Family Member with Mental Health Issues

I'd like to know if anyone has experience, advice, or suggestions of a local group to help me in dealing with a family member that has mental health issues. A little background - at 36 years old my sister was diagnosed as having bipolar affective disorder (approximately 7 years ago). Within the last few years, her highs/lows have gotten much more severe than what I had previously seen. Since her initial disclosure that she was diagnosed with bipolar affective, she has never mentioned it again and is very elusive if she is on medication or receiving treatment (therapy or other). She has pivoted the conversation of mental health to being affected by PTSD (traumatic experience at 18 yrs old) instead of being affected by bipolar. She is located on the East Coast and it is difficult to know what is true/real or not. Her cycles are becoming more intrusive on my own mental/emotional health. I want to better serve her (in my responses to her) and also myself.

In this months "cycle," she calls sobbing at all hours begging for help and/or for me to call the police for her. Her main claims are that she is being stalked by a woman and she is in fear for her life. She says that the police are not serving her and they are out to get her. She says that all the police reports that she files "disappear" -- being stalked and the police not helping is a regular theme. She also rants and raves about a lot of other things ("did you know my IQ is off the charts! Yesterday I laid in the street so someone would run me over! I have a soulmate but he's weak! I have a fever! I fell down the stairs!") She has moments of coherence where it seems she's living in "my" reality but then quickly slips back into "her" reality. 

I'd like to know if you have any advice (how do you respond to a family member in a crisis while maintaining your own boundaries for your health). Do you have any therapists you'd recommend? Are there other resources you suggest? I'm looking into NAMI/mental health support groups but also want to hear if others have successfully worked through similar issues. 

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You are definitely on the right path in pursuing help through NAMI.  A friend of mine found their family group incredibly supportive.  The best of luck to you and to your sister.

I have adult children with bipolar diagnoses; it was very rough the first decade, but things have simmered down, and I'm able to enjoy my family.

NAMI, the National Association for Mental Illness, has several chapters in the Bay Area. Some of their meetings are just for families and some for patients as well as families.

Xavier Amador wrote a wonderful book. "I AM NOT SICK. I don''t need help: How to help someone with mental illness accept treatment," that I found very helpful in the hard times. His method of working with your mentally ill, and recalcitrant, family members starts with recognizing that you don't know what it is like to be in that person's mental world. Then, Listen to what they have to say; Empathize with their feelings; Agree with what you can recognize as truth among all the troubled language; and then, Partner with your family member in finding a way through. I'd highly recommend that book.

That said, I'll add that I experienced a great deal of stress, and I still feel some of it. Bipolar disorder can be managed, but it doesn't have a cure. It's sad to watch great promise veer into another path than what I originally saw for my children. It's taken years for them to find a stable place, and for us to recognize that reality is not what we expected.

I have found that therapy--for me--is essential in keeping my sanity an finding my own path through the chaos, while providing encouragement and support.

Also, knowing others in a similar situation helps. In my case, the disease has a strongly genetic component, so I have a support system in my in-laws, the parents of my children's cousins who have also been diagnosed with bipolar disorder.

Prayer has been very important to me. I couldn't carry this alone.

My heart feels for you in your situation. Good luck, courage, and hope to you.

My heart goes out to you and your sister. What you are both experiencing brought back so many painful memories.  The highs and lows do seem to get more and more extreme. From my understanding, its so hard to have them stay on meds because they feel really good when manic.
My mother was diagnosed Bi-Polar 13 years ago and we have had many ups and downs, on meds off meds, etc.  Sounds like your sister is in the middle of a manic episode. During my mother's manic episodes, she would deny she was bi-polar or manic.  
In short what I did:
1 - obtained a therapist here in California (my mom lives in NYC) to help guide me through this journey and help set boundaries (something that doesn't come easy for me.) There was a period of time I had to block her calls because she was becoming so angry verbally abusive. If the phone calls are giving you anxiety (as they started to give me), don't answer.  I know that's so hard to do, but those phone calls are not helping you or her..... 

Here is who I saw who helped me tremendously:

2 - there was no way I could ever rationalize/reason with her when she was in a manic state.  This really took awhile to sink in for me and needed constant reminders from my therapist.

3 - When she was in a manic episode, I had to wait for my mother to do something really "crazy" in order to call an ambulance/police and have them hospitalize her and get her back on meds. 

4 -  Her last episode almost got her evicted and APS (Adult Protective Services) became involved.  As a result, she now has a psychiatrist, a therapist and APS, which all seem to be helping greatly.  Unfortunately, there is no way she would have agreed to any of these support systems during a manic episode.....

Please feel free to reach out if you want to talk.

I am so sorry to hear that you are going through this. I went through a similar situation with my aunt last year (in fact she has similar claims to your sister) I don't know that I have any great advice, but I can empathize. It was a very difficult time. I called everyone trying to get her help with no luck. My aunt refused to go to the doctor or take any medication. Finally one day, I called the police to ask for a wellness check and they ended up taking her to the hospital on a psychiatric hold. This changed everything for us. Once she was in the hospital they held her for two weeks and we were finally able to get a diagnosis and her on some medication. She was in a better state when she left, but still not great. The hospital would not allow her to go home alone (and we were unable to take her in), so she moved to a group home situation (even though she was young and very high functioning). This has been the best thing for her. She is given her meds three times a day and she is thriving in the structured environment. She is a completely different person from the one that was admitted to the psychiatric hospital. The plan is for her to stay here long term. Although she is fairly independent now, we worry that if she is on her own she's stop taking her meds and things would fall apart again.  I don't know your sister's financial situation, but if she is unable to work, there are resources. We were able to get my aunt psychiatric treatment through medicaid. They have a psychiatric team. Her doctor visits her every 6 weeks and her case worker visits her once a she has a lot of people checking on her. We also had a lot of success working with a special needs attorney. 

I wish you the best!

I'm so sorry you are experiencing this distress with your sister. While I do not have first hand experience with this type of situation, a good friend of mine is the guardian for her long distance brother who was diagnosed as schizophrenic in his 20's (now in his early 60's. lives on the east coast). I've watched her travel a long, hard road, yet it has had moments of joy and always unwavering love. My friend has relied on her sisters and close friends for support. Her family is exceptionally close. Key for them has been managing their brother's health care, including psychiatric hospitalization and day programs when warranted, and finances. While she has not engaged with NAMI, I've heard very good things about it. 

Mental illness of one effects the whole family. Take care of yourself, and know you are not alone.

I feel for you. My mother was bipolar, and ... it was hell on wheels. In retrospect, I took better care of her than of me and that was a mistake. You will need to set boundaries and you will probably feel guilty no matter what you do or don't do. I'll just say, letting someone vent their illness on you won't make them feel better, but it will make you feel worse. So prioritize your own mental health, because this is one rocky road.

The current understanding is that the disease progresses--every episode lays the foundation for even bigger mood swings. So each episode will be a little more severe. Appropriate medication is so far the only option that can stop or slow down the disease progression; she either agrees to take it or is compelled by law. I say this (I know it sounds very draconian) because the search for functional alternatives is agonizing and pointless.  She needs medication and a stable lifestyle to avoid more episodes, and she needs to be on board with that. You can't "make" her better.

NAMI is probably the best place to start. They can help you with community and putting this in perspective. Perhaps they also can put you in touch with a chapter in the area where your sister lives--who can educate you on the actual resources and laws.

Please remember that a person who is manic is impervious to reason and will both demand and reject help. It's very frustrating because they are genuinely in distress. You won't be able to do much of anything unless you learn the laws for the state she's in, and make contact with either someone she will listen to, or a law enforcement professional who will hospitalize her (against her will) and hopefully is medicated enough to stabilize. At that point, she is much more likely to be a willing and active participant in keeping herself on track.

I wish you well.

I feel for you.  It is so difficult to see a family member struggle!  And denial is so common - it is hard to for most people to admit they have a life-long mental illness.

The NAMI support groups are very good - try going to a few different ones to find one that is a good fit for you. Also highly recommend their 12-week free "Family to Family" course for helping family members and others whose have loved ones with mental illness. Found the role-playing parts of it extremely helpful - it is so difficult to figure out how to talk with someone when they are manic, depressed or having a psychotic episode.

Also, there is the Depression Bipolar Support Alliance,  They have both in-person support groups and online support groups, as well as a wealth of resources - click on the "Support" tab on the top.  I think they may even have an online support group specifically for siblings.   Have been attending the SF group for about a year and find it a valuable source of support.

Also self-care is extremely important - "put on your own oxygen mask first."  For me yoga helps me relax and turn-off worrying for a while.  Find what works for you.

Sending you hope, strength and comfort!

Sending you strength courage and hope!  I highly recommend NAMI (National Alliance for Mental Illness) and especially their 12-week free “Family to Family” course on how to cope with a family member with mental illness.  They also have excellent support groups, and you may want to go to several in order to find the best fit.   Another great organization is DBSA, Depression-Bipolar Support Alliance.  They have in-person support groups for family member in SF and San Mateo, but I do not think there are any in the East Bay yet.   Hower they do have online communities , and I believe there is one specially for siblings.  Their site has a wealth of information: