Need input on how to get help for Manic family member

Nurses General Nursing

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I was hoping to get some feedback on how to deal with a family member that is in the manic phase. I have been taking care of him for 3 years, I know when he is going downhill. He refuses to go in on his own accord, which only gives me the choice of calling crisis on him and going in against his will. He is delusional, becoming very open with sexual talk, saying he is owner of major companies, etc etc. Last time he went manic he hit and run and lost his driving license for a year. I do not want him to get to that point. But the crisis team will not come unless he is a danger to himself or others. His blood sugar was 31 last week (he has DM) so it says to me that he is not eating right, he is not sleeping right. Is that not a danger to himself?? What the H#$@ do I do or say to these people to make them evaluate him. He knows the system well, and usually will not speak kooky to the Doctors. He always fakes chest pain so they cannot transfer him to psych hospital until they clear him. Please, If anyone has any ideas I can really use the help. I cannot handle the mental health care in this country, it is disgusting! This man has spent his whole month of bill money in two days, without paying his rent. He did grab my arm the other night and also spoke about going to lay in his hammock and not wake up, in front of his social worker. I thought that was enough info to get social worker to get the crisis team out, but he did not!!! Ideas anyone???:o

Cherybaby

385 Posts

Specializes in Derm/Wound Care/OP Surgery/LTC.

I can't offer you any advice as far as how to get him treated. As a person with bipolar disorder whose mania has been only recently controlled in the past year, I can feel your pain. I was indulging in very self destructive behaviors. My "caretaker" is my husband and I know I put him through the wringer.

What it personally took for me to get help was the threat that my husband was going to leave me. He had had it with me and my horrible outbursts and behaviors. When I realized there would be no one to care for me, I got help on my own accord.

Sometimes it takes losing the things you love most in this world to get you back on track.

I wish I could offer you suggestions. I know that mental health care in this country still needs a complete facelift. The stigma of mental health issues are not taken as seriously as say diabetes or cancer. That's sad.

Anyway, I wanted to commend you for sticking by his side. I know it is an incredible burden to take care of someone when they are manic.

Good luck to you...you will be in my thoughts.

Thank you, that is why I became a nurse. I thought I could make a differance in the mental health field, I was wrong. I am the only family member he has left, everyone else took the easy way out and have nothing to do with him. I made a promise to my mother in law that I would never let anything happen to him, and that I would take care of him. She died 10 minutes after that promise. I feel like I am failing her, although I know it is the system. It is such an awful disease, and people do not understand why they act the way they do. I will never leave him alone, and I told him so last night as I tried to get him help. Funny thing is this morning he calls me to tell me he is moving to Brazil!! God I love him, but I do the graveyard shift and his 100 phone calls a day are costing me sleep. Thank you for your support. You sound like a wonderful person!! And congrats on seeking help on your own, that must have been very hard for you. Good Luck!!!:heartbeat

Specializes in CVICU.

We have the same problem with my aunt... she's actually a doctor and was board certified in internal and emergency medicine. She exhibits schizophrenic traits and there is nothing we can do for her. They say the same thing, that she's not a danger to herself or others. I'm sorry, but since when is losing your home, your job, your savings, letting your teeth rot, and not caring to attempt to get custody of your son not "a danger to herself?"

Mental illness affects everyone either directly or indirectly, but our society would prefer to sweep it under the rug :(

Your right, not eating and not sleeping is not endangering your life. I remember learning in school that these are in Maslows right on the top of the list, right???? So yes, they are a danger to themselves. God do I hate the system. My only alternative is to call crisis and lie to them and have him put in involuntarily, which I hate to do. Once the judge gets involved he is in there for months. I just wish he would seek help without being forced. This is a wonderful website for support, and I appreciate everything being said. It helps alot to get support from my "sisters". Thank you!

Whispera, MSN, RN

3,458 Posts

Specializes in psych, addictions, hospice, education.

I'm wondering....where I live, the standards for admission into a psych hospital against one's will include "inability to care for self due to a psychiatric disorder." Try calling a psych hospital in your area and get their input.

Cherish

876 Posts

Specializes in Junior Year of BSN.

As a person who is bipolar (it's no longer called manic depressive disorder), I understand what your family member is going through. They may not say they need help but they do. If this person does not have a psychiatrist or pyschologist try to make an appointment for them to see one. Is he not on meds (personally I hate Lithium)? I know that it takes awhile (it did for me anyways) to find the right combo for meds. There are support groups that he could join, don't force him as that will make him feel more anxious and agitated.

When I'm manic I get VERY agitated with people (short temper, I start getting an attitude) and can't stand them at that point since I'm on a natural 'high' and you feel like nothing can stop you and yes you make bad decisions when your manic. I almost side swiped a person car while driving once cause of my mania and road rage. I avoid driving while I'm manic because of this.

Some bipolars enjoy the feel of mania as it is better than the feeling of being super depressed (which for me comes right after my mania). Those highs and lows take a toll on your body so yes it does help bipolars to be on an exercise regimen and eating healthy foods (grains, fruits, vegetables, seafood, grain fed meats, nuts, legumes, I avoid fast food or toxic foods because it makes me feel lousy). I don't sleep as much either but you feel energetic so that's why hes not sleeping.

How long does his manic state usually last? If his mania starts to subside you can discuss with him to see if he wants to have a regular pyschiatrist (I see mine once a month since I have panic attacks too).

If he is a Veteran (as I am) he can go to the VA hospital which have pyschiatrist and pyschologists and he will not have to pay. Veterans who are unemployed or make low wages can receive free health care through the VA, and can voluntarily commit themselves if need be.

Jolie, BSN

6,375 Posts

Specializes in Maternal - Child Health.

My heart goes out to you. We have experienced the same problem with a family member and endured the incredible frustration of being able to do little to nothing to prevent him from hurting himself and/or others.

There are a couple of important points to remember: The laws do vary from state to state as to the "standard" of forcing mental health intervention. In some states, being unable to care for oneself is sufficient cause to get an involuntary admission. Unfortunately, in our state, the standard is an immediate threat to the life or safety of self and others, which is much harder to meet.

Secondly, and this is much harder to keep in mind as you endure your loved one's behavior, his firm belief that he is OK and not in need of treatment is a hallmark of his disease, just as chest pain is a hallmark of an MI. He's not just being a jerk or trying to make others' lives difficult, he is truly incapable of comprehending the destructive nature of his behavior.

We ultimately had success by enlisting the the local police department. First of all, if he became involved in an altercation, we wanted to police to know that he was mentally ill so they would make every attempt to handle him without using excessive force. Secondly, we wanted the local authorities to know that he was sleep deprived, probably drinking too much and dangerous on the road. We were powerless to keep him from driving, and we needed their help to make sure he didn't hurt anyone on the road. We lived in a small town and the police were very willing to work with us and eventually, thru a trusting relationship with a local officer, my family member agreed to go to the ER, where his road to treatment began.

Please take care of yourself. I'll keep you in my prayers.

jadelpn, LPN, EMT-B

9 Articles; 4,800 Posts

If you were to call crisis and get family member hospitalized to get meds stable, you could advocate on his behalf for a better discharge plan. Upon discharge is there a "halfway house" that could help keep him on a stable track? Any day programs he could access? In my experience what feels "normal" to the average person feels overwhelming to the bipolar on meds. The frustrations often lie in the fact that is doesn't make sense why a loved one just doesn't want to feel "right"--which is such a natural response and one that I have had!! I had to understand that unfortunetely, our "right" is their "this sucks". To get him on the Department of Mental Health "track" would at least perhaps give him support with others who share his same disease, and structure with others to sort of re-learn what is appropriate social behavior. Many prayers to you on this journey!!

Ruthiegal

280 Posts

Specializes in LTC, Disease Management, smoking Cessati.

I went through a similar situation with a family member. The day he finally broke with reality, I called 911 and off we went to the ER. While there this social worker came and spoke with him for about 5 minutes and said to take him home he wasn't homicidal or suicidal.... I jumped up and down in her face and said we needed help NOW. She said she had sliding scale clinics, I said back how long to be seen, she said weeks, I jumped up and down again, and told her none of us could afford to bring him back to ER every couple of weeks... She finally ask the doctor to send him for evaluation, and after his drug screen came back negative, off he went, he was at that facility for a couple of hours... They sent him right on to a psychiatric hospital with Severe Depression with psychotic features... Sometimes you just have to keep jumping up and down and making noise until you are heard. And yes he was an adult, I played advocate till I was almost in tears, but we got help and he is now doing much better, no more detachments from reality. Hang in there and keep making noise for him. I wish you luck and will keep positive thoughts for you. Bless you for being the caretaker, it's a tough job.

netglow, ASN, RN

4,412 Posts

waitingforthedream:icon_hug: sending "hang in there" thoughts to ya.

These responses are so, so, great. This is what supporting each other is all about! :loveya:

That is why I love this site! Everyone understands, what my family members do not. I do not understand why they will not allow my to call crisis when I grabbed my arm. Today he told me he was in Brazil, God bless him. I worked 11p-7a last night and again 11p-7a tonight, so I will not be able to do anything until Monday (my one day off) But this is something I must do before he hurts himself or others. Thanks for everyones thoughts and support.:heartbeat

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