Mom update

My mom has been moved to a "rehab" facility, which is really a nursing home where they give you physical therapy and other therapies, with the understanding and hope that in the next few weeks, the patient will improve enough to go home. It's been very strange, because on one level, my mom knows that she is there because she was doing strange things (wandering), and she is very afraid that it will happen again. So she gets some peace of mind from the fact that they have her on a "wander alert", which is a little thing she wears like a watch, except on her ankle, and when she gets close to an exit door, an alarm will sound and the door will lock. That gives me peace of mind, too.

On the other hand, well, on all the hands, actually, it's really been a nightmare. My mom suddenly cannot string together coherent sentences. She doesn't know her right from her left. And the worst thing of all, she is so very sad....she just can't stop crying...she's been crying over everything and nothing--because she's such a burden, because she loves me, because her memory isn't too good, because I called her, because I called her last night and she couldn't remember how to answer the phone, because I told her I loved her....you get the idea...and when I say anything, like "Aw, Mom, don't cry, we'll get through this...", she just cries harder. It's breaking my heart.

In the hospital, she had a lot of blood work and a CT scan. She does not have a bladder infection, or anything else that they can see. Tomorrow I'm taking her into town to get an MRI to make sure there's truly nothing unusual there. And more blood work. For Lyme's disease, Lupus, and other unusual things that might possibly be causing these sudden changes. I hope we can get her feeling better.

I am dreading the possibility that she might not get better than this. There's no way she could live in her apartment like she is right now--she'd get lost in her bedroom and it would be terrifying!!! And she's so helpless. The nursing home staff told me that she needed help eating her lunch today. She has NEVER, even when she broke her hip, needed help eating before. It's such a dramatic change. I hope it's the benadryl, but if I am honest with myself (and I know denial is a lot easier), we were seeing some changes before the benadryl--that's why it was prescribed--because we were hoping that the changes were due to a lack of sleep.

I did find out, though (my mom told me) that before Christmas, she fell in her apartment and didn't tell anyone. And it was right around Christmas that we started seeing the changes. I don't know if that fall could have shaken things up enough to cause this....oh I don't know--I'm not a doctor, after all, and I have about as much experience with this dementia thing as I do with bipolar. All I can say is that I hope that she can recover at least somewhat from this, whatever is causing it...

One of the best things about this is, that DH has been WONDERFUL!! He's been going to visit her while I've been working. He brought his guitar and played her some music. And he went over to her apartment to take pictures of her cat, so that she can have that with her. I think being needed like this is actually doing good things for him. (I've always known it would, but there really hasn't been a way to get him to do anything about it)...Tonite he went and spent two hours with my mom. He said she was crying a lot more than she was yesterday, and she couldn't remember how to answer the phone again, but that they had a good conversation. What a blessing!

I didn't think DD should go to see her grandma tonite, as I wasn't sure if DH could handle the additional stress, so I told her I'd bring her up there tomorrow. She made a card for my mom that said "I love you Grandma" and it made my mom cry. Actually, tonite, everything seemed to make my mom cry. I wish I could help.

How not to cook when you're under a lot of stress...

In between everything, I decided that I was finally hungry, and I was going to make a grilled cheese sandwich. MMMMM.

So I got the pan out, buttered a slice of bread, put it in the hot pan. Then I opened a couple of slices of cheese and set them on top of the bread.

When I thought the sandwich was done, I flipped it over to grill the other side. I sat there, dumbfounded, thinking, "Why is it smoking like that? It never did that before...."

Yup, I guess I forgot that all-important second slice of bread. You know, a sandwich just isn't a sandwich, without that second slice.

So I was left with a burnt-up sandwich, a burnt-on pan, and a really red face.

Alzheimer's sucks

Well, it's a scary time for me. My mom has been fairly stable for about a year now (since she broke her hip) and for the most part, pretty stable (although with a gradual decline) for the three years she's lived in the assisted living center. But I guess that has come to an abrupt end.

Yesterday morning, I got a call from the nurse at her assisted living center, and I was told that my mom, in the middle of the night, left her apartment and was found in another woman's apartment. When my mom was asked what she was doing, she said "I was going to help with the meat." My mom is usually very much "with it", as far as her communication, the only difference between her and a "normal" person, would be that when talking with my mom, you needed to use simple words and simple concepts. But she really had very little trouble communicating, with the exception of some trouble finding the right words sometimes. Since at the time, it was way below zero outside, the fact that this happened is even more troubling. Her building is secure, which means, that if you don't have a key, you need to go to the main entrance to be "buzzed in". So if she had, in her confused state, gone out the door, instead of into someone else's apartment, I could be typing a whole different entry right now....

Anyhow, I went to her place to sit with her, and try to figure out what happened. While we were sitting there, she told me she had to use the bathroom. I told her "go do your thing." So she got up and opened up her door that opens into the apartment building hallway, and was about to walk out, when I told her that the bathroom wasn't out there, and showed her where it was.

After this, the nurse decided to check for a bladder infection, but that was negative. So I, after contemplating the possibilities, and realizing that even if I stayed at her apartment, the likelihood of me sleeping through her leaving was great, decided to bring her to the Emergency Room. They ran a lot of tests, which all came up negative. Our only hope is that this is a reaction to the Benadryl--that is/was the "new sleeping med" that we added in about two weeks ago. The Emergency Room doctor thought it could possibly be playing a part in this, but mostly, he said a lot of things about "run-of-the-mill Alzheimer's".

Right now my mom is still in the hospital. She knows what happened, and she is very very upset. In fact, today, she really couldn't stop crying. I have never seen her like that. I'm pretty sure she understands how serious this is. But she's crying over other things, too, like the fact that she has to wear a hospital gown and not her regular clothes, and she's crying because she didn't have her partial (dentures) with her. I have never seen her cry like this. Currently, the plan is that she is going to stay in the hospital until Monday, when she will hopefully get a bed in the nursing home that is attached to the assisted living facility, "for observation".

I don't want to believe that the natural progression of Alzheimer's is what is causing this. (Although my brain knows that it is probably more likely than anything). There is so much fear with this. Fear I had no idea I could have. I'm very very afraid that after this "wandering" episode, my mom won't be allowed to live in her assisted living apartment any more. I'm going to ask about the possibility of door alarms, but right now, I don't know of anyone there who has one, so I suspect there's a liability issue. And the thought of her going into the nursing home, that's so sad. I really can't stand the thought. But I don't think there would be a lot of other options at this point. If the assisted living place can't keep her safe, there's no way I could come up with any other plan that could be affordable....before she moved into the assisted living place, we looked into home care, and it was going to cost somewhere like $4,000 a month to have someone there only for 12 hours! And while financially, she's doing "all right", when nursing home expenses are taken out of that money, it's going to go so fast....

And then there's the thought that "there's probably a better place than a nursing home for her". Like an Alzheimer's assisted living place. Because up until about three days ago, she really didn't need much help. She walks by herself, no cane, no walker. She feeds herself and does not have any incontinence issues. So basically the only reason she would need to move would be this wandering. And while I've known that someday, she was probably going to have to move over there, I didn't figure on her being so independent when the time came. I'm glad that she's been to the nursing home a couple of times, to recover from illnesses/broken hip, so that she's familiar with it, at least...I'm just so scared that since she's gone downhill so fast this week, that maybe "the end" is going to be sooner than I thought, too. There's so much guilt with this. So much I wish I could do. So much I wonder if I did wrong....I'm very much hoping that tomorrow, we'll see some improvement, at least...oh dear....

Confabulated Confusion

I'm sorry it's taken me so long to get back to you all, it's been really hectic at work and I couldn't in good conscience blog when I needed to be working. But things have calmed down a little, so I figured I'd give you the usual update on what's new.

DD--she has been "confabulating" (that's what the fetal alcohol experts tell us to call it, anyhow) up a storm and it really gets on my nerves. I correct her when something she says is a blatant lie, and I've been "catching" her so often, I wonder if she ever says anything truthful lately. She had a friend over this past weekend, and her friend asked me how many dogs we have. I said, "We have six dogs." DD's friend turned to DD and said, "I thought you told me you had NINE dogs!" And DD said, "Well, I was counting my 'real mom's' dogs, too." So I said, "You know darn well your real mom only has two dogs. Do the math. I don't think you're telling the truth." And so then she said, "Well I was counting Sadie, too!" (Sadie is our neighbor's dog, who lives 1/4 mile away!) I told her she didn't make any sense and left it at that. But then in the car, DD told her "friend" that she is "going out" with a certain boy, who we know is in the 6th grade. We called her on it, said, "You aren't going out with anybody." And she said, "Yes I am, he never said we weren't!" ARGH. I'm hoping that new med increase will start working soon, but I don't think there's a med that will help with the "confabulation" and sometimes I just want to be really rude to her and tell her that EVERYBODY can see through these lies and it's probably a big part of why she doesn't have any good friends. But of course, I just save it for some time when I'm in a better mood, where I can say, "hey, let's practice keeping our stories straight, ok?"

I talked to my mom today. She was upset because she couldn't find her "beeper" (that she uses to summon the aides at her assisted living facility). She told me that she couldn't find it anywhere, and somehow she had gotten the attention of an aide, who helped her look, and after a lot of searching, they found the beeper IN THE BOTTOM OF MY MOM'S BEDROOM SLIPPER THAT SHE HAD BEEN WEARING ALL DAY AND WAS STILL WEARING. Quite unusual for my mom, as she had no idea how the beeper got in her slipper, and no idea it was there. Then she told me that she also had a problem with finding her partial (dentures). So she called a helper again, and they looked for her partial, and it was in the little denture bath thingy all along. Also very unlike her. And to top it off, she took the wrong pills today again, before the aide showed up to supervise. I'm scared and worried about her. I'm not ready for this. And the fear in my mom's voice when she said, "It's like I just lost my mind today", it breaks my heart.

And DH. Today when I talked to him on the phone, his voice had that slow, thick sound to it, like he was talking in slow motion. I told him "your voice sounds funny." I had actually forgotten that that kind of speech is a symptom for him. He said to me, "Yeah, I think I'm going backwards a little, I keep having mood swings, and I don't want to do anything except watch TV." So I suggested he take his evening meds and he didn't want to. But he finally did.

And all the while, I'm stuck here at work. I don't know, I feel pretty helpless when I'm so far away, but sometimes I'm glad I can do something besides dealing with all this illness!

Double Bipolar

Well, yesterday was DD's therapist appointment. We talked about the usual problems she has with her peers (an ongoing saga) and we talked about her bio mom, too. (I go to every therapy session, because I can explain the stuff that happens at home from a grown-up viewpoint, and also because it's as close to real "therapy" as I get.)

Nothing shocking there. So then we had an appointment with DD's pdoc. I started talking about the meltdown she had three weeks (or so) ago. We talked about the extra-nasty defiance we've been seeing for the last few months; "It's 9:00, time for bed!" "I'll go to bed in a little while." "No, it's bedtime. You need to put your stuff away, it'll be there in the morning." "I'M NOT GOING TO BED. MAKE ME!" etc.

To me it was just more of DD's "issues". I figured that we were just seeing a "more assertive" version of the issues because she's 15 now. And I don't know a lot of people who didn't sass back to their parents when they were 15. Or try to get away with breaking the rules. But the first thing the pdoc says after we talked about all this was, "Has she ever been diagnosed as bipolar?" Um, no.

Well, now she has been. She's been on Lamictal (100mg) for about two years now, because of her angry outbursts. I have known that was a bipolar drug, but it had been prescribed to DD in order to "stabilize her moods." Oh crap. You know, the more I try to explain to you that I had no idea she could be bipolar, and that they really weren't prescribing her Lamictal for bipolar-TYPE symptoms, well, I basically end up looking pretty foolish, because that's exactly what I should've seen, but didn't. So I'm shocked, but apparently, when I review all the things I knew beforehand, well, I guess I couldn't see the bipolar for the symptoms (or the forest for the trees!)

Anyhow, they doubled her Lamictal dose, and the pdoc is confident that we'll see some very nice changes in the next few weeks. I hope so, but really, I'm not all that confident that it's really bipolar.

Or is it that I just don't want it to be?

Juggling

My mom is slipping, I think. We've known for several years that she suffers from Posterior Cortical Atrophy, which is a visual type of Alzheimer's disease. It started where she couldn't "see", and after a lot of doctor visits, we "figured it out." Now, it's kind of strange sometimes, as she can't "see" the car to open the door, but she can see a fruit fly in a restaurant. It's pretty clear that her eyes "see", but only sometimes do the eyes connect to the brain....

In case you are fairly new to my blog, my mom (age 79) lives in an assisted living facility about four miles away from my house. I continue to set up her meds and take her to appointments, both because it saves money, and gives me more insight as to what is really going on. (But her assisted living place would do that for her, if I could stand it)...

Anyhow, last fall, she broke her hip. Her recovery from that, physically, for sure, has been phenomenal. She doesn't even use a walker to get around. And she seemed pretty stable mentally, all summer, too. That is to say, she knows who she is, who everyone is, she knows who the president is, etc (one of the "blessings" of this form of Alzheimer's), we just have to use small words and relatively simple (non-abstract) concepts.

In the last few weeks, though, I've noticed that she's having trouble finding the right words. This has been a symptom of hers for years, but lately it seems to be worse:

Me: Hi Mom, what did you have for lunch today?

Mom: Oh, it was....um......

Me: Oh, wait--I'll check the menu--did you have a BLT today?

Mom: No, it was....um....one of those things with everything in it.

Me: A casserole?

Mom: No...

Me: A salad?

Mom: No....

Mom: It was--it was--oh, I can't remember...

Me: Was it a bacon, lettuce and tomato sandwich?

Mom: Yes!!! That was it!!!

That's a pretty typical conversation for us recently. And about three weeks ago, she got confused on her meds. See, I set up her meds in those day-of-the-week pill cases, and she has a pill case for each time of day, if that makes any sense. So her morning pills are in a white case, all she has to do is figure out what day it is, grab the morning pills and take them. Her lunch time pills are in a purple case, suppertime pills are in a green case, and her new bedtime pill is in a blue case. The bedtime pill hadn't been added yet, when she got confused the first time and took two days worth of pills in a row. I notified the staff there, and they were supervising her and determined that she was doing it right, so they decided to go back to her just taking them like usual.

Then this past weekend, she got confused again, she took two doses of her lunch time pills. Luckily that was just a vitamin and an iron pill, so it wasn't too big of a mess. The staff started checking on her again.

Earlier this week, we had to add in the bedtime med, because we were hoping that the confusion was due to not sleeping well. I'm afraid that isn't it, though.

Anyhow, this afternoon, before I left for work, I stopped in with some things I had bought for her. I looked at her pills. At 2pm, she hadn't taken her morning pills OR her lunchtime pills, but her evening pills were gone. She told me that it was because the staff person had moved the pill boxes around. I asked her if they came to help her take her pills, and she said "yes, but...." and I didn't get a straight answer. I understand that the staff probably checked the day of the week, but didn't pay attention to the time that the pills were supposed to be given. Mistakes happen--like I've told you, my part-time job involves taking care of people, also, and, there, too, mistakes happen. But I'm worried about my mom. She has been having a hard time dialing my phone number lately. She says the light is bad and she can't see to dial. (I'll be buying her a floor lamp this week). But she has lived there for three years and has always been able to dial my phone number.

I know this is a progressive disease. I know it in my brain. But my heart, my heart has been hoping (and, yes, assuming) that since she was stable for quite a while, maybe she was just going to say like she was indefinitely. Or that maybe I'd see some little changes once in a while. But I'm afraid that's not the case.

I'm hoping that when spring/summer comes, she will come back a little. I don't want to see this. Even though she's lived in assisted living for three years, I am not ready for her to get worse. And the guilt. I work so much. I know she really wants me to spend time with her. And I can't, because I've got DD, and DH, and her, too, and two jobs. And not a one of them is getting the full extent of care from me that they deserve.

The "juggling"? Well, DD was very unstable for probably the first four years after she came to live with us. It was kind of a miracle that she started to stabilize, because right around the time she started to stabilize, DH got unstable. With the spending, the depression, the not working, DD's therapist and I together thanked our lucky stars that only one of them was unstable at a time, I don't know how I could've handled it otherwise. And now, DH is relatively stable, better than he has been for quite some time (as a general rule) and my mom is having troubles. So now I've to keep the DD ball of stability up in the air, while I keep the DH ball of stability up in the air, and hope that they don't fall down while I'm handling my mom's problems. Scary.

How to ask the doctor about this?

There are some things I'd really like to know. But I know what a doctor will say. I say that stuff all the time. Bad idea, DH. Don't do it. Of course that doesn't matter to DH. He feels normal in his head. So I'd like to ask the doctor some things....

Like....

What if DH wants to have company, have a few beers, and stay up until 4am?

Yesh, no big deal for someone who is "normal".

But, with the Lithium, I/we know that alcohol can dehydrate him quickly.

And he's worked so hard to try to get himself on a day/night schedule. Staying up until 4am, for him, is not a good thing.

But he used to do that. Back when things were normal.

What I want to ask the doctor is, "If, say, DH wants to have a few beers, to feel like "one of the guys", should he still take the same amount of Lithium that night?" "How about the next day?"

and...."If DH decides that he wants to stay up until 4am, what is the best way for him to take his pills so as to do the least damage to his schedule?" If he takes his Seroquel at 4am, he's going to sleep until 4:00pm. And so on. So does he just not take any Seroquel? Or maybe a half a tablet? I might ask the doctor anyhow. I'd like to do the right(est) thing when DH does the wrong thing.

Just in case you were thinking about his pre-Lithium alcohol issues...this is not the same thing. And actually, it already happened, but I wish I knew what we should be doing. DH had 6 beers last night and stayed up until 4am. He had fun, and it was nice for him to be able to socialize a little. Took his pills at 4am. To his credit, he got up at 11am, which was earlier than I got up :-) But all day long, he complained of "not feeling good". I suggested that maybe he shouldn't have beer when he's on Lithium, and he said I was probably right. It's pretty easy for me to see that whatever is making him feel bad probably has to do with either alcohol or medications or sleep or all of the above. But he walks around saying "I don't know what's wrong with me." Oh. And his back hurts today, too.

Today's Karma

Last night, I stayed in the city, as I usually do on Wednesday nights--it saves on time and gas, since I have to come back on Thursday anyhow....I haven't gotten brave enough to stay in the city for TWO nights in a row, yet, because sometimes DH forgets to take care of the animals and I can't stand the thought of that....but anyhow....today, after I got up, I went to the post office, as I had to send some money to pay some of DH's Dr. bills--the billing office has been getting rather cranky! So anyhow, there was a customer at the counter who was asking lots of questions, taking a lot more time than anyone ever thought a person could take at a post office....so after I waited in line for about 10 minutes, another waiting person, a scraggly old guy in filthy clothes, who looked kind of frail, said, "This is just taking too long!" and walked out. I remember thinking he looked like a classic example of a bum--gray hair, unkempt beard, absolutely filthy (we're talking almost shiny with filth), worn-out clothes....but beyond that, I didn't think much of it, because in that neck of the woods (in the city), you see ALL kinds of people and nothing really surprises me any more!

Anyhow, I got my stamps, mailed my bills, and walked out. The first thing I saw was an older (but still in pretty good shape) white car, with its hood up, signalling car trouble. Then I saw that same old man, looking at the car and looking kind of flustered. I asked him if he needed to use a phone, and he said that what he really needed was a ride home. I gave myself a few seconds to think about it, realized I was probably bigger than him and much more fit (although I'm not fit at all...sigh) and I offered to drive him home. The entire way, that little voice in my head was yelling at me. "You idiot! How on earth do you know he's safe? This isn't your small town where there is no crime!!! Why are you doing this?" And I couldn't answer myself, because I really didn't know why, other than he looked like he needed help. Luckily, he was not harmful, and I dropped him off at his house, an older, well-kept house in an older, but not slummy, part of town. I kicked myself for a while, mentally, and then just went on my way.

Now I'd like to tell you that he gave me a gazillion dollar reward or something like that, but the karma in this story is more subtle than that. I wasn't feeling really good about having helped, because I was aware that it had been unwise. But all of a sudden, people got nicer. In ways that I don't expect in the city. Someone let me go ahead of them in line. Someone else offered to take my cart back from the parking lot. People were smiling at me (and that's really weird in the city!) for no reason that I could see.

So, being the realist that I am, I came to the conclusion that really, those people probably weren't any nicer than they usually were. Maybe I was just noticing it more? Maybe I was subtly feeling better about helping than I thought I was and it was showing? All I know is that I have always been a very firm believer in "What goes around, comes around", even if I don't live to see that happen.

Anyhow, I figured that somehow, me helping that guy either temporarily changed the message I send to other people, or it changed the way I look at other people. Either way, all the positive interactions really made my day. So I'm not kicking myself any more.

Mental Illness and Back Pain

I came across this article and thought some of you might be interested. As you know, DH has struggled with severe back pain that very closely corresponds to his instability. Since all of the doctors he's ever seen, including the ones that he was when he was hospitalized for mental illness only prescribed pain killers and ordered scans, I found it exciting to see that some researchers are recognizing this connection.

Here's a link to the full article:
Click here to read the full article

The Mind-body issue

Most people think that the mind and the body are separate and function independently. Instead, these two usually work together in shaping our experiences. Sometimes psychological factors can reduce or eliminate the effects of physical problems. For example, one line of research asked normal volunteers (that is, people who have never complained of chronic back pain) to undergo imaging procedures such as CT scans or MRI scans. Surprisingly, about 40% of these subjects had ruptured disks, pinched nerves, cracked vertebrae, or some other form of physical problem that should have produced significant back pain, but didn't. On the other end of the spectrum, there are some rare cases of conversion disorder: a psychiatric condition where the person feels chronic back pain, but there is no identifiable physical problem at all. In most cases, though, chronic back pain is a psychosomatic (literally, "mind-body") condition, where a real physical problem exists, but psychological factors play a large role in determining the person's experience of that problem. In some cases, mental processes such as dependence, depression, or frustration may make the pain worse; in other cases, a positive attitude and a sense of independence may lessen the pain.

Bipolar disrespect

Hi everyone, I hope you had a Happy New Year--it was nice to get a day off where there were really no big obligations...we stayed up with my mom until Midnight--she was very proud of herself and really happy to be a part of it, so I'm glad we did that!!!

But, now, we're back to reality. Today while I was sleeping (I got home at 9am so I slept all day) I realized I could smell cigarette smoke. (In case I haven't mentioned it, there is a 'no smoking in the house' rule at the Mr/Mrs DH house). When all was said and done, I discovered that DH has been smoking in the house when he thinks I won't find out--like when I'm at work, or when I'm sleeping. He's been instructing DD not to tell me, and for once, she did. (Of course, she totally spilled the beans once I was on to things, but still...)

I wasn't really mad at first. I think I kind of went "Oh, so what's new..?" I guess there's a part of me now (and I'm not liking it) that is no longer surprised when these sorts of things happen...but the more I thought about it, the madder I got. First, because there are a lot of beings in our house that cannot choose whether they breathe smoky air or not. Including DD, but also all of the animals....and to me, smoking in the house like that is very selfish....but also, because of the example he is setting for DD. So he's showing her "If there's a rule you don't like, see if you can get away with breaking it and having nobody notice." or "It's ok to break rules if nobody notices" or "this is how a responsible grownup acts." Not good.

So I did what any self-respecting angry mom who didn't want to have a big fight at the moment would do....I went back to bed until it was time to go to work.

During that time, DH wrote me a letter apologizing. I didn't have much of a response, though, as I could tell this one "one of those times" where he messes up, I get mad, and then the mental illness/self-pity takes over, and he gets so depressed I don't get to make my point, because I'm afraid he'll kill himself. I know it's dysfunctional.

So I called him at 10:30 to tell him to take his pills. Here's the conversation:

Me: I'm just calling to remind you to take your pills. I've been calling for the last half hour and was getting worried because nobody answered the phone.

DH: I was in the shed.

Me: Oh. I was worried.

DH: Can I call you later?

Me: Yes, I'm sorry if you're angry. (the only thing I could think of in relation to this was that he was angry because he was "busted"...I don't know...)

DH: I'm not angry with you.

Me: Oh.

DH: I'm angry because I break your rules, I sit around all day, I hardly help you at all, you're broke, and I'm not helping. I'm a piece of sh**.

Me: Are you feeling like hurting yourself?

DH: Yes.

Me: Can you take a Lorazepam to maybe feel better?

DH: I already did. Can I just call you later?

Me: I guess so....don't forget to take your pills.

Ok, so then I'm really worried. I called him back and he said he was doing better and was cleaning the house. I was thinking that he probably wouldn't hurt himself, but you never know, right? I never know what to do when this happens. My feelings get all messed up, because if I get mad, he gets "suicidal" and so I'd better just forget it, so that he stays ok. Not fair. Not fair at all. And then if I do get angry, I end up worrying all night about whether I'd sent him over the edge. I wish he was still seeing his therapist, because his therapist would be strong enough to point this out. I'm not, because I'm afraid it would be more of the same (he'd want to hurt himself because he's making me feel bad.)

Bipolar sucks. Big time.