Archives for Relationships


Stop Trying to Stop Enabling Bipolar Behavior!

Sandra lives with bipolar disorder. I am her psychiatrist or p-doc or shrink (as in Dr. Fink, the shrink). Sandra (not her real name), and I have worked together for many years. At today's appointment, she is moving a little slowly due to some back pain, but she tells me that her mood and energy have remained steady. That is outstanding news, because until a couple of months ago she was experiencing a terrible mood episode that rocked her life—a difficult mixed episode (mania and depression), along with substance use and memory and thinking problems. Her symptoms disrupted relationships with her family and worsened existing financial troubles. But, fortunately, her mood and energy level have not wavered to any clinically significant degree. Today she smiles and tells me about her volunteer work and playing tennis with a friend. Then she stops, and she cries softly and asks me how to help her parents understand what is wrong with her.

While the good news is that many people in Sandra's life are starting to grasp that bipolar disorder is the problem (and that Sandra is not the problem), her own family of origin shuns and shames her, telling her that they have been advised to "stop enabling" her "bad behavior." They will not let her come to stay with them, and she has been excluded from family events. Sandra is heartbroken.
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Supporting a Loved One Who’s in Prison

From Joe Kraynak, co-host of Bipolar Beat: I have been corresponding with a young man who is currently being held in a federal detention center (FDC). I asked him to share his insights and advice for how friends and family members can support a loved one with bipolar or another serious mental illness who is in prison. He wrote this post.
Everyone knows the importance of communication in maintaining one's emotional and psychological well-being. Communication is even more essential for those with bipolar disorder and other mental illnesses who may be confused about where they are and why and may even be experiencing paranoia and psychosis.
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Do You Hesitate to Call the Police?

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?
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Defusing Confrontation with “I” Statements

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.
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If You Want a Certain Outcome, You Need to Work for It

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.
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Helping Loved One

Separating What’s Bipolar From What’s Not

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.
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“Unlisted” Impressions

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

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Bipolar Stories

Wishful Drinking

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.
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