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Question
Posted by: Joe | 2012/08/27

Help

My fiance is bipolar. Yesterday she had a severe episode, featuring depression and cutting herself. It came to such a point where I had to leave (with all the cutlery) and stay with a friend for the night. From messages that she sent me on my cellphone it looks like she stayed awake most of the night, last msg was at about 4am. Knowing how things go, she is almost guaranteed to have another episode today, because of the lack of sleep. I''m hoping otherwise, but we''ve been through this before and I''m not even sure if she took her meds. I am at work today and I don''t know what she''s going to get up to. How do I prevent her doing any further harm to herself? Where do I turn to for help?

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Our expert says:
Expert ImageCyberShrink

Bipolar Disorder is treatable, with meds to help both depressed and manic phases of it, and to reduce the frequency and severity of episodes. Self-cutting is not a part of Bipolar Disorder, but a not uncommon problem in its own right, which of course may also occur in people with this disorder. This is relevant because this part of her problem is not usually helped by medication fromm a psychiatrist, but psychotherapy from a skilled and experienced psychologist can help.
If this has been a recurrent problem, she absolutely should be regularly seeing both a psychiatrist for medication supervision and a psychologist for therapy. And while your wish to hlp is admirable, it is absolutely essential that she recognize that she herself has to take prime responsibility for controlling these situations rather than just surrendering to her impulses and leaving it to others to try to sort it out.
Such a situation is far beyond what a GP is trained to be capable of handling alone

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2
Our users say:
Posted by: Joe | 2012/08/27

Thank you Cybershrink. She''s regularly seeing a psychiatrist and has seen a psycologist a while ago. After the 3rd visit at the psychologist she felt that there was no more therapy happening and he wasn''t trying to help her deal with her problems but instead just talking about general things, so she cancelled it after the 5th consultation. The psychiatrist she''s seeing on a 6 monthly basis because things have been going well, up to now.
So, besides taking the usual approach, as you described above, there is no help I can get her while she''s having a moodswing?

Reply to Joe
Posted by: cybershrink | 2012/08/27

Bipolar Disorder is treatable, with meds to help both depressed and manic phases of it, and to reduce the frequency and severity of episodes. Self-cutting is not a part of Bipolar Disorder, but a not uncommon problem in its own right, which of course may also occur in people with this disorder. This is relevant because this part of her problem is not usually helped by medication fromm a psychiatrist, but psychotherapy from a skilled and experienced psychologist can help.
If this has been a recurrent problem, she absolutely should be regularly seeing both a psychiatrist for medication supervision and a psychologist for therapy. And while your wish to hlp is admirable, it is absolutely essential that she recognize that she herself has to take prime responsibility for controlling these situations rather than just surrendering to her impulses and leaving it to others to try to sort it out.
Such a situation is far beyond what a GP is trained to be capable of handling alone

Reply to cybershrink

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