Updated: May 13
A sister, nurse, & healthcare provider perspective. Our family journey through my brother's diagnosed Bipolar mania, depression, substance abuse, & sobriety. Behind the scenes with a nurse, her brother and managing mental health....
Let's Get Real Here, Mental Health & Substance Abuse.
The Most Taboo Topics as they come.
Yes Taboo. Even for us in the medical field. Yes as a Nurse, substance abuse & mental health disorders are still stigmatized. Yep, I said it. This it is a sad, yet a true fact. Hence my passion to write this blog! If a patient lands themselves in ICU bed due to a heroine overdose or drunk driving accident, as providers, we must set aside our judgements and heal them no matter the cause. However, often we find it hard to sympathize. Honestly, this was the case for myself! If a mother landed herself in an ICU, in preterm labor with a NICU baby, you bet my head went to judgement and frustration.
Well, that was the case until my brother landed himself in an ICU bed after his first (of several) near fatal car accidents. I thank god for the nurses who helped save his life (with no, or limited judgement). His blood alcohol level was far above the legal driving limit & to this day I am thankful he is still alive.
But Let's Take a Step Back
Let me give you a quick recap of my younger brother Vince. We grew up close. He is 13 months younger than myself & I would consider us, "best friend" kind of close. Even in high school. We were a package sibling deal with so many of the same friends, dances, parties etc. We separated during college days. I went to University of Arizona, and my brother went to Fresno state.
Lovable Vince Recap:
- 2 college degrees from CSFU (Agriculture & Construction Management)
- The guy every mom LOVES.
- Funny & charismatic.
- Farmer & construction builder.
- Athletic & a "Mans Man" (he can swing a hammer and rebuild a car blindfolded).
- Loving & Cunning
- Handsome & Stronger than an Ox
- Also, Diagnosed Bipolar 1 & Recovering Addict.
Bipolar Manic Substance Using Vince:
But let's talk about the monster of my brother. The one I hate to relive. This is the brother who managed to land himself 3 DUIs, several stints in county jail, was fired from one of the best construction companies in the nation, wrecked (not one, but two) cars in near fatal car accidents, ruined two great relationships, destroyed family trust, had his license revoked, was stripped down to nothing at the age of 27. The reason? It is two fold.
First, he is living bipolar, & the second was substance abuse. And when I mean substance, I mean all of it! Alcohol, Adderall, Weed, Cocaine, Uppers/Downers, Hallucinations (shrooms), etc. Anything he could get his hands on to alter the mind.
Vince was officially diagnosed Bipolar at the age of 25. According to Mayo Clinic, "Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression)." Definitions are cute & all on paper.
But let me explain to you what we experienced.
How Bipolar Looked to His Vince's Family
My brother was a monster of himself. The most selfish, egotistical, rotten to the core monster of Vince. A person who had no license but still managed to buy a car off the street. A person who continued to wipe the family of funds in various ways (court hearings, lawyer fees, selfish endeavors) someone who was so blinded by his motives, no one else mattered (even his sister). A monster who was aggressive, scared girlfriends, used manipulation to get what he wanted. Bipolar had literally stripped away my best friend. The younger brother I had grown up with, the person everyone loved & laughed with.
The irony about this disease... he loved his "manic phase" as many do. There is nothing like it. You feel like a super person of yourself. No one can stop you or tell you no.
Something we (as a family) learned and took to heart was understanding this disease. It had its place in history! So many warriors, people of interest, world leaders, famous historical icons (Napoleon, Hitler, War Hero's) most likely struggled through mental health issues such as Bipolar. Leading a war, conquering a nation, settling the people, and then going into remission for months to recoup. Sound familiar?
I urge you to listen to Episode #4 & Episodes #12 of this podcast to grasp a better understanding. We speak about this on both of these Podcast episodes.
The "euphoria", I don't call it that, I just call it fire. Because it is something I feel right in the middle of my chest. And I have done a handful of drugs & alcohol. There is no drink or drug that matches what mania feels like. It's like fire in your chest. And you are just bulletproof. I can literally do anything and I don't think about consequences of my actions. I definitely don't think about anyone else. I don't intentionally do anything to harm others, but my own well being...I don't give a crap. That fire is something that is so pleasurable, you never want to come off it. That is why without meds, I wouldn't be able to physically change my brain chemistry and get that dopamine out of your head. ~ My Brother Vince
Let's fast forward 3 years.
Currently, my brother is 3 years sober, has regained his license, regained family trust, landed himself a great job in construction and is now running our family ranch again. He has an amazing girlfriend who understands his disease and diagnosis & has regained his happy go lucky personality. I am so thankful for this. He has truly built a new life for himself. Worked out the right regime of medications and become a leader in mental health. And yes, we learned a few things along the way. So I thought I would divulge.
1. Mental Health Comes in Many Forms
I will tell you, as healthcare providers, we learn about mental health but often times it is unrelatable. The books can only tell you so much. They can give you a vague description of a disease process, but until you experience the true nature of a mental health disorder, it is not relatable. For many people believe having bipolar means simply dealing with alternating very high and very low moods, but there is so much more to it. During a manic phase, the person can experience delusional hallucinations, euphoria, increased energy, erratic behavior etc. which can be terrifying. During a depressive phase, the person may become very forgetful or indecisive. It isn’t as simple as “today I’m happy, tomorrow I’m sad”. It can be life-threatening. So please, the next time you crack a “bipolar joke” – bear this in mind.
2. Bipolar is the Best Friend & Worst Enemy
During a manic phase your loved one may be on "cloud 9!" Like a rain shower in a drought or an avalanche on a mountainside village, it is extreme. In all honesty, for many diagnosed, it can be refreshing & also bring with it a range of creativity which leads to destructive behavior leading to a hard to rebuild from in the wake of its damage. This was diagnosed after a period of both depression and hypomania (a lower level manic episode characterized by a huge amount of energy and disinhibition) spanning over a year.
3. You Can Love Someone to Death
Often times, it is hard to let go as a family. To give up the reins to a "professional" and allow them to take over. You can’t always be there for someone struggling – and that’s ok. Many parents (including mine) had a difficult time letting go. Allowing the professionals take over and help in a way that even a blood relative, or healthcare provider can not is important. But I can honestly say, it wasn't until we completely let go and had The Last House Take over, were we in a better place. Honestly, we were so ready for the help, and in true Crisis that their help was welcome. The Last House.
4. It Feels Great To Be Manic, Why Would You Stop?
Imagine yourself getting drunk, but without any alcohol. You feel lighter, talk more easily & you feel more daring than usual. As it progresses, your judgment begins to cloud. You overestimate yourself. Strangers are suddenly friends. Reality begins shifting – you start perceiving things you didn’t perceive before. In my case, I had a million thoughts and ideas rushing in, which I felt I needed to express. This is a similar idea to what it feels like to be manic.
A perfect example: "I painted 10 paintings in a row and wrote 60 pages on a creative project. Put on bright colours and felt like everything I did was divine. I thought everybody else was stupid because they didn’t understand my ‘genius insights’. I became psychotic. I posted a lot of weird and embarrassing things on social media and texted people inappropriate or random messages. I wasn’t aware what I was doing during that episode – I had lost my rationality and sense of inhibition. By the time my family noticed I was not being my usual self (I was living abroad), I had already lost connection with my body. I barely slept or ate. I shifted between feeling extremely scared to aggressive, overly sexual or outgoing, and believed I was totally fine. I stopped looking after my body, believing that I could not die. I eventually ended up in hospital to be treated." (Time to Change, Blog)
Coming Down From Manic Episodes
Needless to say, “coming down” from mania is very tough and confusing. Some need to realize what had happened and apologize for the things they do not recall saying or doing. This was the case for my brother on several occasions. It took months to get back to how he was and I had lost trust in him. On the flip side he felt ashamed and frustrated. Then, depression slowly sneaks into their mind & sucks the life out of them. Often they feel insecure, worthless, silent and numb. Or like a burden to everybody around them. Concentrating can be particularly difficult. Even going to the grocery story often Bipolar diagnosed are unable to make decisions. Forget my keys, get lost on the road, feel scattered. The topic of suicide come to mind at times. Yet, they may not find the ability to cry. Rather, they feel completely numb, isolated within themselves, even around my closest loved ones. They can not feel anymore. Or feel joy or gratitude. The only feeling is wanting more sleep and not wake up again – to stop existing. It was a dark and scary place to be in.
5. Support is Essential, But Shouldn't Stand in Your Way of Help From Professionals
"How can I help?" and ‘What can I do?" - these are the two questions I swirled around numerous times but as I have pondered what response would best suit the occasion. Sometimes it is letting go. Let the professionals take over. For us, that was The Last House.
It is a tricky situation, allowing and trusting others to know the ins and outs of the bipolar- addict vortex. From the inside and outside, life can feel chaotic. Yet other times, it seems serene and calm. It ebbs and flows. So, when the winds pick up, it helps to have others weigh in who understand the disease.
6. Substance Abuse is Common, but Shouldn't Become a Crutch.
People with Bipolar are much more likely to look for a ‘quick fix’ to a feeling, because the rollercoaster can be so incredibly draining and confusing. The need to calm down, feel something, stop the mind. This is where the professionals come in. Those with dual diagnosis (of ANY MENTAL HEALTH DISORDER) need help to grasp better coping strategies as a matter of priority, this is something I strongly believe needs to be incorporated into treatment. Life skills that ACTUALLY help. From proper medication regimine to establishing healthy daily habits, these are all essential to mental health patients.
7. They Don't Choose How They Feel...
But They Can Choose to Work to a Solution.
This was one of the hardest parts for me to deal with. When Vincent was being so heartless, rude, aggressive, and demanding. We were slaves to his needs in order to keep him alive. And I was resentful. But remember this, they didn't choose how they feel. I am going to repeate this. They did NOT choose how they feel. They can’t make themselves feel something - can any of us? In addition, many mental health diagnosis don’t have the same emotional processes you or I do. They I still love the people in their life. And I know Vince would agree, he is grateful that I am there for him. But just as it wouldn’t fix a broken leg, it won’t fix his bipolar either. It is apart of him and his greatness. And I am also proud of that.
7. Education is Key in Order to Erase Mental Health Stigma
Here I am at the ripe age of 31, a nurse, wife, sister, blogger, podcaster, writing a blog about my Bipolar brother. Why? Because I want someone (anyone) to grasp something from this. Having a mood disorder doesn’t make you a bad person, or someone incapable of living a full and meaningful life. My brother was diagnosed with Bipolar 1 Disorder at the age of 25, after a long and painful process of navigating the mental health system.
Help and support is essential. Those diagnosed can't manage the storm alone. Please fight for your loved one. Even in the hardest time. I know it is hard but trust me living with a mental illness is harder. Be the friend, family member, person who listens. Don't become a ghost. You can't fix the storm, but you can be there while it rages, and it will pass.
8. Bipolar is an Illness, Not a Personality
My brother is not Bipolar, but he LIVES with Bipolar. It is a strange thing that seems to occur in our society ‘do you know that this person is bipolar?’ They are the embodiment of a whole illness? Great news, they do not suddenly lose our identity at the diagnosis of a mental health problem.
9. Medications. They Take Time To Understand & Work Properly!
Vincent's medication regimen, along with his lifestyle habits & work at the Last House. took a year to dial in properly. I know the thought is "a quick fix." As a future Nurse Practitioner, I am in the process of learning about the many medications, labs, diagnostics it takes to help someone in crisis. But the true work comes in the day to day. It is not an easy fix. It takes time, support, endurance, and an honest attempt on the patient. My brother had to put in the work. He had to work through cravings, aggressive behaviors, the impulses, uncomfortable habits. Thanks to his hard work, I have him back. It is always a work in progress, but I am thankful for his endurance.
10. Family Support and Understanding is Essential
A support network can mean many positive things – From a listening ear to financial support family/friends are amazing. For those who struggle with suicide, this is essential. I think VIncent would agree, we are lucky to have such a great family unit. So many struggle with far more life issues, and have far less support. Our support network has given him the freedom to live and not panic or worry hugely.
11. Diagnosis Doesn’t Define You as a Person
Despite the fact that this whole article was written about Vince and his Bipolar/Substance abuse dual diagnosis, it doesn't define him. In fact, most days now, we forget about it. And as a future NP, I truly believe you can still lead a happy and productive life despite having any form of serious mental illness. Vince will have this condition for the rest of his life. He knows how best to manage it but there are still hard times. Either way, he will continue explaining it to people who ask, so that people can understand. Yes, you can live a full and fulfilling life with this illness and so that stigma falls.
12. Call The Last House for Help or Referral
No really. Reach out to them. I am so thankful to have my brother back. We went through hell and back for years. This program came to us in a time of crisis, and so I want you to know about it.
The Last House is a nonjudgemental support system who can provide top notch treatment to the guys out there. And if you need a female perspective, call them! They will find a resource for you. Now Vince is carrying on with a full functioning independent life. He has his friends, family, and community who make him even better. Words can not begin to describe how thankful I am for this program. Thank you Clayton, Chris, Andy, Miles, and the team who truly gave my my brother back. I hope this blog does some justification to the horror we felt and the journey we overcame with mental health and substance abuse.
Tori Meskin BSN RNC-NIC has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, Podcaster, NICU & Pediatric Critical Care RN, Nurse Practitioner student, a Barco Uniforms Ambassador, & Brave beginnings affiliate. Find her at www.tipsfromtori.com or email@example.com
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