While he was working in real estate, Stuart had a series of four hospitalizations. Dick believed that his mother did not try to get help for Stuart early enough. While recognizing the importance of medications in Stuart’s treatment, Dick is also frustrated with the side effects resulting from medications.
The medication sucks joy out of his life. I’ve asked him, “How do you feel about this?” He says, “I don’t have any choice. I have to live with this.” He’s resigned himself to that existence. Prior to this last series of hospitalizations, he was on just Depakote [used to treat the manic phase of bipolar disorder]. These antipsychotics, holy crap. I’ve likened mental illness treatment, at least in my brother’s case, as similar to medieval. It’s very, very medieval medicine. It’s just terrible to watch. The side effects are beyond horrendous. I get so frustrated—we’ll see if it helps you, and if it doesn’t, we’ll try something different. It seems likes experimental therapy. It’s not as bad as I paint it. That’s my emotional reaction. The practitioners are doing the best they can. But the way insurance works, you have 10 minutes with the psychiatrist, so for 10 minutes he observes your loved one and then makes a treatment decision.
Dick has found he needs to advocate for Stuart. When he accompanies him to psychiatrist appointments, he brings a list of Stuart’s symptoms to share with the psychiatrist because often Stuart’s response is “Oh, I am doing fine” when that is not the whole story. Another time, Stuart had to switch to a different psychiatrist because of an insurance change. Then he developed manic symptoms and ended up in the hospital when his medication was not effective. Dick encouraged Stuart to find a different psychiatrist; however, his brother did not want to make a change.
Dick noted this brother was fortunate to find a psychiatrist, given the shortage of psychiatrists. When Stuart moved to an outstate location, he looked for a psychiatrist in January but could not get an appointment until September. He continues to drive two hours for his psychiatric appointments, until he can transfer to local care. Dick observed, “If you look at the delivery of mental health services, you have the doctors and hospitals and it doesn’t always mesh very well together. There’s that frustration.” On the plus side, Stuart had never had any problem with getting his mental healthcare paid for by insurance.
Dick acknowledges that psychiatrists have few tools to use, other than medications. Currently, he wants Stuart to try electroconvulsive therapy once again.
I’ve done a little research about shock therapy [ECT]. Instead of these damn psychotics, why don’t we try? His last hospitalization, I had three doctors who said he probably would benefit from shock therapy. You don’t have the side effects. He’s adamant. He does not want any part of that. I told him, “If you get placed in a regional treatment center, you’re going to have shock therapy.” He said, “I don’t want it Dick. I won’t let you.” I said, “Well between me and the courts and the regional treatment center, I’m telling you if I have a choice of having you pissed off and out of the hospital and you in the treatment center, that’s the choice—that’s an easy choice for me.” We’re at a standstill on the course of his treatment.