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.

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?

If a loved one with mental illness or suspected mental illness is arrested, the goal is to transition the person as quickly as possible from the legal system to the healthcare system. The Los Angeles NAMI Criminal Justice Committee has posted a very thorough seven-step guide to help families navigate the criminal justice system in Los Angeles County when a family member who suffers from a brain disorder (mental illness) is arrested. It’s called “Mental Illness Arrest: What do I do?”

This post changes the process a bit, removes details related to the Los Angeles jail, includes some additional notes and tips, and presents everything in more of a checklist format.

NAMI Indiana has some very valuable information about what to do in a psychiatric crisis in Indiana. It actually publishes a small book called What To Do in a Psychiatric Crisis in Indiana.

Along with that, you can go online at namiindiana.org, click What to do in a crisis, and click your county to find out which Community Mental Health Center (CMHC) to contact, the number to call for police, whether the police have Crisis Intervention Team (CIT) officers who are trained to respond to people experiencing a mental health crisis, and additional helpful information.

Basically, what you do is contact people who can help:

When you’re experiencing a major mood episode, having key information available is essential to ensure that everyone on your treatment team is brought into the loop and the doctor on call has detailed information about your medications.

If everything’s on an even keel right now, you probably don’t want to think about the possibility of a future crisis, but a period of relative calm is the best time to prepare.

Prepare an information sheet that contains all of the following information:

Cathi asks…

My friend’s 9 year old has had severe behavioral problems and several alternating diagnoses. The Dr. has prescribed Focalin, Trileptal, Lamictal, and Seroquel. She has no concentration, violent outbursts, hallucinations, etc. She has been diagnosed, at present, with ADHD, Bipolar, ODD, and PDD. She will not do work at school; instead, she sits and picks at her skin. She has been violent and tried to choke other individuals. Mam says she can’t even leave the house with her.

My friend has no money. The state has removed an older child due to DMH reasons. She is afraid of the state agencies, but has nowhere to turn. Court appointed attorney said to call if she won the lottery. What happens to these children? These medications seem excessive and risky considering her age, the possibility of adverse interaction, and off label usage. Any advice or help. We are desperate. Thank you.

Dr. Fink answers…

This is an all too common situation in children with multiple levels of developmental, emotional , and behavioral symptoms, especially when the family’s resources are limited. The first place to start is with the current doctor to get a clearer picture of the reasons for the current medications and to express clearly the ongoing symptoms that are not being addressed.

Part II of How’s That Working for You?

Tuesday’s post asked those with bipolar to weigh in on what works and what doesn’t. This week, family and friends of those with bipolar get their chance to weigh in on the same question in a different context. As a friend or loved one of someone who has bipolar disorder, what has helped you deal best with the situation in terms of helping yourself and your loved one?

I’ll kick off the discussion of what has and hasn’t worked for me in the past.

As Joe pointed out in his post “Bipolar Disorder and Family Dynamics,” bipolar disorder typically affects and is affected by everyone in a family. While no family member is to blame for having or causing the disorder, all family members can and should work together to try to avoid conflict and keep the tone of unavoidable disagreements to a dull roar. Strong emotions tend to fuel conflicts, which isn’t good for anyone involved.

While every family is different, here are some basic strategies that are often helpful in reducing the level of conflict at home: