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Psychosis is treatable - get help early

Things came to a head on Mothers Day 2008, when my 19-year-old daughter, Tracy, wouldn’t reply when I spoke to her. (I later learned that she was answering me telepathically and couldn't understand why I wasn't hearing her.) Her behaviour had been uncharacteristically odd for the past several months — laughing inappropriately and the next minute in tears; for days walking on tip-toes, stretched up as if floating; staying very close to me like she did as a child... I thought my daughter was getting stoned, but she flatly denied any street drug use and agreed to go to the hospital for a drug test.

When the triage nurse asked her why she was at the hospital that day, Tracy replied that she had bipolar disorder. I looked at my daughter and the triage nurse incredulously. This was the first I'd ever heard of it. Tracy tested negative for drugs. And Tracy had diagnosed herself from a pamphlet she'd read the previous summer.

I stayed with her overnight in emergency because the hospital staff and I were afraid she would flee. In the morning a psychiatrist concluded Tracy was in a manic episode and committed her to hospital for 14 days.

After release from her first hospital stay she became acutely psychotic followed by soul crushing, deep, dark depression. There were many hospital stays. Eventually, St. Paul's hospital referred her to UBC Hospital long term stay and then to EPI. She was diagnosed with Bipolar Disorder I with psychotic features.

EPI took on her care with enthusiasm and optimism. She saw a clinician and psychiatrist weekly and sometimes 2 or 3 days a week if she was really struggling.

With the help of Tracy's team I was able to understand that she had had a "brain attack" and that it takes much time and effort to regain normal brain functions. She could not concentrate for long on anything and there were other symptoms, too. Repeated negative and self defeating thoughts. Reliving her bizarre actions when she had been manic and psychotic. Also because of her illness her brain had not had a chance to mature at the same pace as most people her age.

She remained acutely depressed. In the early days at EPI Tracy's eyes were vacant, face void of expression. As her caregiver at the time we spent much of our time together. She would continue to intimate her dark, disjointed and distorted thoughts to me and yet would be silent while in the presence of her psychiatrist and clinician at EPI. The EPI team would encourage me to attend her clinical sessions in order for me to prompt her to share her thoughts. Tracy was reluctant to share her thoughts with EPI staff. She knew that her thoughts were strange. Tracy did not know anyone else who had these kinds of thoughts, except for people on tv and in movies who were inherently labelled "crazy". She didn't know what the repercussions of sharing these thoughts would be. Her job was to get well. My job was to make notes, get her to therapy sessions and group sessions until she was well enough to travel by herself. I spent countless hours with and on the phone with EPI staff. Gradually, Tracy was willing to communicate by herself to the EPI team without my prompting and at the need lessened for me to be in sessions with her. She was taking baby steps toward wellness.

EPI encouraged my daughter to continue to attend group therapy sessions with young people grappling with serious mental illnesses. Tracy attended a session and sometimes 2 sessions of some kind on most days.

Tracy is now in recovery, managing her symptoms, living in her own apartment, taking university courses, facilitating support groups, public speaking about mental illness, sober, going to AA meetings regularly, doing peer support work, going to the gym, yoga, biking, taking her medications, keeping daily journals and living a healthy lifestyle. With her commitment to attend ongoing therapies and an excellent mental health team she has gained insight to her illness and takes responsibility for her mental and physical health. Her illness is chronic and she will have symptoms flare up in the future. She now has many supports and strategies to deal with these episodes. She had the courage and strength to re-invent her life in order to live well with a mental illness.