Should he be driving?

[Louise]

My son is nearly 19. He was hospitalised with psychosis 2 years ago, diagnosed with Bipolar Disorder, took his medication and recovered well. After 6 months of coping very well without medication (starting Uni and getting good marks, working out at the gym, socialising and even doing a little part-time work)....he is now struggling with mental illness again. He is not ill enough for hospital and he doesn't want to see a psychiatrist so there is not much I can do except keep an eye on him, listen to him, try to get the balance right between giving encouragement but not too much advice. I am disappointed, concerned, lonely, frustrated. There is no-one else in the household. He has been trying to attend Uni but can't follow the timetable or find the venues. He begins assignments but gets lost in thought or can't figure out how to use the computer. He begins household tasks then forgets about them. When preparing food or putting dishes away he puts everything in the wrong place. In conversation it takes him a few seconds to register what has been said and even then he often can't understand the simplest piece of information. His friend informed me that he drove through two red lights the other day and was nearly driving right off the road. The same friend thinks I should take his carkeys off him because he shouldn't be driving. I understand his concerns but by the same token, being forced to pay immediate attention to driving might be good for my son, it might be stopping him from getting worse. Also, my sister has had severe chronic mental illness for 20 years and though I have never felt safe in the car with her, she has never had an accident! But if my son has an accident and someone is injured I suppose I will feel pretty terrible. But I don't want to upset him by taking his keys! He would be so cross and could even move out of home and be far more vulnerable than he is now. Also, why does this burden have to fall on me? I feel I have enough on my plate! Why can't his friend take his keys if he is so worried?

[NikNik]

Hi @Louise

It sounds like this is a much broader issue than just driving (although that's probably the most dangerous). I have seen others share tips and advice on how to approach difficult conversations with their loved ones when they think they want help. Some tips I've seen from other carers include:

• Approach your loved one when they are a relatively good head space
• Premise the conversation with the purpose of the conversation is because you are concerned and you want the best for him
• Objectively point out what you have noticed - removing any emotive language. So for example you may point out that you have noticed all the plates put in the wrong location
• Ask him if he's noticed any changes too and why he thinks this is happening 
• Reiterate that you care and are concerned and you want to work with him to get him back on track
• Work on a plan together 

I know that sounds really straight forward, but in reality may not be, however just planting the seed that you're noticing a difference and things can get better, could get the ball rolling.

Another piece of advice I see often discussed in the Forums is that recovery isn't a straight line - there can be two steps backwards, there could be round abouts and there's times when things can get wobbly - and people shouldn't be too tough on themselves if things go off track.

What can be helpful to know is that, while he may go off track every so often, the more he gets back on track, the quicker he will be able to identify the wobbly times in the future and know what to do to get back to where he was.

It was really tough that you have to be the person to manage this - but you don't have to do it alone. We are here and there are mental health carer organisations in all cities around Australia (for example, Mental Health Carers NSW, Mental health carers TAS, ARAFMI QLD - the list contines - so please google for your local service).

I hope some of the above is helpful - take care

[Louise]

Thanks for your reply @NikNik. All your suggestions are helpful, but they all fall under what I meant by "listening, keeping an eye on him and getting the balance right between giving encouragement but not too much advice". I am doing all those things and I can cope with all that. But making the decision about whether or not he is safe to drive and/or confiscating his keys is harder and I can't cope with it at the moment.
Thanks again

[NikNik]

No worries @Louise
I can understand your frustration and wanting the friend to take the keys of your son themselves - rather than you having to do it.
Has this friend asked you to not tell him they have discussed this with you?

If not, then I would suggest that you raise your concerns in the context of noticing these other things (lack of concentration etc) and share your concern that this might be impacting his driving too from what his friend has told you.

I don't know of any evidence (though I haven't looked at it deeply) that suggests that being forced to pay immediate attention to driving is a good thing. Lack of concentration (eg: fatigue) is shown to be very dangerous.

I can't definitively say whether you should take the keys or not - but I would raise it as a concern.

Does your son know you're contemplating taking his keys?

[NikNik]

There are a few members who have children around the same age or who are now adults, that might have some advice @Louise

Does @MrRightEnough , @007mum , @SarahKate, @Appleblossom @PeppiPatty @Skylark have any advice for Louise?

[PeppiPatty]

Dear @Louise

How are you this morning?

My name is PeppiPatty, I am a community guide here. When I read your oiginal message, I felt really annoyed at the hospital that you are on your own. 

When you write : 

@Louise....it feels like to me that you are used to no one listening to you. From one Mum in Western Australia to you, Jeepers Kreepers, I can so hear you. When my son at 20 years old had his first psychosis; even my Mum wasYEelling I didnt know how to care for him properly and told me very forcefully that I was wasting the money to visit him at the East of Australia where he lives.

This gave me more insight how her self works, if it is'nt about my Mum, I am always wrong.

Back to your son. Congradulations on having this strict way of not being too involved. 

I'm asking you to bring his friend into the picture and take the keys away from him. If anything happens to him, you will never forgive yourself. 

Am impressed with you, 

[Appleblossom]

Hi @Louise It is tricky enough balancing the mothering and caring roles .. . with our own personal needs and boundaries.

Gaining maturity is a sequential and gradual step ... as the young learn the HUGE range of skills needed to survive in today's society. I found first term at uni .. terribly exhausting ... working out where everything was ..

Re friend .. did he discuss the driving with your son? ... or is everyone walking on eggshells and not talking about it.. Can understand why a peer would hesitate to take keys.

Talk about the whole driving situation first ... gently  .. raise the issue of concentration & energy levels. Driving thru red lights .. is not good .. get him to reflect on his own skill level .. eg., ask him to rate self .. out of 10 .. then it can be a safety and general thing ... and you can try and keep it chatty ... rather than a sudden & punitive action .. of removing keys.

Maybe you can relate his indoor behaviour to his outdoor behaviour ... and assess his driving readiness .. but i dont think you can take total responsibility for it .. he is adult ... it is hard enough as they may see comments as a threat to their mental health can be taken as a put down .. it is a delicate situation that takes the skills of a diplomat. Maybe talk about your own variations in concentration on the road .. to get him talking about his ..

My brother had frequent run-ins with the law .. re driving .. though he never had an accident ... there are no guarantees ...

My son was very reluctant to drive and did not even have a permit when he had his episode ... so I was relieved from making those decisions. He is very cautious and safety conscious ... It is more me encoiuraging him to get more experience and skill ... I am his supervisor ... so we take it easy ... he only drives once every 3-4 months .. my son is 24. it is frustratingly slow .. but it is safer... all personalitites are different ...

Does he have his own car?

[PeppiPatty]

Dear @Louise, How are you?

I just saw my Support Worker here in Perth for some time out. We sit in her car and drink milkshakes....yummy.

But now I'm back with a clear head: I thought....who told you that your son is not sick enough to go to hospital?

Although there is many people on the streets who has Psychosis,:

has anyone told you what this means or where you can get support for yourself?

Psychosis basically means that you live in a different world.The problems are with hallucinations and hearing voices ( NOT split personalities)

People with Psychosis can become very dangerous because sometimes....their minds are so confusing, they do what they are told by the delusions and the halluconations.

I met a young lady who was too scared to meet her Mother because her Mother had been diagnosed Psychotic. I have no degrees in this terrible condition, I told her that my advise is from living with someone who gets Psychotic...

We discussed how scared her mother would feel from as soon as she opened her eyes in the morning in bed. That her life would be very confusing and scary.

I Don't know how you are feeling....but I may have a bit of that lonlilness you feel. I get judged a lot. All the time. You seem like a very intelligent woman who I would like very much to hear from again,

PeppiPatti

[SarahKate]

My daughter is nearly 22 and was diagnosed bipolar type II about a year ago I think it was - time has warped since she fell terribly to MI. When I read your post I really understood the feeling of exhaustion from trying to find that balance. I haven't had to cope with the driving issue other than having concerns about her driving under the influence of dope which she was using heavily to self-medicate and escape her suicidal thoughts.

What I actually 'heard' from you, though, was the feeling of powerlessness to help your son and fear that something dreadful would happen. I think what may be at the heart here is the lack of treatment, including medication. My daughter has progressed and relapsed constantly and one of the main factors in this rollercoaster ride is stopping and starting her medication. We have been told by psychologists that this is a very common behaviour in people with BiPolar. Fortunately, recently my daughter asked me to look after her meds so I wake her every morning and she takes them. She is so much better on them, but struggles with some of the side-effects. This has been a very recent positive change so I'm counting no chickens! 

I guess I'm thinking the driving is just another symptom, just unfortunately one that could have dire consequences. However, even the suggestion of taking a young person's movement independence away could provoke quite a repsonse. But if it were me, I would have to try and do something to limit the risk. Is there some way you could talk to your son about how he is feeling now, what challenges he is facing and how that differs from when he was on his medication? Could you take him for a drive out for a day somewhere, or go for a walk? I have found that conversations side-by-sde rather than face-to-face have been much more conducive to talking freely - less confrontational. Maybe you could talk about how you feel, your concerns. And maybe ask him how he feels about his concentration when he's driving. 

One thing I have learnt to do is limit the amount I say to my daughter in one go. I plant the seed of something, maybe ask her something, and then as soon as I sense a big reaction on its way, quickly move on to something she is happier talking about. Then the next time I might take things a little further. What we might see as just reasonable, rational and not a huge thing can be overwhelming to her. We are on a long journey but I am sure therapy, medication and the love of her family are what will help her to better mental health.

The other thing I have learnt is to accept there is only so much I can do...the rest is up to her. I cannot take responsibility for her actions, I can only do the best I can to guide, support and love her.

[Louise]

Thank you so much @PeppiPatty @Appleblossom and @SarahKate for your responses, you all have some great ideas from struggling with the same issues yourselves.
The driving issue has been sorted out thankfully. I returned from work in the evening to find my son home, but not his car. I asked him "Where's your car?" and he said "I don't know. I've lost track of it somewhere." I said "Did you drive somewhere this morning?" and he said yes, he drove into town and parked somewhere near a certain landmark....but later on he couldn't find the car. So I said " okay, I will go and find it. Do you have the key?" He said yes, and gave me the car key. I said " I will find it but honestly if you are not well enough to remember where your car is, I don't think you are well enough to drive it." He agreed. I said " okay, I will bring the car back here but I am going to keep the key okay? I am going to keep it until you are well enough to drive again okay? Are you okay with that?" He said yes. So I got a friend and we drove around looking for the car but couldn't find it. I rang my son's father ( my ex) because the car is still registered in his name. He said " Give me the key and I will ring the police to find it" which they did. So now my ex has brought the car here but kept the key himself. I said please don't give him the key back until he is well enough to drive . I think he will need psychiatric help before he is well enough to drive.So I am glad at least he can't drive now.
Today he has taken his tent and sleeping bag and laptop and phone and gone off to camp for a night or two in the bush. I hope he will be okay. I actually feel less lonely now that he is gone. I have a bad cold and was feeling really irritated because he is unable to help with the simplest chores. Thank goodness I have the afternoon off work to rest. Don't know whether to ask for tomorrow off as well. Not sure how much longer I can keep going like this. It was the mental health services helpline who said he is not ill enough for hospital and I know myself they wouldn't take him. He knows he's not well but he's trying to get better by eating healthy food, getting plenty of exercise and using willpower. I think he may as well try. I doubt it will work....then we can say "You spent 3 or 4 months trying to get better and it's just not working. If you want to drive or work or study....I think you are going to have to see a psychiatrist."