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Friday, May 16, 2008

Cruella's Actual Diagnosis and How It Came To Be

It was October of 2005, two months after "the crazy hospital incident" . We were back in court again to attempt to determine how the children could safely visit with their mother. At this point she had only seen them that one time since July. Big Cruella was in court that day with a petition for the court asking that she and Lucifer be allowed to supervise the visits. That was immediately shot down based on their family history and low standing in the community.

It was ordered that the visits were to be professionally supervised at the Court House every Saturday for a period of one hour for each visit and that Cruella must submit to a psychiatric evaluation. She had already refused to participate in the two previously ordered evaluations and Judge Johnson's patience was beginning to wear a little thin. Cruella's antics inside the court room were always ridiculous, ranging from uncontrollable sobbing, to speaking out of turn, to screaming and yelling about conspiracy theories, to sitting back with the stupidest looking smirk on her face like she was somehow in control. Well, this time she really "lost it", cursed everybody out, and stormed off before we were even dissmissed.

That evening I received a telephone call from my sister-in-law Mary telling me that Cruella was in the hospital because after leaving court, she went to the mall with her son Snake and overdosed on her medication in an apparent suicide attempt and here's what happened next...

The following is an actual copy of Cruella's diagnosis and discharge report.


FINAL DIAGNOSIS: AXIS I: BIPOLAR DISORDER, DEPRESSED. AXIS II: BORDERLINE PERSONALITY DISORDER. AXIS III: NO ACUTE MEDICAL PROBLEMS. AXIS IV: SEVERE STRESS, LOSS OF CUSTODY OF HER CHILDREN AND PENDING DIVORCE. AXIS V: 30
(A rare and valuable explanation of the 5 Axis system used for mental health diagnosis, exclusively provided by Mental-Health-Matters.com.)

REASON FOR ADMISSION: This patient was admitted to Other Town Medical Center two days prior to her admission on REED9 following an overdose of 40 Depakote tablets in a suicide attempt.

HISTORY OF PRESENT ILLNESS: The patient stated that she was at a mall when she took the overdose. The trigger and stressor for this action was losing custody of her children. The patient had just left court several hours before ingesting the overdose. The patient has been separated from her husband since July of 2005. Her husband has an order of protection against her as she was accused of verbally abusing her children and her husband. It is to be noted that the patient's older son was at the mall with her. He is between 15 an 16 years old and he was responsible for EMS being summoned.

PAST PSYCHIATRIC HISTORY: The patient has had two admissions this year, one in June and one in July of 2005. She was in Reg Town Hospital and also in Froot Loop General. Froot Loop General had prescribed her Depakote and referred her to Dr. Shavez on an outpatient basis, however she only saw Dr. Shavez several times. Dr. Shavez did contact the undersigned once the patient was hospitalized on REED9 and was surprised to hear some of the history that was given as the patient did not represent herself in a consistent manner. Dr. Shavez also explained to the undersigned that he would no longer be able to care for the patient on an outpatient basis since he did not believe that they had an honest and open relationship which would be working in her favor.

SOCIAL HISTORY: The patient states that this is her second marriage. Her first marriage also ended in divorce. Her older son is a product of that union. The patient has four other children ages 3, 8,10 and 13 who are now all staying with their father. The patient's 16 year old son is staying with the patient's mother as his father is from the patient's first marriage. The patient's mother works in this hospital as well as does her sister. She also has two other siblings. The patient initially gave an erroneous history, saying that she was adopted and that her natural mother had died in childbirth. However, as was discussed in the family meeting, in fact the patient's mother is alive and well, however is schizophrenic and living in an adult home in the community. The patient's adoptive mother is her biological mother's sister. There are other siblings who are also reported to be mentally ill. This patient dropped out of high school in the 10th grade due to her first pregnancy. Throughout her life her personality disorder and her substance abuse have sabotaged most of her attempts at success.

Drug and alcohol history - On admission the patient denied alcohol or drug abuse. However, this history was also inaccurate and it was confirmed by her mother that there is a history of both alcohol and substance substance abuse.

PAST MEDICAL HISTORY: There is no significant medical history.

ALLERGIES: No known drug allergies.

HOSPITAL COURSE: This 35-year-old female presented to REED9, angry, argumentative and loud. She was extremely derogatory to the staff from the beginning and created much commotion on the unit. Her mood was dysphoric, angry and depressed. Her affect was constricted. She showed no obvious present suicidal ideation. Her insight and her judgement were both limited.

It was decided that the patient would be started on a trial of Depakote once it had returned to an acceptable level. Therefore three days after admission the patient was started on Depakote 250mg in the morning and 500 mg at h.s. also being prescribed. Depakote was later increased to 500 mg p.o. q a.m. and q h.s. The patient tolerated this increase in her medication well. She did complain that the Seroquel created difficulty when she was trying to sleep in the form of increased dreaming, however this was later addressed. The patient found that there were no side effects from the Seroquel if she took it and went to sleep in a timely manner. The patient remained angry, argumentative, oppositional, and was very medication focused. She needed p.r.n. of Vistaril quite frequently. She was using poor judgment in her relationships with people on the unit.

A family meeting was held and the patient also sabotaged that meeting. Present were the patient's adoptive mother, her father and her brother. Her family related a lengthy history of mental illness. The patient's symptoms beginning in her freshman year of high school. They also discussed her divorce stressors and her inability to tolerate any kind of structure. The patient's mood was very labile. Initially she was cordial and then later became mistrustful and oppositional, eventually kicking her family out of the meeting and rescinding any kind of communication with this staff and her family.

Eventually the patient showed some improvement. Most of her traits appeared to be personality in origin and she could communicate in an appropriate manner when it was in her own best interest. The patient was medication compliant and eventually her Depakote was increased to 500 mg in the morning and 750 at h.s. which left her with a discharge Depakote level of 100. The patient's physical appearance began to improve. She no longer had dark circles underneath her eyes. Her eyes no longer showed signs of strain, however her anger remained present and she continued to have difficulties with her family. The patient was unable to come up with an acceptable discharge plan as far as being housed by a friend, therefore it became necessary for her to consider moving into a motel, which she did.

Her outpatient treatment would be conducted at Supervised-Num-Nuts in Wacko-Land where she has an appointment to see Dr. Wannabe at 2:15 p.m.

Discharge medications - Depakote 500 mg in the a.m. and 750 mg at h.s., Seroquel 200 mg at h.s., and Colace 100 b.i.d.

###

Congratulations for making it down here to the bottom of this very lengthy post! So now let's see who's been paying attention. If you've been here before or if you take a look around the main page of this blog, you should notice that there are two major, yet very basic factual inaccuracies in this report. Can you find them?

Signed, Regular Guy

20 comments:

  1. Well for one thing, they've got the kids wrong. It says Snake is from her first marriage and the rest are from your marriage to her.

    And I thought the restraining order was about more than her "verbally abusing" you and the kids.

    So what did this Dr. Shavez mean by not being able to have a working relationship with her or whatever he said?

    ReplyDelete
  2. Good catch April...yes, they got the kids wrong... kind of surprising how that wasn't caught before the report was written and there is another similar type of inaccuracy that definitely should have been caught in the "family meeting"

    But you are correct...there was all kinds of physical, mental and verbal abuse going on for years, however the order of protection was specifically based on her physically attacking me on our front lawn and then abandoning the kids and I the following day leaving the state to "visit a friend" for two weeks.

    As far as Dr. Shavez goes... He refused to treat her because he "did not believe that they had an open and honest relationship" All she did was lie to him.

    One of the biggest problems here is that Cruella's BPD is so bad that she believes her own lies... they become reality to her and she uses them to justify her craziness. She insists that there is nothing wrong with her and that all she has is post traumatic stress disorder.

    ReplyDelete
  3. They do that a lot. I think they just consider stuff like that to be "small details". I've seen similar mistakes on mine - things like me having an older brother when all I have is younger brothers. Whenever I point out the errors, they're pretty much "whatever" about it.

    Ya know, just like alcoholics and drug addicts, someone with BPD has to make that first step and admit that they have a problem. I hate to say it because I'm usually trying to get people to realize that there is hope, but she's never going to get better if she can't even do that.

    And what breaks my heart about that is your kids (and her other two). The one thing that motivated me to get things under control and get treatment was losing my kids. That was my rock bottom. I had to do it for them.

    The only explanation I can fathom for that is that other than being clearly mentally ill, she's probably also avoiding the pain of the situation by just convincing herself that it doesn't exist.

    Its so sad. People like her are the reason I am so open about my own issues. I wish I knew how to help and get them to see that its a lot of work and its hard but its soooo worth it!

    ReplyDelete
  4. I find your blog very interesting and am sorry for your situation but am glad your children have such a devoted father.

    ReplyDelete
  5. Thanks for sharing april and I sincerely hope that you're always able to maintain control over your illness... you definitely have the right attitude... unfortunately... I see absolutely no hope for Cruella... she's not only severely ill and in denial... she's also evil.

    And, thank you for the kind words health nut... I'm so devoted, it's somewhat demented... lol... but it's all for the greater good :-)

    ReplyDelete
  6. Wow. I'm sorry I didn't read it all, but I got to the point that shows this woman is definitely not safe to be around any children. I'm sorry your children have to go through this and I hope you eventually win full custody of them.

    ReplyDelete
  7. Thanks frigga... I do have physical custody and final decision making authority, however technically we share "joint custody"

    "Sole Custody" means that the other parent has no rights whatsoever and although in certain circumstances that is justified, the courts will almost never award it.

    ReplyDelete
  8. Ah yes... the double-whammy of BPD comorbid with Bipolar disorder.

    I'm not wholly unconvinced that isn't the case with my PEW given that two of her 3 siblings are diagnosed Bipolar and Lord only knows what either or both mom and dad have.

    You know me well enough to know I'm right there with you. I try not to dwell on why I put myself through the horror and brought kids into the mix... I blame on my complete lack of understanding with what I was dealing.

    Now, people like you and I (and many others) simply manage the situation the best we can and pray our children come out of it as minimally affected as possible.

    ReplyDelete
  9. Thanks mister-m... the BPD/Bipolar mix is one one bad-ass explosive cocktail... I had a complete lack of understanding of what I was dealing with for a very long time! It's not a very easy thing to understand at all and what makes it even more difficult is the arguments between supposed mental health professionals... some say BPD isn't a real diagnosis, that it is a form PTSD or a number of other more well known, more well understood disorders.... some say that BPD and Bipolar cannot co-exist... I'll tell you from personal experience... that they can, they do and BPD is VERY REAL!

    ReplyDelete
  10. In addition to her diagnois of BPD (which my own therapist suggested to me- 13 years ago- that she suffered from BPD after listening endlessly to my frustration) and Bipolar she is Learning Disabled, environmentally affected, and has a long family history of drug and alcohol abuse,low intelligence, incest and sexual deviance.It is an amazing fact that after my therapist suggested that to me that I started reading books profusely on the subject of BPD. My husband (Rocco) and I would shiver because it described "her" so well. At one point in my "quest" I fantasized about sending a book to R.G.- anonymously. I didn't and I never, ever thought that R.G., Rocco and myself (Erin) would come together as friends.

    Erin Exists

    ReplyDelete
  11. Mmm Hmmm... Who woulda thunk it?? Certainly not me...

    It is quite amazing though how coming through all of this... that my ex-wife's ex-husband and his new wife along with my ex-wife's brother and his wife would become four of my closest friends.

    And ohh yeah... Erin exists alright and certain people should be scared... lol

    ReplyDelete
  12. wow, and i thought my husband and his son had it bad w his ex. i'm sorry that you and your kids are going through this. i'm going to come back when it's not so late so i can read more. my husband has custody of his son and didn't get custody at the div though he tried.

    p.s. i came by way of the mom & dad bloggerhood blogroll :)

    ReplyDelete
  13. Thanks for visting Clara... hope to see ya again soon :-)

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