What advice would you give to a family that is dealing with the mania of a sibling who has bipolar disorder?

Lithium is still a terrific option for treating both poles of the disorder. The problem is compliance: when people feel better, they go off their medications. I would ask a loved one please to continue his or her meds, and to continue seeing a competent Cognitive-Behavioral therapist as well as a Psychopharmacologist.

There’s bipolar on both the mother and father’s side. One sister committed suicide. I think two others have bipolar. The mother was on Lithium and had a lot of trouble with it. I think she lost a kidney or something. So her son distrusts it, and uses that as an excuse not to take it, although he is taking it now as part of an experimental protocol. Well, he has accepted the prescription, but his compliance is spotty. We’re all pretty sure he has to hospitalize himself. There is the option of a forced committal, but they don’t want to do that, and I agree with them. It would be much better if he chooses to get treated.

@daloon i agree that tough love is what’s necessary. i don’t know if involuntary hospitalization is an option based on what you’ve described, but it’s certainly something i would look into.

in any case, an affected person who won’t take care of himself might need to be allowed to suffer the consequences of his/her decisions until they either come around or hit rock bottom at which point involuntary hospitalization becomes an option. i do have personal experience with relatives suffering mental health issues and my heart goes out to them. but as you mention, we all have multiple responsibilities and sometimes we need to focus on those we can do something about as the better good.

my relative goes though cycles where he refuses to take care of himself until we take steps to have him taken care of. for a while then he does take care of himself, but that so far has been only for awhile before he reverts. he’s a great kid with ambitions and goals but whose condition has severely impacted his ability to follow through. it’s really sad to us because when he’s well, he’s a bright, intelligent and joy to have around. right now he’s on a positive track and of course we hope that continues. best to your friend’s brother!

Lithium is a horrible medication. It is a deadly poison. What an incredible joke that it tends to normalize people with manic bi-polar behavior.

For the depression end we now shock/electrocute the poor buggers.

Electroshock can work. I know people who have experienced it, and are grateful for it. It sounds awful, but it can mean the difference between life and death for some. As I understand it, it is generally not prescribed until an awful lot of other things haven’t worked.

When I was hospitalized with my mania, I was crashing hard….you are aware but not in control of the situation. I remember hating myself every minute of the day, but continuing with the reckless behaviour :(

For me, I was already in therapy, but not really taking it seriously. He wasn’t the type of therapist I needed, I needed someone who was also able to give meds. I have found that when in a severe mental stage, a psychopharmacist is best. They’re expensive though. Luckily my insurance covered it.
I checked myself into the hospital. I remember calling my mother and telling her. I remember no one understanding, since no one really knew what was going on in my life. I had the support of my family, but I knew they didn’t fully understand. They tried though. They stuck by me. They made me take my medication every day.

I actually went on a mix of Lithium and Lamictal, I think the Lamictal helped a lot. All the blood work though was annoying. I had to get it every morning I was in the hospital, and when I got out. I’m not really sure why, but I would be awakened very early by a needle stick in the arm for a week.
Family can’t just wipe there hands clean of this, unless they don’t care. In my opinion, if it were my brother or child or parent, I would fight and keep fighting. Saying he needs to take responsibility is like denying he has a disease.
My parents took care of me, and I was able to go back to work after a couple weeks off, I had to quit school but it was for the best.
It probably took a year from my hospitalization for me to get myself together. It takes time. The family needs patience.

I’m so sorry they’re going through this. I do hope they know that he is not doing this to hurt them, even though I’m sure it feels like they are. I’ve never been on the receiving end, I just remember causing my family pain and that made it hurt that much more.

Get the bi polar to accept meds and to stay on the meds. So many people start feeling better than ever before and decide they feel good enough to go off their meds which makes them erratic again. Also, the family has to accept a bi polar person will always be a bi polar person, probably not one of those genius kind and that medication or not, there will need to be a lot of support and effort made. Not everyone is up to this and that has to be talked about and sorted out without denial, guilt, etc.

The sibbling should take the NAMI Family to Family class. It will give her tools and support to cope.

But if they aren’t compliant with meds, how can you urge them to comply? If they don’t go to meetings, how can you raise the likelihood they will go? I mean, most bipolar people know what they should do, and they even want to do it, but the disease gets in the way, and they just don’t have the will to take care of themselves. @casheroo‘s story illustrates that. I could tell some of my own.

The thing is that even though tough love doesn’t really work, what do you do when the disease is affecting everyone? They all live together. The brother has an 11-yr-old daughter who was visiting, but had to go home early, because she was put in the position of caring for her father in his mania. How can you be supportive, yet protect yourself?

My only advice was that they should keep on encouraging him to hospitalize himself, and to get on a schedule and stay on it, and to watch to make sure he took his drugs. It’s tricky, though. I think most bipolar people need love more than anything. They just don’t believe they are truly lovable. When people kick them out, it’s proof they aren’t lovable and suicide is a real likely possibility. When you really don’t give a shit about yourself, and you convince yourself that no one else does, it’s pretty easy to off yourself.

Yet, enabling them to remain sick doesn’t help either. It’s a tricky area where there is no easy distinction between help and enablement. Between care and rejection or even destruction of your own life. I don’t think a lot of people understand this. Most people think in fairly black and white terms. I think the only people who can understand it are people who have lived it, either as someone who suffers from the disorder, or someone related to that person.

But even that’s not enough. It’s so hard. We try so many things that don’t work. We constantly need new ideas and approaches that are both caring, yet effective. There is no manual. There is no uniformity of response. We just need a lot of tools, so we can try one after another.

@daloon You are hitting so close to home with me. I feel almost lucky to not have had to be the one that had to deal with it, as a family member…even though I was the person suffering. I think the most painful part is realizing how much you are hurting the ones you love.
I don’t know what else to say, because I feel I hit a point where I wanted to help myself and if a person doesn’t get to that clearing…then they will never get better. Even with a supportive family, the person needs to be on meds long enough to think clearly and realize “Hey, I have to stay in therapy and on my meds” and make a plan for themselves. If he can’t even get to that point, then I don’t know what else a family can do other than still love their brother and be supportive as much as they can.
Has he been hospitalized before? I know the last time I was hospitalized, it was for (I think) 7 days, which I think is a decent amount of time, but some may need much longer than that.

For me, as a bipolar, it was understanding the science. The fact that the chemistry in my brain was wrong and medication made it right.

If you go to fill your own soda at Taco Bell and drink it and it tastes good that is fine. But if you stop adding the syrup it doesn’t taste as good. When you put it back in, your fine. Also, it can’t be just any old amount.

Pretty simple but same principle.

You can’t make someone get treatment. You can only change the way you deal with it so you can live with it better.

@casheroo i was entering a response earlier that i was called away from, but luckily @Daloon captured all of my points above.

anyways, fortunately in your case, you recognized that you needed help and your loving family was there to support you.

Sometimes, however, it’s the case that a person’s loving family is there, but the person is unwilling or unable to agree to get the help needed. and in such cases, what is the more loving thing to do? enable the affected person to continue to spiral downward and disregard the impact of that downward spiral on those around him/her?

i would say in the case where a person has not reached the point where you can force treatment on them (and you can make someone get treatment @Judi) and that person’s behavior is having serious impacts on those around them, then you have to focus on those around him.

also, in the interest of not enabling the person to continue to refuse treatment, let the person experience the consequences of his/her actions – another way of saying, let them take responsibility. eventually that person sees the light or reaches a point where loving family members can step in and “force” treatment or hospitalization.

again, how a family should react to a specific situation is dependant on the details of that situation and so the above is NOT to be taken as a general prescription.

rather, i am addressing a case where the condition of the person is severe and impacting other loved ones who can’t help themselves, and the ill person is unwilling/unable to seek treatment. it’s a case borne from personal experience.

He is a danger to himself. I think it is time to get the police and hospital involved. They will take him in with a 5150. He needs to be institutionalized and forced to receive help. This is coming form person experience. I have not personally been detained for mania, but I have friends who have.
It doesn’t sounds like his family is going to help at all. Does this bipolar person have health insurance?

@Violet I’m not in favor of involuntary hospitalization except when people are endangering themselves or others. I think voluntary is much preferable not just because it is more likely to work. In fact, his family did prevail upon him to commit himself, but for some reason, he was out in three days, and he took off back home without even saying good bye. I’m not sure what his insurance situation was.

Obviously, our experiences have been different. So I’m sure we each see this in light of those experiences.

@daloon – An adult can only be held against their will for 2–3 days, depending on the case. I don’t think there is anything anyone can do for him now. His family could try an intervention.

DO you know of any interventions that worked? If so, how did they intervene?

@daloon – I have NO idea. I’m sure if you did a web search for intervention, you’d find basic guidelines for an intervention. Have you ever seen the show Intervention?

As someone who is bipolar, let me tell you if family tried to have me committed against my will, I would no longer trust them nor have anything to do with them. Even if I came to realize that the forced commitment was for my own good, I would still not trust them in the least, and odds are the relationship would not ever be what it was.

As far as medication, everyone has the right to refuse it- be they in a hospitalized situation or jail. As it should be.

actually, in at least some juridictions, a person can be ordered to take medication and be monitored to ensure compliance. strictly as an example where that has been done (i.e., not to draw any relation to the present question), those of you who have a recollection going far back enough may recall the controversial case of a rapist ordered to take libido lowering medication in an attempt to prevent the rapist from repeating the offense.

That said, persons that are not a danger to themselves or others should be allowed to live and let live. While some can make an argument against the former (danger to self), the latter is where an unstable person must helped, voluntarily or otherwise.

I have a great deal of empathy (not pity) for persons suffering mental disease. Mental health issues are not properly appreciated or understood by the legal system let alone by society at large, not the least of whom may be my self as well. Much more work than is presently applied needs to be focused on finding cures,alleviating suffering, and correcting the perceptions of society.

Do not scorn pity, that is the gift of a gentle heart