Victoria Maxwell

BFA: Bachelor of Fine Arts / BPP: Bi-Polar Princess... one of Canada's top mental health educators, is the owner of Crazy for Life Co., a company specializing in keynotes, workshops and performances for corporations and conferences on a range of mental health topics. Her one-person show, Crazy for Life, her true-life story of overcoming bi-polar disorder, tours throughout North America and Europe.

"I really do not know how to begin..."

Q: 
Victoria, I really do not know how to begin. My son's father and I started a relationship 11 years ago, 2 years after my son was born we moved back to his country. 8 months later we separated. I moved back to Calgary and he stayed in his country for 2 and a half years. During this period of time I found out that he had been missing for about 7 days, wandering about. He was throwing himself at cars, breaking mirrors from vehicles, throwing rocks at cars, and he would be constantly taking about the bible and God. His brother had to chain him so he would not get out of the house. They looked for ways to help him and get him into a treatment. He apparently got better. When he came back to Calgary and we got back together he never acted this way with me. We have recently come back from holidays from his country. 3 days after we arrived there, he started to behave differently. He was constantly laughing by himself, picking up garbage from the streets and writing a lot of nonsense in his notebook. He does not sleep well and it is very hard for me to make him eat. He says he hears voices talking to him and that he is in a fight with God. I am very worried about him. All of this is new for me and I do know which way to go. He has no health care and I have no money to take him to a psychiatrist. Please if you know of any organization that would subsidize me, and help me find him help. Could you please send me this info? This situation is affecting my son and me very much. Thank you the time you have taking in reading my e-mail
A: 
Hi, Hang in there. It can be doubly difficult helping a loved one who is dealing with a mental illness who is also new to the country. It sounds like your husband is not just visiting Canada, but living here. If that's the case you have more options. <a href="http://www.cic.gc.ca/english/newcomer/fact_health.html">The Citizenship and Immigration Canada (CIC) website Health Services Fact Sheet</a> states "Medicare (Canada's public medical services) is available to all permanent residents and Canadian citizens". Some people who are in Canada temporarily are even eligible. That means appointments with psychiatrists or other medical doctors are free to you and your family. You do not need to pay for the meetings or extended health care to be eligible. There may be a small monthly fee for the health insurance in some provinces. Your husband should apply for a health insurance card as soon as possible, if he hasn't done so yet. You need to contact the Ministry of Health where you live or get the application from any doctor's office. "There are many agencies that provide services designed for newcomers to Canada... your local immigrant-serving organization should be your first point of contact" states CIC. This following link lists such agencies organized by province that can help you find medical coverage and refer you to the right places: <a href="http://www.cic.gc.ca/english/newcomer/welcome/wel-20e.html">Citizenship and Immigration Canada: Finding Help in Your Community</a> I'm not a health professional, so I can't offer a diagnosis, but if your husband's behavior is worsening and he's hearing voices and you're very worried - take him to the nearest emergency immediately. Although this isn't the ideal solution, it may be the best place to get a diagnosis and to help him get well. He may be admitted to the psychiatric for a period of time for assessment. An alternative is to make an appointment with your family doctor. Go with your husband; tell the doctor what symptoms and behaviors you've noticed and how long it's been happening and how it's interfered with daily living. The more details you provide your GP, the better. Write a list as you did in the letter to me to read from to make sure you give the doctor all the information. Your doctor should offer some treatment options. Also ask for a referral to a psychiatrist, if he doesn't give you one. The wait lists are usually long, but they're worth being on. Two other choices: your area should have mental health teams for people who do not have extended health insurance. Contact your local hospital or call OBAD for the phone numbers. In British Columbia we have <a href="http://www.psychosissucks.ca/epi/">Early Psychosis Intervention Programs (EPI).</a> Check with your doctor or with OBAD for programs in your area or check the BC website for possibilities. If your husband doesn't have or can't get a health card - I would still go to your nearest hospital. Your husband needs support and care. Be persistent. These situations are stressful and will take time to work out. You need to remain as healthy as you can. OBAD runs excellent supports groups as do the Mood Disorders Associations and some Canadian Mental Health Association (CMHA) branches. Calling these groups will help you find other solutions. All the best, Victoria

"My son has been married for 15 yrs..."

Q: 
My son has been married for 15 yrs. They are 40ish. After 5 years they had a son. Then she started having seizures. She was over medicated for epilepsy for a year then brain waves tested and determined the seizures were coming from the wrong side of the brain. They went to plan b with the doctor saying it was associated with post partum depression and lots of women have seizures with post partum. She didn't have the depression associated with it just the seizures. (I have never heard about seizures being associated with post partum depression). Then they went into family counseling to deal with stress and other medications to keep her stable. Then the second child was born and she started having the seizures again and right away they knew what was necessary to control them so they were short lived. However, sometime prior to the birth of the second child I started to witness some of her extreme unreasonable anger to my son at which time she would leave the room for a short cry, return soon and apologize to me. She is a type A personality, has a lot of the classic symptoms of bipolar (high spending habits, cant sleep, over achiever, hopelessness) 'wide mood swings' (have not witnessed depression) (family stepping around her as if on thin ice) and at that time I asked her if she had ever asked the doctor about the possibility of bi polar as I have a brother in law who is being treated for bi polar. She said she had asked the doctor. Recently, now 5 years after the birth of the second child, I am questioning if she really had asked her doctor about bipolar. I have begun to suspect again the bipolar and have tried to come up with a way to approach my son or her family about the possibility. Of course the hostility is all addressed at hubby; he is quiet and just rides the storm out. They have a business that she runs together with hubby. However, youngest child is now expressing his anger by screaming and he is 5. I think he is just mimicking his mother. They are a close family and doting parents to the boys. She has recently become very close to her mother who is in stage 4 of cancer but in control of it at the moment and outwardly looks healthy, and an older sister who is 50ish. Presently those two live together. Father is recently deceased. I get along with my daughter in laws I 'know my place'... only a couple of times has she hung up on me on the phone, lolls. I doubt if I am a candidate to approach her or even to ask my son to approach her (unless her family teams up with him). I love her mother and sister who are very sweet. I am thinking I should visit with her family and go over the possibility of bipolar and see if they could approach her or her and my son. They have also witnessed her spending, anger at hubby, sleeplessness, mood swings etc. (she is a twin and her sister is normal) Can you think of another way that I should proceed? It sure seems to me that if she has experienced a brain misfunction with the seizures that bipolar is a high possibility. She also has a close friend who has gotten her, hubby and kids involved in church. But I'm thinking that the mother and sister are the way I should go. PMS is right around the corner for her and I hate to think how it will add stress to the situation if this existing condition doesn't get under control. Thank you, from a concerned mother in law. Sharon
A: 
Dear Sharon, You may be right that she is dealing with bipolar disorder. Only a qualified professional can make an accurate diagnosis though. It's a delicate situation when approaching someone about the possible presence of a mental illness. But that doesn't mean we should avoid the subject. Does your son agree that her behavior might be due to in part to a bipolar disorder? If so, he might be the person to talk with her about it. You're wise to see that having someone she feels close to and trusts is a good candidate for starting a dialogue. And once the topic is 'on the table' - the next step is to go with her to talk with her GP or specialist if she has one. I have several suggestions for the person who will initiate the discussion: <ul> <li> Be prepared for some resistance. If you're nervous role play the conversation with someone. Rehearse it, anticipating different responses. Remember: just because an individual gets defensive or upset, doesn't mean you've done the wrong thing. Also, remind the person that your suggestion there might be a mental illness present, doesn't mean that there is; only that it might be worth exploring. </li> <li> Use the first conversation to open the possibility of a dialogue and establish some rapport, not get them to see it 'your way'. If it seems appropriate to directly ask about bipolar illness, then do so. But it might just be to say you're here if they need you. </li> <li> Focus on behavior, not character. Pointing to changes in the person's behavior is less threatening than having their personality under a microscope. Remove all judgment from your voice, words and body language and instead be caring, compassion and kind. E.G.: "I've noticed you used to go for a walk everyday. Now I notice you stopped. Is everything okay?" or "I remember you used to laugh a lot. For the past couple months, I've noticed you're not laughing much anymore. Is there anything you'd like to talk about? I'm here if you need me." </li> <li> Have information handy to leave with the person. Ensure it's simple, clear and user-friendly. Find a concise brochure from a reputable mental health website, from OBAD or another local mental health organization. Make sure it is optimistic about prognosis, highlights that it is treatable and that the disorder is not a personality weakness, but a physical illness. </li> <li> And lastly and really most importantly: Be loving and empathize. Reiterate you're talking to them about this because you care and see them struggling. Repeat your suggestion isn't meant as a criticism, although it might feel that way to them. It is meant as support. And: Love them. Love them. Love them. </li> </ul> I hope you or someone in the family finds a way to have this dialogue with your daughter in-law. Many good wishes to you. Warmest, Victoria

"What do you say to a person (with whom you live, and who is also a parent) who suffers from schizophrenia..."

Q: 
What do you say to a person (with whom you live, and who is also a parent) who suffers from schizophrenia (or any other psychosis for that matter)? I know that such individuals have poor insight regarding the fact that they have an illness. Yet, what if the person COMPLETELY denies the fact that he/she is even SLIGHTLY ill? How do you respond (in a calm, logical manner) to someone who suffers from extreme paranoid delusions/hallucinations (and has been suffering ever since adolescence)??? Or, for that matter, how does one respond to a person whose behavior and speech is grossly disorganized and remarkably petulant and impetuous? Moreover, what can one do when his/her parent REFUSES to take their medication or see their psychiatrist? I know that I, as one individual, have no power over another. However, is there absolutely nothing I can do to help????
A: 
It sounds like you've been dealing with this for a long time, and perhaps on your own too. Realize your anger, frustration and sadness are all really natural reactions to a very difficult situation and certain things become even more painful when the person who is ill is your parent. I speak as someone who not only lives with a mental illness but also grew up with a mother who suffered from bipolar disorder for most of my life. First and foremost: take care of yourself by talking to someone who knows how to help you cope with this. I wish I had gone into therapy earlier than I did. I don't know how old you are, if you're in high school, graduated from college, living with your mom or dad, regardless I recommend talking to your family doctor to discuss the intensity of the situation. You are not your parent's parent, yet you might be in that position. It was vital for me to get emotional support and practical tools to understand how to deal with a very hard situation. Have your doctor refer you to family counselor or psychiatrist who does psychotherapy (visits to psychiatrists are covered by Medicare). If you go to school, talk to an adult there who you trust. Create a coping strategy with them so you have steps to follow and practice when the going gets tough. Secondly: let your mom or dad's doctor know that the illness is not being managed well and that it's very stressful for you. Ask them what can be done. You may not get a lot of information from them, but it's important you let someone know and get some help yourself. You have a really good understanding of the illness and the lack of insight that accompanies it. When someone is in a psychotic episode, trying to speak rationally is futile. Remaining calm and neutral without engaging in debates about the paranoia is important. But sometimes regardless of how you respond, things don't improve. Get other family members on board, so you don't have to shoulder the brunt of the illness. Click on this link for schizophrenia societies and support groups across Canada. Many of the organizations have excellent support and information for family members. You will find out you are not alone. <a href="http://www.bcss.org/affiliates/provincial.html">British Columbia Schizophrenia Society</a> Also these books may be helpful: <ul> <li> Marsh, Diane T. and Dickens, Rex M. (1997): Troubled Journey: Coming to Terms with Mental Illness of a Sibling or Parent. Jeremy P. Tarcher Inc. </li> <li> Mueser, K. and Gingerich, S. (1992): Coping with Schizophrenia: A Guide for Families. New Harbinger, Oakland, CA </li> <li> Secunda, Victoria (1998) When Madness Comes Home: Help & Hope for Children, Siblings and Partners. Disney Press </li> <li> Torrey, E. Fuller 2001 Surviving Schizophrenia: A Manual for Consumers, Families, and Providers (4th ed.). Harper Row, NY (2000) </li> </ul>

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