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.

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:

Recently, Bob posted a story on our original Bipolar Blog called “Heartbroken and devastated from ending a marriage with my bipolar wife.” In his story, Bob talks about all he would do for his wife only to feel unappreciated and heartbroken. I don’t know Bob or his wife or their situation. Nobody really knows what goes on behind closed doors in anyone’s home. However, I could sort of relate to Bob’s description of how he responded and how he felt.

When you’re in a loving relationship with someone who has bipolar disorder, it’s common to feel frustrated and unappreciated at times. No matter how much you do to show your love, your loved one may not be in a condition to return that love or respond to it in any positive way. The more you do without receiving anything positive in return, the greater the frustration and resentment.

You might start to wonder, “What about me? How long should I have to put up with this?”

I can usually tell when a loved one is upset with me. They sulk around the house, bang stuff, slam doors and drawers, avoid eye contact, and stop talking to me. Maybe I know the signs because I engage in the same behaviors when I’m upset.

Until relatively recently, however, I didn’t fully grasp how abusive the silent treatment can be. A major client of mine “went dark” on me. The client had failed to pay me upon completion of a project. Payment was about two months late.

After repeated phone calls and e-mail messages that never produced a payment, I stopped providing services, responding to e-mail messages, and returning phone calls.