Some time ago, on our other blog, Bipolar Blog, a visitor posted a piece in our Share Your Bipolar Story section entitled “Bipolar Extramarital Affair,” which generated some discussion.
Recently, another visitor commented on that story about the need to make some allowances for bipolar: “Allowances must be made. Not to do so is unfair because it [bipolar] holds people to unrealistic standards and disappointment becomes the inevitable outcome.” He goes on to say that “You have two choices: moderate the behaviors and/or moderate the expectations.”
While I agree that allowances should be made, I wonder whether there could be too much of a good thing. NAMI’s Family-to-Family Program while stressing the importance of developing a sense of empathy, also encourages loved ones to set well-defined boundaries. In fact, not having clearly defined boundaries and consequences in place could be a disservice to the person with bipolar – see “Setting Boundaries in a Marriage Complicated by Mental Illness,” by Kathy Bayes.
The concept of “boundaries” speaks to the idea of a point at which behaviors, whether they are symptoms or not, may become so harmful or toxic to the patient and/or loved ones, that something (or things) must change. It is important to keep in mind that bipolar disorder presents with behavioral as well as emotional symptoms. Teasing out the difference between planful and volitional behavior and symptom behavior is a daunting and often impossible task.
In short, I believe that compassion is the primary approach – if we default to the position that our loved one’s ability to respond appropriately is impaired due to illness and we try to adopt a problem solving, rather than blaming, posture we will generally have more positive outcomes. However, as the illness is not rational, and can present with extreme behaviors that can be dangerous, we need to be sure that we do what is necessary to keep our loved one and ourselves from serious harm. Boundaries and consequences need to be identified that trigger more assertive responses, but short of those we need to remember that the illness can interfere with every level of function and try to remain non-judgmental but engaged in trying to solve problems.
Please post a comment to share your thoughts and insights. If you’ve defined boundaries, what are they? What consequences are in place? If you’ve achieved a greater level of calm and stability in your relationships through the use of boundaries, please offer your suggestions. And if you have a negative view of or experience with boundaries, we’d like to read about that, too.
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Boundaries and Bipolar « Revolt and Resignation (August 16, 2009)
I am bipolar. I have devastated our finances with my uncontrolled spending. My husband loves me and I believe did not object to my habits for many years for fear of losing me. It was I who decided to step up to the plate and place a self-imposed limit on my spending. I credit this to good medical management of my illness and good therapy. I believe that no matter what mental impairment a person has, if they are consciously aware of their actions, then they are responsible for the ethical implications of those actions. It can be likened to the way you would handle a child who does not behave appropriately. Harsh punishment is not effective in the long run. Correction and a better expectation in the future would be more appropriate paired with consequences for repeated actions. With regard to behaviors that harm the bond of marriage, surely those can be addressed in therapy but they should still not be allowed to continue. Any mentally ill patient who is in the “here and now”, as opposed to having a disassociative disorder or frequent psychotic episodes, should and must be expected to follow accepted ethical behavior.
Understanding….VS…Enabling. Tolerance and discussion are keys to better managing one of “us”. It is not ok to coddle and continuing to sympathize with bad behavior. Accountability applies to all. The best way to present the problem to the bipolar person is with compassion and calmness. Yelling and threatning does NO good. However, continued bad acting must have consequenses and sometimes that involves saving yourself, and letting the other person go. That is a sad reality for lots of people. No matter…seek good counsel before making any decision.
I grew up with a bipolar mother. My father was always the one that was able to keep a lid on the entire family. Unfortunately he passed away from Leukemia when I was 12. When he was alive he had clear well defined limits within the house. If she did anything violent, put our safety in jeopardy or acted impulsively/erratically around the children she was out(she usually went to our grandmas house) until she gained control. It wasn’t a permanent situation, it was just until she could get it together. It may sound harsh but you have to keep in mind when you have 3 young children the house you have to crack the whip so to speak.
Unfortunately after my dad passed away all hell broke loose and things have been living hell for us ever since. I am now nineteen and saving every penny(that she doesn’t find, her spending is so out of control that she racked up five credit cards worth of debt and even dipped into my college and dads life insurance money he left me..atrocious and inexcusable) so I could just get the hell out. I have given her so many chances and I understand her violent and hurtful actions are the illness and not her, but at some point enough is enough. She can’t hold a job and I am afraid paying for the house is not going to happen anymore. Luckily I am the youngest so my brothers are out (they have severed ties with her, as she too has taken their money). I tried setting limits and getting her help with medications that she won’t take and therapy that she will NOT attend. Unfortunately she doesn’t take me seriously so I am out as soon as I can get out.
Has anyone ever been diagnosed as some bipolar with aad and ptsd?
Kelly, I used to be married to a bipolar woman. On top of that she had serious obsessive compulsive disorder. It’s all very well being understanding etc. but unfortunately it just doesn’t bear fruit. My two daughters from that marriage live in a different country and vist her twice a year. It is their way of coping with the problem. Be tough, and find your own way. Am sure it will be possible. Cheers
~Kelly~I sympathize very much with your situation. I too grew up with a mother who was bipolar type one, with psychotic episodes. Unfortunately, not much was known back then and my father had no way of stopping what was going on. She put him and all of my siblings through almighty hell.
My mother is still a really, really difficult person to like or to care about or to feel any compassion for. Having just returned from visiting her, I find that I am still dealing with the effects of her hurtful and manipulative behavior.
About boundaries, and things like that? Of course you have to set up boundaries with pretty much everyone in your life. If it’s your mother, though, it’s a lot harder when you are still living with her.
I find that when I am not in the company of my mother, I am able to feel sorry for her. Unfortunately, this only lasts as long as I am not in her company as I was earlier this month. Instead, I find that right now, I’m still suffering the bewilderment that such a destructive person can cause.
So these boundaries that I have set up with her will always remain in place. That means that when I am feeling stressed myself, I make very good use of caller id. I do not have to talk to her at times like that, and I do not at all feel guilty about that. I have told her many times that I do not want to hear gossip, but she persists and is a conduit for ugly gossip. I do not have to listen to it and I am firm with her on the telephone: if you do not stop talking about so n so, I will have to get off the phone. If she does not stop, I make good on my word and get off the phone.
I have come to several conclusions about this very confusing and upsetting topic of bipolar.
One is that in addition to being a type one bipolar, my mother has a personality disorder (or two, or more). In other words, while she may suffer with bipolar, she’s also got a miserable personality. She seems to enjoy causing problems, and she loves to find out that others are suffering. Anyone who can cackle (yes, cackle) at the suffering of another person has something very wrong with them, and I do not believe that bipolar disorder explains this.
My mother is also convinced that she is right on every topic that is ever brought up–she is a true narcissist. She does not understand the value in listening to others and never says “I do not know.” While she is busy gossiping and enjoying every last moment of sharing private, negative information about other people, she is enjoying it. She believes that she is a wonderful, caring individual. My teeth almost fell out when she described herself as generous–this woman is as miserly as they come. All of these personality characteristics are part of narcissistic personality disorder.
So while my mother is to be pitied because she **suffers** with bipolar disorder, she also has a lousy personality–she’s a narcissist, plain and simple. Refusing to get help for this is as bad or worse than refusing to get help with her bipolar disorder. She has finally done that (gotten help for the bipolar disorder) and has been psychosis-free for a couple of years now. Not so with the personality disorder. There are no drugs to cure this, only therapy and a willingness to admit that there are some pretty bizarre and bad elements in her behavior and personality.
I don’t think she will ever change. I don’t have to put up with her ugly ways, however; nor do I have to expose my own children to her. That’s where boundaries come in.
I also believe 100% that this disorder is genetic. I am certain that I have a milder form of the disorder, but not having health insurance, I am very much afraid of seeing a psychiatrist about this. Still, after my last bout of hypomania, and realizing what I’ve done, I’ve made the decision to see my GP and explain this to him. He has given me medication for depression, but I’ve never talked to him about triggers that set off severe insomnia, racing thoughts, and strange uncharacteristic, impulsive behavior. So I myself am making the decision to do something about this. I’ve suffered long enough.
The highs are no more bearable than the lows. When depressed I am suffering terribly, unable to get enough sleep, feeling worthless and lethargic, and thoughts of suicide are frequent. When “up” I am suffering from the terrible effects of insomnia, fears of having car accidents due to mental exhaustion, and lack of impulse control. Fortunately for me, I am able to keep myself from going berserk spending money, but that might be due to this being a much milder form of bipolar disorder than people like my mother have (she lost her home due to wild, out of control gambling). I have never had psychosis–the break in reality, thinking that I am as powerful as God, or whatever. The impulsive behavior this last time was a bit less than it has been during other episodes, but I still did something that will shame me forever. Other times I have done very embarrassing things, harmful things (to myself), but this last time, I did something that I cannot just tell myself: time will heal all things and this too will. No, this time I have done something that really will shame me forever and I have no control over it. THAT is bad.
I simply do not have judgment control when this mania or hypomania occurs. Now that the episode has passed, I realize that I absolutely have to do something about this, insurance or no insurance. So tomorrow I am going to call my GP and make an appointment to ask for one of the anticonvulsive medications. Since I know which one my mother takes, and I believe that this disorder is genetic, I am going to ask for that particular medication and see what the lowest dose is that I can stay on. I also hope that my doctor will honor my request not to put this diagnosis in writing so that I cannot be turned down for medical insurance in the future because of a pre-existing condition.
This is a horrible illness to have, for both the person who has it and those in their families. Although I myself do try my best to leave my family out of this, I know that my children are sometimes bewildered by my mood swings when I’m going thru some sort of mixed episode. I feel very much for my children going through this, even while it is happening. Right now, now that the mania/hypomania has passed, I can honestly say that I do not harm my children, that I realize I am going through a spell of mixed moods, etc, and I do my best to leave them out of it. But since I am now feeling very distracted by what I did, they certainly are affected. For them, I must do something about it. But I also must do it for myself. I cannot continue to live like this. It’s horrible. If there is some medication out there that can help, I want to try it because I’ve damaged myself enough.
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