On May 17th 2015 my husband began having a sever panic attack at work and went home sick around 10:00 am. I left about a half hour after he did to go check on him as his behavior was unusual. At this point he had reached his breaking point. I called his psychiatric medical provider immediately to schedule an emergency appointment. During the appointment he presented with suicidal ideation, high levels of anxiety, and inability to focus. It was as if he was not mentally aware of what was going on around him. His psychiatric medical provider requested that he initially be off work for two weeks and that I stay home to care for him. To this date, he does not remember anything that went on during this two-week period. I had no idea that what he was about to experience was two weeks of psychosis.
I can remember that during the first few days he was extremely scared, anxious, and didn’t make much sense when speaking to him. At this point, I did not call his mother and inform her of what was going on because I did not want her to worry. But she called daily as if her mother’s intuition was on high power and she just sensed something wasn’t right.
Our Journey – Psychosis
While awake, he was very aggressive, skittish, anxious, cried a lot, and was in a state of extreme fear. I could not do anything to calm him down. While he slept, which was very rare unless assisted through heavy medications, he would have terrifying nightmares. I was on edge the entire time because I had never experienced him this way and had no idea what was going on with him. I spoke with his psychiatric provider often throughout this time for advice and direction. I was also the communicator between the owner of the company where we worked regarding his condition. I was challenged with giving enough information to satisfy our employer without divulging too much private information. Because I was so confused regarding my husband’s condition I asked his psychiatric provider for a synopsis. Plus, I didn’t know if we would need a synopsis for any legal reason in the future. Since his psychiatric provider was retiring I felt it was a good idea to get this right away.
Synopsis From Psychiatric Provider
After reading the synopsis my heart sank. I have included a few excerpts here for you.
“Significant Stressors – Work-related stressors caused by his direct supervisor, and professional stressors due to him performing three significant positions within the company.
He was under the care of a pain management specialist for his back pain and was prescribed medication on a continuous, consistent basis. It appears, via his Pain Management Doctor’s reports that he was and continues to be compliant to all medication regimens.
Initially, I prescribed a Selective Serotonin Reuptake Inhibitor (SSRI), Sertraline for his depression; a mood stabilizer, Lamotrigine; Minipress for nightmares associated with work related incidents; and Melatonin for sleep. She experienced unacceptable side effects from the Zoloft and it was discontinued.
He continued to experience panic attacks at work, related to incidents caused by his supervisor’s ongoing harassment and teasing of his appearance related to his disabilities, during his minimum 12 hour workdays. These occurred on an average of twice a day, and were severe and debilitating. However, he did continue to work daily and did not stay at home during those times. I prescribed Xanax, a short-acting benzodiazepine, to be taken as needed was added to reduce both the frequency and severity of the panic attacks. The Xanax was only partially effective and provided little if any lasting effects.
Our Journey – Synopsis Continued
Kolonipin was added to attempt to achieve a steady state of reduced anxiety but this caused significant drowsiness and was discontinued on except to initiate and maintain sleep, per the patient’s request. This was due to him wanting and needing the ability to perform his job at extremely high levels of responsibility. The Xanax was doubled to be used for “breakthrough” severe anxiety and panic attacks. Abilify and Wellbutrin XL were added to his prescriptions at that time to replace the Zoloft. By 3/4/15 it became apparent that he was also suffering with Attention Deficit Disorder with symptoms that started in his childhood. Psychological questioning and the ASRS, v. 1.1, was completed by the patient and his spouse took the screening tool and both confirmed the diagnosis. Mood swings, depression, and anxiety appeared to be unremitting due to continued work situations.”
By 3/24/15, it became apparent that the patient would benefit from a stimulant medication for her ADD. This was approved by her pain specialist. Adderall was started and dose adjusted. Excellent improvement in his focus and concentration abilities were seen. Kolonipin at bedtime was continued to ensure adequate sleep. His depression, however, worsened and he presented with suicidal rumination with no plan or intent to carry it out. A request was made to his employer for a two-week leave of absence to eliminate the work-related stressors from his daily life. I personally called and spoke with Mr. XXXXX on the phone to express the severity of his condition to reinforce the need for the patient to have no contact with anyone from the workplace. He was cautioned not to work, or have contact with anyone from work and to stay with another adult during this time who understood the gravity of the situation – preferably his wife. A request for his spouse to have the same time off to care for him was also made both in writing and verbally with her supervisor. I encouraged him to think about his life and what could potentially be changed to ensure his mental health.”
First Week Of Psychosis
Due to the extreme changes in my husband’s behavior and not knowing what to expect hour to hour I arranged for family to keep our children. Most of all, I had to protect our children from seeing their Father in this way. Up to this point, I still did not know that he had developed Complex Post Traumatic Stress Disorder. Additionally, I didn’t even know what psychosis was or that this was what was happening to my husband. Psychosis is best described as a severe mental disorder in which thought and emotions are so impaired that contact is lost with external reality. In other words, someone experiencing psychosis is not connected with the real world. They are hallucinating and mentally checked out – unaware of what they are doing or what is going on around them.
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