Yesterday, I served on a panel of family members who have loved ones with mental illness, where we talked to a room full of police officers (approximately 30 of them) as part of their crisis intervention team (CIT) training. NAMI-WCI (West Central Indiana) provided the training.

As I prepared my story for the presentation, I realized that I am never the one who calls 911 when my wife is experiencing a manic episode. My wife has always been the one to call, usually because she is experiencing paranoia and psychosis and feels the need to call the police for protection.

This made me wonder… why?

Shortly after bipolar disorder invaded our home in 1999, a series of marriage counselors encouraged me to learn to speak in “I” statements. That was the advice I got from NAMI’s 12-week Family-to-Family course, too.

My initial reaction was, “Great, not only am I a lousy husband, but now I can’t even speak properly!” We had had 15 years of connubial bliss, relatively speaking, before the fireworks started, and I wasn’t doing anything different, so how could this inability to communicate suddenly be my fault?! In short, I was very resistant to the idea.

In the mental health community, we often find ourselves wringing our hands when our loved ones fall victim to a flawed system. Too often, I hear of stories from family members who do everything right and have everything turn out all wrong.

They take their loved one to the emergency room in a psychiatric crisis, and three hours later, the patient calms down and is released with no follow-up care in place. They contact their Community Mental Health Center only to be told that they need to contact an attorney, instead. They call around to psychiatric facilities and find out that no beds are available.

They call 911, and the police show up, arrest their loved one and file criminal charges.

One of the things I hate most about bipolar disorder is how subtly sinister it can be when a loved one is trending toward mania — not manic yet or even hypomanic, just talking faster and louder, blurting out statements that are a little too open and honest and perhaps hurtful, and being more self-centered than usual.

A lot of bad stuff can happen during these times to drive a wedge between loved ones, but nothing bad enough to convince the person or a doctor or therapist that bipolar is at work.

During periods of low-grade pre-hypomania, uncertainty fogs the mind. In our family, we argue more and “walk on eggshells.” Everyone’s afraid to mention the elephant in the room out of fear of being accused of blaming bipolar disorder or the person who has it for our family drama. After all, the rest of us in the family are admittedly less than perfect, and even in a normal, healthy family (whatever that is), interpersonal conflicts arise.

Last Thursday, my wife and I attended a viewing of Dr. Delaney Ruston’s documentary film Unlisted followed by a panel discussion. The film and panel discussion focused primarily on schizophrenia, but individuals with bipolar disorder and their families face similar struggles.

I was very impressed by the keynote speaker, Dr. Alan Breier, MD, who passionately and compassionately described the struggles of people living with schizophrenia. He called schizophrenia the “quintessential human experience,” because it affects the two qualities most responsible for making a person feel human:

• The ability to work
• The ability to love

Last night my wife and I watched Carrie Fisher’s Wishful Drinking – the HBO film version of her solo Broadway performance based on her book of the same title. In Wishful Drinking, Fisher recounts the emotional ups and downs of her childhood and career and her struggles with depression and mania, all in a very humorous way.

One thing that struck me, and I’ve noticed this in other situations, is that families are often pretty screwed up and sometimes it’s the most “normal” person in the family, the one who seems to really have it all together, takes the hit and ends up with the bipolar label. Then the family treats that person as the crazy one – the problem. I can’t claim that this is usually how it plays out, but I’ve observed it in a couple cases.

Several years ago, when my wife was recovering from a major manic episode, she turned over the task of paying our bills and managing the checkbook to me.

We were just looking for ways I could help, and that was an easy one. The other day, however, I came across an article by Ginnie Graham published on the Tulsa World website entitled “Bill-paying program helps mentally ill avoid becoming homeless,” and it made me realize that missed payments could lead to major problems for those with bipolar who don’t have someone who can take on that task, especially during a major mood episode or during recovery.

Date: 2nd Thursday of every month starting May 10, 2012

Time: 6:30 – 8:00 pm

Place: Crawfordsville First United Methodist Church, 212 East Wabash Avenue, Crawfordsville, Indiana

Group type: For people with serious mental illness and family members and friends who have loved ones with serious mental illness

More info: Visit the Crawfordsville NAMI website for additional information.

(I posted the following when we were training to become NAMI support group facilitators and added the information above as we geared up to actually start our support group.)

My wife and I and one of our neighbor friends spent part of our weekend in Lafayette, Indiana training to become NAMI (National Alliance on Mental Illness) support group facilitators. We’re planning to start a support group in our town, Crawfordsville, Indiana later this spring and offer a Family-to-Family course in the fall.

I’ve been to several NAMI support group meetings in Lafayette (and Indianapolis when we lived there), and I’ve found them to be very helpful. Even when everything is going well in my family and I don’t really need the support, spending time with others who’ve struggled with mental illness in their families and having an opportunity to help someone by sharing the knowledge I’ve acquired over the years feels great.

The meetings always start and end on time, and the facilitators have been very good about giving everyone a chance to speak and not allowing any attendee to monopolize the meeting.

Maggie asks…

My 21-year-old was diagnosed with Bipolar I after an extreme manic episode (he was hospitalized). It was a long and difficult few months (awful treatment, bouncing around to different doctors, etc.) during which his mania tapered down, and then turned into a deep black depression, which he is out of now.

No one can persuade him to take medication. Now that he’s feeling normal again, he seems to think that he doesn’t need medication. So no meds, no therapy, no treatment of any kind. And I am quite sure he’s self-medicating with “other” substances. (He lives with us – me/mom, younger brother, step-father.)

Advice?

Dr. Fink answers…

Continue reading… »

I recently got a call from an aging family member who has suffered with bipolar disorder, untreated for most of his life. He explained to me about the police cars that had “surrounded” his home and were “monitoring” him, but really were trying to harm him because they were involved in a “conspiracy with the gangsters who live down the street.”

I sighed. This was just another in a long line of these kinds of episodes, and I was pretty sure it would resolve on its own with my relative hunkering down in his house for a while until he was sure the police had gone away.

But then I decided to go see him as soon as I could, because he just turned 80 and I began to wonder if I should be worried that in addition to his bipolar disorder he might not be showing some signs of dementia. I wasn’t sure about the overlap between bipolar and dementia. We know from studies that people with bipolar disorder often have cognitive problems – memory, executive function, and other thinking problems. But does this put them at higher risk for memory problems in old age?