K.Z. asks from Appleton, WI on May 15, 2012
Bi-polar Family Member
Please, this question is for those who have knowledge in the mental health field only. I have a family member who is suffering with Bi-polar. He is currently in a Manic state right now. He is saying things that are hurtful and inappropriate, He is headed down a scary path. His counselor and Psychiatrist are aware of what is going on. I have been involved in many of his counseling sessions but have recently stepped back. I have been informed by another family member that he is not doing well, risky behaviors, spending sprees, making poor choices, saying he wants to stop treatment. He does not know that I know what has been going on and from experience, when someone is Manic they are irrational and cannot be reasoned with. Do I say something? Do I confront him on things, or do I let things calm down and see what happens. I have been over-involved for many years and it is hard to ignore his behaviors and cries for help, but not sure this is the right time to come in and take sides, when he doesnt even know I know what has been building up. I feel that if I call his counselor, he will tell him I called, which makes things worse. What do you do when someone is manic??? How do family and friends help, respond, intervene, etc. He is not a danger to himself or others, just wanted to add that.. Help!
N.G. answers from Dallas on May 16, 2012
I'm bipolar but I'm bipolar type II, which means I don't get manic phases, more like 'hypo-mania', which is a much, much less severe mania. However, I have encountered type I bipolars, and I agree with you, when they are manic, they are NOT reasonable.
If he is a danger to himself or others, call the police. That would be the quickest way to get him into a facility. I also like Krista's option of having an intervention with family to try to convince him to enter a facility. Either way, he needs in-patient care NOW, to get him properly medicated.
M.G. answers from Chicago on May 15, 2012
When my father was in his manic state, NOTHING helped. Saying something would only make it worse!!! You need to wait until he comes down out of the manic state (which could be days or weeks). Is he on meds? It sounds like he should be to stabilize his moods. You can gently broach the subject by asking if he takes medication and if he feels it helps. But, in my experience, there really isn't much anyone can do to help a person with this disorder. He has to want to get help and needs to stay consistent with medication. No matter how much my mother begged and pleaded, my dad never stayed with any course of treatment for any length of time. Unfortunately, this is common with people who suffer from bipolar.
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M.P. answers from Portland on May 15, 2012
I have a family member and a close friend who are bi-polar. I suggest that saying something to him will only make him more manic.
You can call his counselor and ask that (s)he not say that you called to your family member. I've found that most like to be updated by close family members, who are directly affected by the manic behavior,about what is happening and will treat your conversation as confidential when your information is about behavior that he's unlikely to observe in person. However, if your family member is keeping his appointments the counselor will be able to see that (s)he is manic. If this is your husband or son who lives with you the counselor should be working with you too. Unless, of course, the family member asks that you not be involved.
What is most important is that he's on medication and takes it regularly as prescribed. Counselors usually cannot prescribe. If he's not on medication it might help to suggest that your family member see a professional who can prescribe. He can see a counselor and a prescribing professional at the same time.
If this family member is an adult, there is very little that you can do. And talking with them will only cause them to defend themselves. While manic, they are not able to think logically. It is good to not get overly involved. Good for you who will be frustrated and anxious. Good for the patient who can become angry and hostile.
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S.W. answers from Minneapolis on May 15, 2012
The most helpful thing would be if the people who are actually observing these behaviors would contact the counselor. From you it would only be "hearsay" and less likely that the counselor could take any action. On the other hand, you say they already know? If so, then you need to take care of yourself and any other family members affected by these behaviors. Unless he becomes a danger to himself or others, he is an adult, is receiving appropriate care, and must make his own decisions.
My ex is diagnosed Bipolar Disorder II, which instead of the manic phases has angry, depressed, irritable phases. I am less personally familiar with the manic side of BPD.
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K.C. answers from Norfolk on May 15, 2012
My Stepfather hit a very severe manic stage. He did become a danger to himself and my mother. At that point, my siblings and I had an intervention. We, along with my mother, convinced him to admit himself to the hospital, which he reluctantly did. But had he not, I assured him that we would have called the police and they would have done it for us.
Before that he had the same poor choices you indicated such as spending sprees and irrational behavior. One thing I can note now is that he was on a medication that was geared more towards depression and that really set his manic stages off. Now that he is on bi-polar type medication, he is much more reasonable, and definitely no longer a threat.
I would call his counselor and see about adjusting his medication. Give specific examples of his behavior and don't take no for an answer. At the very least, have him seen again. I never would have in a million years expected my stepfather to be a threat and he became one, so please be careful. Wishing you the best because this is such a hard position for you to be in.
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A.N. answers from Madison on May 17, 2012
Well, I'm the one in my family with bi-polar and I can tell it from his perspective. Mania is good fun! Everyone else can see that it's not healthy, but he cannot see that - he's just fine and normal, in his eyes. The last thing he needs is to be "told" that he's wrong, or what to do. It will backfire every time and put him on the defensive, creating the angry, irrational outbursts and behaviors. I will also say that it's very exhausting, and even though he may not express it now, he wants help. Deep down, he knows he can't do it by himself, but cannot accept "defeat" and doesn't know how to ask for help.
There are different bi-polar diagnosis - mine is classified as bi-polar I. My mania is triggered by interruptions in my sleep pattern, and I have not experienced severe depression. I've only had two manic episodes and the only thing that got me back on track was inpatient therapy, once for 2 weeks, the other about a week. The solution he may need is dependent upon which type he is.
Even though he's in out patient therapy, it's really easy to "fool" them for a really long time (at least it was for me), until it escalates into severe mania.
I understand your concern and wanting to help, and you should, but very carefully. You didn't reveal your relationship - just that he's a family member. Those closest to him (wife, parents, siblings) should be taking the lead on this, however, if you are a little further removed, you might have the opportunity to provide a "safe" outlet for him.
For starters, please do not go on what others in the family are saying through the grapevine. What happens quite often is that certain people are much more sensitive, quick to judge and blame the illness on any behaviors that they don't agree with. Please make your own decision, based on your own personal experiences with him. Talk to those closest to him to get their feel - just showing your concern and offering help, if they want it. Take it from there - you may feel compelled to invite him for lunch or something, to form your own opinion. There are calm and positive ways to express your concern with anything that you deem inappropriate or destructive. You may do a little reading about the illness to gain a better insight. Then, you may feel the need to call the counselor, but please ask those closer to him first - I'm pretty sure they are not allowed under law to discuss with him your discussion.
One thing I know for sure - it does not get better on its own. Eventually he will "crash", meaning come down from it, but then most likely will sink into deep depression. I know that my family members rallied to get me the help I needed, with my doctors, and somehow got me to admit myself into treatment. I sincerely hope that your family will experience the same success.
If I can provide any more insight, please message me. Good luck!
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H.W. answers from Portland on May 15, 2012
First, let me be clear that I am not a mental health professional, but I have been in counseling pretty steadily for a number of years and do go back from time to time. Perhaps a certified mental health pro will answer, and this is my take on it...
First, I'm going to ask you: do you have some support in all of this? I ask this because being a peripheral person in the life of someone with bipolar disorder can be hugely traumatic at times and emotionally draining, to say the least. So, I'm wondering if you have your own counselor or other resource to call...
Second, my guess (and it's just a guess) is that if you talk to this relative's counselor, the counselor will reveal the communication or it could stress their relationship. (I get this from here:
Unless your relative is suicidal and needs to be committed for their own safety, I would not make that call.
I have more than one relative in my life with bipolar disorder, and have worked with a few people who suffer from it. At some point, it's good to have support for those manic times when we are watching chaos in action and don't know what to do. I've had to learn a lot about acceptance, esp. in those cases when we see that this person we care about is harming (only) themselves-- but I do understand, it's a doozy. Unfortunately, other than talking to a counselor for yourself or seeking your own support, I'm not sure there is anything anyone else can do. You are right, trying to be rational right now is only going to further make your relative upset or further deny that he needs help.
What you can do is work with someone to make your own boundaries, to help you get to a place of acceptance and to give you support. It's hard to see our loved ones like this--we are helpless and it can really feel like we've failed them. It isn't us, it's their brain chemistry, and that's what makes it even harder. I wish you the best. You are obviously a caring person, and I'd encourage you to take good care of yourself throughout all this.
Added: by the way, regarding the link I sent: the forum responses were informative but pretty unkind in to the original poster; it's too bad, as she very obviously cares about her friend. I just wanted to warn you not to take other people's garbage to heart.
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M.S. answers from Minneapolis on May 17, 2012
You say you have recently stepped back after being "over-involved." You might want to re-visit the reasons you stepped back--I have a feeling it may be because you know the outcome of confronting him. NAMI might be a good support for you and you may be able to get some ideas from others who have experienced your situation.
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R.K. answers from Appleton on May 16, 2012
I would get together with family members and talk about the best way to help him. You can also contact Outagamie County Human Services and ask for advice. In Wisconsin you can sign a family member in for a 72 hour hold to be evaluated and medicated. However you can not make them take their medication, I'm sure you already know that.
It takes 3 people to sign someone in usually 2 have to be family members the other could be a sister-in-law, or family friend.
I am close to you if you would like more advice PM me I am more than happy to help.