A support network can help monitor his behavior and provide a united front when discussing treatment options. Sometimes, hearing concerns from multiple loved ones can have a greater impact.


Conclusion
Navigating the complexities of mental health, especially with a loved one who is resistant to treatment, can be incredibly challenging. It’s important to remain patient and persistent, focusing on open communication and support. While you cannot force someone to seek help, you can create an environment that encourages them to consider it. Remember to take care of your own mental health as well, as supporting someone with a mental illness can be emotionally taxing. Seeking support for yourself, whether through friends, family, or professional counseling, can provide you with the tools you need to help your father effectively.

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