Bi-Polar with psychotic features

Shawn is an interesting patient for sure, a man in his early 30’s, with short brown hair, glasses and a missing tooth. He was super nice, always making me little paper frogs for me to remember him by. He was so sweet and kind hearted. He took the big brother role to other patients, especially the violent aggressive ones who he should probably have kept a distance from. He claimed to have Multiple Personality Disorder, one time he even pretended to become a “dead 16 year old girl named Tabatha” going on and on in a high pitched voice for hours to my co-worker. It was a pretty convincing act but we all know better and were able to see that he was lying. Us staff members came to our own conclusion that he is gay and wishes he were a woman and so that was his way of coming out. He confided in me one day out on smoke break that he sees and hears things, spirits mostly, and that he can see Auras around people. He told me that I was a yellow and the next day I was green. He’s actually not the first patient who has told me what my Aura is. It’s pretty cool. Shane also never sleeps. He spends hours drawing and coloring. His room is full of his pictures and papers full of nonsensical sentences streamed all over the room. He will stay up all night drawing and writing. It seems that people with psychosis have so much going on inside their heads that you will find them scribbling constantly. It is their way of releasing the scrambled information floating around in their heads. When I would go into his room I would find papers with random drawings, words and sayings hung all over the walls. This explained why he was always asking for tape at the nurses station. For the first week he was with us he never slept, he would stay up in his room all night scribbling away and pacing up and down the halls happy with a smile on his face. Then he took a dive going from the manic stage of bi-polar to the depressed stage. He no longer smiled and we would find him in his bed all the time. It was very sad to see him go through that, to see him so depressed that he couldn’t even force a smile. He had always been so pleasant and happy, always making the best of his situation. He was a great example to me. I hope he is doing well wherever he is now.

 

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Acute Psychotic Break

I had an experience at work a couple days ago that was interesting and so I thought I’d share it. I came into work to find my unit with about 12 patients and a few that I hadn’t met yet. Amongst the new was a woman in her 50’s, she had short brown hair that was starting to gray and she was round in stature. Almost immediately after I had walked onto the unit I heard a “Oh” ing sound. I looked over to find her sitting in the dayroom swaying back and forth while saying, “Oh” over and over again. It almost sounded as though she was having an orgasm. The other patients felt uncomfortable leaving the dayroom to go hide out in their rooms. My co-workers explained that she had a history of psychotic breaks but in between them she functioned  very normally. She was a teacher and had been teaching in her classroom only a few days before. Her husband had begun noticing some odd behavior with her and had brought her in.

When it was time to go meet her and get her vitals I walked down the hall to find her sitting on a couch “Oh” ing and swaying back and forth. I interrupted her by saying hello and she immediately stopped, stood up and walked really close to me. I backed up a little feeling a little anxious about what she was going to do next. I said, “Hi, would it be ok if I got your vitals?” She proceeded to look at me with wide eyes and a smile that looked like she was going to hurt me and then said, ” I’m Satan.” I said, ” Ok.” and the she said it again, ” I’m Satan.”  She then laughed as she stared me straight in the eyes. I realized I wasn’t going to get anywhere so I was about to turn to leave but then she said, ” Ok, I’m just going to sit down and go to the bathroom.” She then turned back towards the couch and sat down on the third cushion and began urinating. It was then that I realized that the first two cushions were completely soaked in urine.

Interestingly enough two days later when I returned to work she had completely come out of her psychotic break. The doctors had tested her and found that her sodium levels were low. She greeted me with a smile, told me that she remembered me and that she was excited to get out so that she go back to teaching. It’s crazy how things happen. It makes you realize how important it is to take care of yourself, mind, body and spirit.