Running out of medication

[babyducks]

A couple of months ago,  changes in insurance lead to my partner needing to switch doctors and reorganize her health care.  She started and things didn't really pan out the way anyone hoped for.  When it got complicated, she bogged down and became avoidant. 

Now in 3 weeks she will run out of her medication for her Bipolar.     

I know it's not my job to fix this.    I'm preparing for what will happen if the medication runs out.

I'm having trouble validating and supporting.   Frankly I am annoyed and it's coming across.     

Any suggestions on how to respond better?

[RELATIONSHIP PROBLEM SOLVING]

RELATIONSHIP PROBLEM SOLVING This is a high level discussion board for solving ongoing, day-to-day relationship conflicts. Members are welcomed to express frustration but must seek constructive solutions to problems. This is not a place for relationship "stay" or "leave" discussions. Please read the specific guidelines for this group.

[Notwendy]

Ducks, this is scary for you. I know it is her illness. In the case of someone being ill, I think we can ask them if they want our help, but if they say no, it is hard to push it.

We kids have had some concerns over our mother and medication, but none of us want to get into this with her or be monitoring her. Our conclusion is that, we would have to get emergency medical assistance if we thought she was at the point of being a danger to herself.

Your partner needs her medication. If she is in a place where she can not help herself, then she would need medical assistance. One option would be for you to step away from this- and let her take care of it- to a point. If her medicine runs out, then you could call 911 ( it may not be safe to drive her if she was agitated) and let the medical staff take care of it.

I feel like this is a caring thing to do. We are not health care workers. If someone ran out of medicine, then this is a serious medical situation that would have to be monitored, so we can help by getting  our loved ones into professional care.

[sweetheart]

Hi babyducks,

I share your annoyance big time and I too know that this is sometimes communicated to my husband in ways that are not productive. I figure that's ok because it is annoying and it is something where the fallout effects all of us.

What does your partner respond well to around potential triggering areas like this ?

Can you express your frustrations to her in a way that conveys your concern around this issue as well, even if she is triggered as a result ?

In the past I would have rushed in and sorted this for my h, it was one of the many issues that I had to look at coming here. It's really hard to not to rescue him, but even harder to watch him mess up. My h has a diagnosis of schizophrenia with comorbid BPD, so messing up with his meds as he has done this last year has had serious consequences for him.

What I do because I know the warning signs really well is if he becomes too unstable I let his care team know and they will now hospitalise him if necessary. I have to try and micromanage aspects of things as we have a young son, so I like to try and be proactive rather than reactive.( all behind the scenes of course )

My irritation around this is surfacing as I write because I am aware that my h has started not taking the full daily dose of his antipsychotics, so he's on a downward spiral.

This is a tricky area for sure.

[babyducks]

Thanks NotWendy.    It's not at the point of a 911 call.     There is still some time to get this sorted.  If things happen and I need to call 911 I  will.

I want to be basically encouraging but right now I am most definitely doing it through gritted teeth.

[babyducks]

Thanks sweetheart.  I understand about the poactive management.  I have a map that lays out what happens in the event of a psychotic break.  If X happens I do Y and it's not negotiable.   

Communication feels particularly challenging right now.   

[TheRealJongoBong]

I feel for your situation. My wife was prescribed antipsychotics after a particularly bizarre episode but only got her prescription refilled once, mainly due to my insistence and efforts. Her refill ran out about 2 months ago and I have to admit that I was pretty nervous about what was going to happen. So far nothing very serious has occurred, except for me getting triggered by some of her behaviour patterns. Some days I'd swear she was heading for another episode and then the next I'd swear it was me imagining things.

It's not a pleasant feeling waiting and wondering if the S*** is going to hit the fan again. It's really easy for somebody to say "you just need to set a boundary about this" but the reality is different.  It's their medical situation and like it or not they get to make the decisions about it.  I can only keep true to myself and watch out for my own safety.

[ct21218]

Every month, my partner will run out of medication and scramble to get his refills on the day they run out.  It drives me crazy.  He will often go several days without meds until he feels so bad that he gets them refilled.  He has a lot of trouble planning anything in his life and this is no exception.  I have given up reminding him to get them filled and the only things that seems to motivate him is physical discomfort.  Often he will want me to drop everything to get his meds and I will go get them, but only when I am available. It's not my problem if he can't plan approximately, but it does affect me in that he is short tempered when he stops taking them. 

[babyducks]

I'm hoping that in the next day or two a productive conversation can be managed about how to keep the medication flowing uninterrupted.     I need to handle my own frustration before that can happen though.

[waverider]

We go through this regularly. Chaos ensues and everyone gets blamed. If she feels bad enough she either ends up in ER or somehow she will find a way to bully her way through the medical system and manage to get an emergency script or appointment somehow.

Like others I have found it best to stay out of the firing line as much as possible, otherwise I get trampled in the panic. Unfortunately she never learns to be proactive and it repeats.

Medication packs handed out by the pharmacy are the best we have managed, with standing appointments with the doctor who issues sufficient scripts to last until next visit. The scripts are then given straight to the pharmacy after docs appointment. Then I pick up med packs from pharmacy each week.

Once you establish routine like this, pharmacy may allow owing scripts for any temporary shortfalls, with doctor sending emergency scripts straight to pharmacy if it runs out due to delay or missed visit.

Panic because meds are going to run out before they can get an appointment is the biggest issue. That starts doctor shopping.

Doctors and pharmacists are aware of the need to take patient control out of the loop at times, particularly with psychiatric meds, as these are often subject to lack of responsibility and/or misuse. It is best you discuss it with them rather than between the two of you which ultimately result in you being responsible for it, and her compliance (potential ongoing conflict)

[sweetheart]

We go through this regularly. Chaos ensues and everyone gets blamed. If she feels bad enough she either ends up in ER or somehow she will find a way to bully her way through the medical system and manage to get an emergency script or appointment somehow.

Like others I have found it best to stay out of the firing line as much as possible, otherwise I get trampled in the panic. Unfortunately she never learns to be proactive and it repeats.

Medication packs handed out by the pharmacy are the best we have managed, with standing appointments with the doctor who issues sufficient scripts to last until next visit. The scripts are then given straight to the pharmacy after docs appointment. Then I pick up med packs from pharmacy each week.

Once you establish routine like this, pharmacy may allow owing scripts for any temporary shortfalls, with doctor sending emergency scripts straight to pharmacy if it runs out due to delay or missed visit.

Panic because meds are going to run out before they can get an appointment is the biggest issue. That starts doctor shopping.

Doctors and pharmacists are aware of the need to take patient control out of the loop at times, particularly with psychiatric meds, as these are often subject to lack of responsibility and/or misuse. It is best you discuss it with them rather than between the two of you which ultimately result in you being responsible for it, and her compliance (potential ongoing conflict)

This is an exact copy of our life with medication. There's a bit of me that's relieved I'm not alone.

[babyducks]

My partner has been compliant about medication for years.  And responsible for her own schedule and organizing.  Unfortunately the change to her insurance meant she has to change doctors.     And what I am just realizing as I type it, is she doesn't want to go through the gauntlet of a new doctor,  new office,  new staff and new ideas.    Dang.    I didn't pick up on that until now.

[sweetheart]

It's really good you've realised, my h fell to pieces when his old P left, disengaged from a team and treatment program he had been compliant with for six years. He was in free fall for the next two years, it took me ages to work out what was going on.

He feels embarrassed and I think ashamed of his history and how his illness presents and he hates feeling vulnerable with someone new. He has never managed to return to his previous levels of functioning.

I'm not surprised your partner doesn't want to put herself through this.

Does it help you process your annoyance differently ?

[babyducks]

Does it help you process your annoyance differently ?

It does sweetheart.   Understanding always helps take some of the reactivity out of the equation.   Unfortunately its only some.    As these things tend to do, things escalated pretty quickly yesterday afternoon.   and I became the target of 'you aren't meeting my needs',  'you aren't doing enough to ______.   I got one of those emotionally black mailing texts.   which I didn't respond to.   and she went off.   which of course I understand.  its so so hard to validate when the target is 'me'.   frankly I didn't try so very hard.   I picked up the bait and argued back a little.   which is okay.    I'm human after all.   Right now I've gone off and am doing my separate things and she has been crying for about 12 straight hours.       It's going to be interesting to see if how this works out.

[sweetheart]

 

I can relate to that escalation pattern.

For me when h is in this, validation no longer works because he is already aware that he has messed up in some way, or about to, so I too go do my own thing.  

[Grey Kitty]

If I get this right, she is failing to take the actions that would get her meds renewed promptly.

Sounds like a situation for S.E.T. I'm not real good at that one... .so find the lesson or maybe somebody else can help. But the Truth part is easy:

"If you aren't able to continue taking your meds, you will suffer a lot more."

[waverider]

"If you aren't able to continue taking your meds, you will suffer a lot more."

Problem is that states a consequence and a pwBPD will automatically then need to blame someone else for this occuring, with the expectation that someone else will fix it.

[babyducks]

hi Grey Kitty,  thanks for your comments.

On Thursday morning I was able to have a decent SET type conversation about medication and doctors with her.  I am normally pretty good with SET, it fits into my natural pattern of speaking.   She is normally pretty receptive to SET.

On Nov 1 her Psychiatrist retired.   She was supposed to move to practice B but that fell through on insurance and medical record problems.    There is a real shortage of Psychiatrists here.   It's very hard to become a patient.  most Psychiatrists have long waiting lists, or just aren't taking new patients.

So on Thursday we had a decent SET conversation and she agreed to call a couple of doctors offices on the Monday after the holiday.   

Her mood which had been very stable for a long time,  suddenly devolved after that conversation.   In a very short time frame, about 2 hours,  she went from fine and communicative to pretty dsyregulated.  Right after the SET conversation about Doctors she sent me a text which I didn't answer.   The text rang my bells for not healthy,  it felt manipulative.   Since then it's been all down hill.   Panicked, crying, scrambled and blaming and attacking me.    I did pick up the argument and respond to one of the attacks and yes that did make the dsyregulation worse.  I know better.    I'm very susceptible to hearing how 'mean' I am to her.   So when that one came out I fired back.   

Right now it's been about 36 hours of crying.  What I am hearing is the stuff I find most difficult to communicate around.   She is basically repeating the events of the last 36 hours, explaining to me how she did everything perfectly and how I've been wanting.   That drives me nuts quickly, and I did become sarcastic.  I slipped into fighting the way you would with a normal partner for about 30 minutes.   which gave her the material she seemed to need.   

I'm  pretty sure she still has medication and is taking it as prescribed  so I don't think this is medication withdrawal.  I'm not sure what exactly this is.     She hasn't been this bad in about 2 years.   I am pretty good at recognizing the symptoms of hypomania.   This looks like the opposite of that.    It looks as if her mood suddenly fell of a cliff.

I've moved back to my condo, for a cooling off period.   What I see as my problem to address here is my reaction to her disordered thinking.   I actually had to remind myself last night that crying for 36 hours nearly non stop is not normal.   I did better at not engaging in the blame game than I have in the past but that is still my weak place.

any thoughts on how to do that would be much appreciated.

'ducks

[Notwendy]

Ducks,

Do you think she feels abandoned by her doctor? Sure the doctor is retiring- that isn't personal, but with the tendency of pwBPD to take things personally, this event could trigger all kinds of feelings of worthlessness, being unloved, rejection. Not to mention the fear of finding a new one that she likes.

It is good that you are taking the time to take care of yourself and to get away from the stress.

[waverider]

any thoughts on how to do that would be much appreciated.

'ducks

I think it comes down to practice and a constant awareness that it is your weak point. Accepting that it is always likely to get to you to a certain extent. That way you wont self blame as much and so it wont be such a biggie.

Being aware of it happening means you can limit the effect. Dont set your own bar unreasonably high.