Treatable?

Postby Intrepid1 » Wed Dec 02, 2020 5:02 am

I’ll just keep this straightforward so it sounds general.
My girlfriend is the oldest of 4 siblings, her oldest brother in his early 20s has some problems that nobody can seem to help resolve.
Her brother has been in and out of psychiatric and drug treatment facilities for years. He is a drug addict but that is not his main problem, the main problem is that no type of treatment plan or rehabilitation program in numerous states have worked, he’s been diagnosed with basically PTSD (childhood trauma) and Bipolar with psychic episodes (extreme mania), going so far as to require treatment with ECT this past year with no benefit.

The problem is with the complexity in the trauma. I think the kid is not going to respond well to any treatment from a doctor, since the childhood trauma was caused... by a doctor.

Does anybody have any recommendations?
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#1

Postby Richard@DecisionSkills » Wed Dec 02, 2020 11:58 pm

Intrepid1 wrote:Does anybody have any recommendations?


Yes. You are a boyfriend. Your role in the life of a girlfriend is to be the boyfriend. Your role is not parent, sibling, doctor, therapist, uncle, or any other relation with the "oldest brother". In other words, my recommendation is you stay out of it.

You communicate with your girlfriend. When she asks, "Do you have any treatment recommendations for my brother?", you say, "Nope."

The reason for the above advice is that once you start down the road of trying to "help" you have inserted yourself into a situation where not only do you not belong but are most likely unwelcome.
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#2

Postby Intrepid1 » Sat Dec 05, 2020 1:18 am

Too late... i’m in too deep.

Any further recommendations?
Is this trauma Treatable?
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#3

Postby Richard@DecisionSkills » Sat Dec 05, 2020 2:29 am

Intrepid1 wrote: Is this trauma Treatable?


It depends on how you define treatable, but there are definitely ways to modify the brother's behavior.

https://www.livescience.com/42199-lobot ... ition.html

For the equivalent of a modern-day lobotomy, drugs are used. Here is a 2019 article that can give you some treatment options.

https://core.ac.uk/download/pdf/324162241.pdf

Intrepid1 wrote:Any other recommendations?


Get a license in clinical psychology and/or psychotherapy. This will broaden your options.
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#4

Postby Intrepid1 » Sat Dec 05, 2020 6:11 am

Lobotomy seems a bit old-school, but psychosurgery sounds interesting... i wonder if this is in clinical practice...
Any research on this for trauma patients?
Maybe a solution if nothing else helps and he can’t calm (crash) back down into a more realistic psyche... there has got to be a way to crack this nut, unfortunately, his shell is like pure Tungsten though so not easy to get through by any means, completely non-compliant to normal psychotherapy treatments... which really is no permanent solution anyways. Is well put in that 2019 article referenced on psychotherapy and mental health treatment; this pretty much sums up Psychopharmacology in the US in the year 2020:

In retrospect, atypicality has served as much as a marketing tool as it has a legitimate description of a differently acting class of antipsychotic drugs. The term atypical increasingly has lost its mean- ing as we learn more about the efficacy and side effects of these drugs. After all, other than cloza- pine, all antipsychotic drugs (new and old) have nearly equivalent efficacy; all produce nasty side effects, some potentially fatal; and none works nearly as well as clinicians and patients wish it did.


The only other psychopharmacotherapeutic method that maybe worthwhile to explore further... MDMA-assisted psychotherapy
—> See MAPS
He probably won’t be able to get to a point where normal psychiatric methods and therapy can help until he’s gotten over the trauma. The drug addiction is certainly not helping him; only covering up the pain from the trauma, but even when sober, he’s still never really been able to develop an independent functionality in his adulthood, to try and live a normal life. The kid is smart and if he could resolve his severely complicated mental health problems, he would be pretty successful at life... unfortunately nobody knows what to do... could more drugs in the form of a strategically planned drug assisted therapy crack this nut?
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#5

Postby Richard@DecisionSkills » Sat Dec 05, 2020 11:51 am

Intrepid1 wrote:... could more drugs in the form of a strategically planned drug assisted therapy crack this nut?


Sure. That might be possible. To try this here are two options to consider:

(1) Gather up all his medical records and see which previous "drug cocktails" have already been tried over the years. Figure out a new mix to try. After all, you don't want to repeat the same ineffective treatment plans. And don't forget you might want to try a mix of both drugs and behavioral therapies, like ECT. You will want his full history to review. His parents probably can provide you with most of it.

(2) Without access to his entire medical history, do some research and come up with your own "strategically planned drug-assisted therapy" and offer it up to your girlfriend as a treatment option. She can convince her brother to give it a try.

Of course, given you have no experience your plan might actually backfire and cause more trauma. Have you considered that? Have you considered that while your intentions are good, that given you don't have any clue what you are doing, that whatever "help" you offer can actually add to the trauma? And maybe not just adding to the trauma for the brother, but for the parents and the girlfriend. Or do you think no matter what you offer up in the way of "cracking this nut" that it is impossible for you to be part of the problem rather than part of the solution?

After all, your very first "drug cocktail" might not work exactly as planned. It might take a few tries to get the mix of drugs just right. Not only will you not know the right mix, but you also will not know the frequency or correct dosages. For that you will need to seek out a licensed therapist. Will you use one of his former therapists or seek out a new therapist to help prescribe the treatment plan you develop?

(3) As a third option you might consider saying to yourself, "Hmm, the issues with her brother are definitely treatable, but it is nowhere in my scope of knowledge or abilities. I'm not yet a doctor, neuroscientist, therapist, pharmacist, hypnotist, or any other -ist that might be of any value in developing alternative treatments. Maybe I should be a "friend" in this situation as in boy-friend and use my time with my girlfriend to show my support for her struggles."
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#6

Postby Intrepid1 » Sat Dec 05, 2020 9:02 pm

Or do you think no matter what you offer up in the way of "cracking this nut" that it is impossible for you to be part of the problem rather than part of the solution?


Based on my involvement thus far with my understanding the background family history the details of which are not easily communicated and with my direct experience, i know i can only be capable of providing solutions at this point instead of exacerbating the problems. The mother and father have nearly given up and beyond legal responsibilities and unconditional love have no interest in helping this kid sort out his problems. It’s not because they don’t care... is because they can’t care anymore, it’s too overwhelming to try and keep up with his condition, he’ll likely end up locked away in a State Hospital until he’s matured enough to get a grip on reality enough to manage the trauma and stop fantasizing his goals in life.

Why is there no other options to treat mental illness in the US in the year 2020 beyond unprofessionals developing customized treatment plans for people with conditions that can’t be diagnosed by professionals to be treated effectively or by just locking people away in State Hospitals?

Maybe we should just go back to the barbaric practice of severing neural networks physically to treat mental problems by means of lobotomy... or maybe that Musky fellow and his Neuralink can be of use here... if i tell the kid he’d be a rhyming, wordplaying, rapping genius that could freestyle battle rap extraordinaire with that piece of Brain-Machine Interface tech... then he maybe interested to beta test it with the US-FDA Emergency Use Authorization when available.
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#7

Postby Richard@DecisionSkills » Sun Dec 06, 2020 12:36 pm

Intrepid1 wrote:Why is there no other options to treat mental illness in the US in the year 2020 beyond unprofessionals developing customized treatment plans for people with conditions that can’t be diagnosed by professionals to be treated effectively or by just locking people away in State Hospitals?


I know, right? It is the year 2020. Why does utopia not yet exist? Mental illness, poverty, disease, cancer, use of nongender pronouns, are all problems that should have been solved by now. Geez.

Lucky for this kid it is impossible for you to make it worse.
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#8

Postby Prycejosh1987 » Mon Dec 14, 2020 4:38 pm

My recommendation is a lot of prayer to God and also forgive past hurts. We have all been hurt in the past, we cannot walk into the future until we decide to stop carrying the chains of the past.
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