It's not ok to diagnose people and prOscribe medications.

[unsunghero]

When the pic mentions someone with bi-polar was prescribed an antipsychotic, which puts them on the road to chronic disability, neither of these things should be true

For one, it is ENTIRELY possible to have bi-polar with psychotic features and need an antipsychotic. For example, last week I assessed a lady with that diagnosis who was having a manic episode and hasn’t sleep a wink in 4 days. She had rapid speech, verbose, flight of ideas, hypersexualized communication, and almost entirely completely incoherent communication. She wasn’t oriented to date (didn’t know the current month or year), location (didn’t know where she was), or situation. Some of the answers she would give to questions like “would you like to see a doctor today to talk about how you haven’t been sleeping?” (This is a good angle of approach because the goal is just to get them in front of a psychiatrist who will immediately recognize the psychosis). Her answers to questions like these included:

“I have HIV legs”
“I am not a football player”
“I am not going to show him my vagina”
“I have a human female vagina”
“I am in a hospital”
“I have sex with lesbians”

These were just the answers that weren’t complete word salad. It is entirely possible to have psychosis if the person has a bi-polar diagnosis with psychotic features, and especially if they are off their meds and not sleeping. Sleep deprivation isn’t an entire explanation for their symptoms but it certainly contributes

Ultimately this woman was too psychotic to be able to understand and accept voluntary treatment and had to be forced treatment by her parents (she is an adult) because she had become a threat to them in the home (had grabbed a knife that day and made a stabbing motion towards her parents in the home). She also at that point didn’t know the names of her parents and believed her parents had been replaced by imposters

Does her being prescribed an antipsychotic lead to long term disability? Not that I’m aware of. Maybe they are trying to mean tardive dyskinesia with Halodol, but no one prescribes Halodol anymore. What is this “long term disability” they are referring to??