Bipolar is wrecking my family...

Nurses General Nursing

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My family is having a crisis, and it all centers around my bipolar sister. I posted a thread probably a year ago about the process of her diagnosis and the S-L-O-W treatment leading to her continued instability. I'll summarize: She is currently 19 years old, and has Bipolar type II (rapid cycling-- like one week she's low, won't get out of bed for days, and the next week she's high, can't sleep, full of energy, spending money, partying with friends, disobeying long-standing house rules) with ADHD. She has been to two different psychologists as well as two different psychiatrists. None of them have been aggressive in treating her. She recently stated that she only feels "normal" 40% of the time. Geez! I can't imagine!

So, my sister disobeyed a house rule, and my mom called her on her cellphone to ask her to please come home to discuss it. Well, she did come home-- to get a pillow and clothes, and storm back out to her car. She is currently living in the local party house-- they owner provides the alcohol to all the minors (yes... the police know about this), the house is FILTHY dirty-- so much so that my sister once said that she doesn't know how someone lives in so much filth, and leaves the front door WIDE OPEN all the time. She states that she is going to pay rent, but once we added up the rent, car insurance, and cellphone bill, she was already in the negative numbers. She doesn't have enough money to pay her car insurance and registration due on March 1st, and frankly, doesn't care.

Her friend, who is barely 17 years old, ran away from home a few weeks ago. Her parents filed a missing persons report, and guess who the police found her with?? Yup, she was driving her friend around to various "hiding spots." Hmm, harboring a minor wouldn't look too good on the record.

Neither would a DUI/DWI-- since she admits to driving drunk, even though "it's just a mile down the road." We found empty liquor bottles in the garage trash, and neither my mom or I drink alcohol.

To top it off, my mom hasn't been able to find a job for the past 6 months, and my entire paycheck from my new-grad job (stressful enough) goes into the family account.

So, if you're still reading, I have a question... Technically, my sister isn't a threat to herself or others, so we can't have her admitted to the hospital unless she WANTS treatment-- which we all know isn't gonna happen cuz she's on top of the world right now. But the stress has got to lessen for my mom and I. I feel myself dropping into a depression from being around it, and I know that my mom isn't going to last too much longer. Dad isn't in the picture (although technically I guess he is because it was his abandoning us that lead to her bipolar-- or so the docs say), and we really don't have a strong support system (both sides of the family sided with my abusive alcoholic father, and won't interact with us). Are there options? Any psych nurses out there who have any ideas? Is there a way to get her back into the hospital if she isn't a threat/won't sign herself in? I guess even hospitalization isn't always the answer unless she wants the help... which she doesn't.

I need a vacation, preferably in the tropics!!

I wanted to reemphasize this statement. My DS23 is bipolar and unmedicated. As such, he takes risks and has had several significant speeding violations, one for going 85mph in a 25mph school zone at 8:15am! He could have easily killed someone. DH accompanied him to court for that and the judge flat out told him "Get this kid off your insurance. Either take the car away or sign it over to him. If he hits or kills someone they are going to take everything you have--you house, your cars, your retirement. You have a lot to lose and he has nothing. If he kills someone the victims' family is going after YOUR deep pockets, not his." We signed the car over to him shortly after that and required that he get his own insurance.

If you think this was the end of his driving violations, you must not know much about bipolar. He has since then had several more speeding violations which required court appearances and one "speeding with open container" violation. He refused a breathalyzer and if the cop had hauled him in I"m sure he would have blown a 0.25. Instead all he got was points on his license and a fine. :down: I was kinda hoping they'd haul his butt off to jail for a few days. Maybe then he could be forced to get the help he needs.

And to the poster who says the OPs sisters' previous doctors weren't good or she would be in better control. The very nature of bipolar makes it very hard to remain compliant with treatment. You feel bad so you start experimenting with your meds, taking more than you should, mixing with alcohol or benzos. Then you start feeling good, even great, and suddenly you don't even need meds! You can do anything! Who needs doctors? Everyone is just trying to keep me down! Doctors can only do so much with a patient who won't comply.

That's unfortunate. You see, I have a family member and a close friend with bipolar, and they don't do any of the non-compliance things you are writing about. I think it has a lot to do with their doctors being excellent at their jobs and keeping them from sliding into mania -- which is what you seem to be describing.

mustlovepoodles...are you and I related?!

Prior to the past few years of successful treatment, my son was a CRAZY driver! Multiple tickets -- one for racing. To make his "daring" streak even better, he is a great little mechanic and found loads of ways to make his cars faster and faster.

You're also right about BD folks being noncompliant with care. I knew this from years of working in family practice, even before my son was diagnosed. Being manic seems GREAT and being like the rest of us (with just normal-sized highs and lows rather than MASSIVE highs...) seems pretty boring to them. For a person who is used to living in hypomania (faster than a speeding bullet, but not manic to the point of losing touch with reality) life seems pretty good and they get a LOT done.

You are absolutely right about protecting yourself and your family's financial assets. It's not that those with BD are bad people; they don't mean to take anyone down with them and they may truly love their family. But if not adequately medicated and compliant, they just can't think it through to its logical consequence.

Specializes in ICU and EMS.

Well, she apparently came around the corner in the parking lot at work this evening, and plowed into the back of a parked car (seriously!? how FAST was she GOING!?). If she files an insurance claim, she's out of insurance (she previously totaled a car, and was told by the insurance agency that this was her last chance). If she attempts to pay out of pocket, she won't make her car insurance and registration. She called the house absolutely hysterical, crying, saying her life is in pieces, blah, blah, blah. My money is my money, and it isn't gonna pay for her mistakes. I'm so tired of hearing about her never-ending problems when she won't do anything to help herself (then I feel guilty because I'm in healthcare, and should know that it's the disease, not the person...).

I'm so done with this roller coaster ride! I want my family back (Mom, sister and I). I want my sister to care about herself enough to take this bipolar stuff seriously, and actively seek and participate in treatment.

I spoke with our social worker at work today. She was going to try to consult with the director of our inpatient psych unit. We had a lot of family meetings and critical patients today, so I'm sure she got busy and didn't have time to check into it. She was pretty certain, though, that she wouldn't qualify for an emergency petition... yet.

Thank you all for your kind words of support. It definately helps to know that I'm not the only one going through it, and that in many cases, a positive ending can be reached.

Specializes in psych, addictions, hospice, education.

One of the biggest problems with bipolar disorder is it feels good (to most) when in the manic phase, and then the person also may not believe he or she has a problem. These things make it terribly hard to get them to accept treatment. This isn't true for all though. Does your sister know she has an illness? Some have told me how terrible it feels to be out of control, and that's the entry into helping.

Take away her keys, disable the car, hide the car somewhere...do whatever you have to do before she kills herself or someone else. My mom would drive extremely fast, believed the car could fly OVER people, and one time loaded the trunk with all the food in the fridge and freezer and headed cross-country. In all these situations she didn't believe she had an illness. However, she would accept, from me, that something wasn't quite right and would go see the doctor and get treatment. She didn't like to take her meds, but she did, most of the time. I had to be constantly on my toes though and had to do a few emergency admits. I'd take her to the ER and she would sign herself in because I wanted her to, even when she wouldn't admit, at least to me, that there was a problem. I don't know the relationship you have with her, but maybe an "intervention" is called for.

Can you talk to the doctor? If she says ok, you can go with her to an appointment. Also, in some states, there's a document you can get that will allow you to be part of treatment even if the person doesn't want you to be involved. It's a loophole in the confidentiality law. You might check into that. I mentioned NAMI in a previous post. They're the ones who told me about this document. Talking to the doctor may give you information and a feeling if the doctor is being appropriate or not.

Specializes in OB/GYN, Peds, School Nurse, DD.
That's unfortunate. You see, I have a family member and a close friend with bipolar, and they don't do any of the non-compliance things you are writing about. I think it has a lot to do with their doctors being excellent at their jobs and keeping them from sliding into mania -- which is what you seem to be describing.

Do you have bipolar? Cuz I do and at times I have been the definition of non-compliance. Even though I'm a very experienced nurse with an excellent treatment team. When that demon gets hold of me I can get pretty squirrely, both high and low. Lows are dangerous for me because that's when I will dabble with my meds(and everyone elses--DH locks them all up and delivers me each dose) Of course when I'm going high I don't "need" the drugs and I conveniently "forget" to take them.I don't do things that are risky to others, just myself. I run away from home. In the winter. With no shoes on. Goal? get to Tennessee where I can live in a homeless shelter and work at Walmart so no one can find me. :uhoh3: Oy~ Lucky for me I have a sister and a husband who aren't afraid to throw themselves in front of a speeding bus(that would be me!)

Specializes in CCU, ER, Psych.

I do some psych nursing and have some suggestions. First, become knowledgable of all the resources in your area such as all the in-patient psych facilities, the county health dept services, and emergency rooms. Next learn where there are homeless shelters, and places that provide free services such as food and medicine. Most severe bipolars usually end up using these types of services. The best opportunity to help her will probably be the next time she contacts you when she's in one of her depressive states. When they're down, they then to better comprehend the havoc they've created in their life and their family's life. She will probably state, at some point, that she wishes she were dead or that she should kill herself. Those are common statements when they realize the mess their life is in. Once this type of statement is made, a 72 hr hold can be initiated. Sometimes, this is the true entry point into the psych health system for the patient. What you do is when she makes the statement and you know where she's at, call 911 and tell them she is either thinking of suicide or that she wants to kill herself. Also tell them about her bipolar and her out-of-control behavior. She should be placed on the hold and most likely to be taken to an ER to have a medical screen exam. Many psych facilities will require this of patients to be sure all medical causes have been ruled out (ie. structural or antomical brain defect). I know this sounds sneaky like you are setting her up. But, you would actually be doing what she needs. Don't worry that she will have a history as a psych patient. She has a psych illness and needs care.

Also, your sister cannot, again cannot, control her behavior. It's like if you eat bad food and your stomach wants to throw it up - you're not going to be able to stop it from coming up. Uncontrolled behavior is inherent in the disease. There is hope though. Most bipolars can be successfully managed on medication and therapy to help them learn about their disease and it's triggers. However, their are some people who are refractory to medications, but I hope your sister is not one of them. I know you are incredibly frustrated the turmoil your sister has created. Try to turn your energies into helping her. Because, in helping her, you really are helping yourself. Prayers for you.

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