Expert: Rebos - 1/2/2008

Question
QUESTION: Hello, I have a friend who is an alcoholic and I fear that I have become an enabler as you described in your answer to Alice on 5/14/07.  However, I am afraid of stressing the consequences of her alcoholism because she is also diagnosed with bi-polar disorder.

I have become an enabler because while she is in her down period, I have been representing her to a client in a high profile artistic project.  Her bipolar disorder raises the question of her ability to complete the project and also potentially the issue of authorship.  To address this I have set up the project so that I am taking care of the technical aspects, while she can easily do the creative with a minimized amount of complication.  This is a situation that is not uncommon in various applied design fields where a creative team is needed for a project.

On one hand, I am afraid confronting with the consequences if she is not able to do the creative aspect of the project because of her bipolar disorder, on the other hand I do not want to be an enabler to her alcoholism.

Up until now I have been trying to take the route of minimizing her stress and pain from the bipolar, however I do not know how much the factor of being an enabler should affect the way I should try to help her.

Your advice would be much appreciated.




ANSWER: Good afternoon Rick and thank you for your question. You haven’t mentioned if your friend is seeing a doctor for her bi-polar condition or if in fact is taking her medication as prescribed? Has she ever been detoxified or tried a program like Alcoholics Anonymous? If you can provide me with some of your friend’s background I can then share the experience that I have had with others relative to your question.

One thing that I can tell you is that alcohol has the same chemical formula as ether, (the anesthesia) except that ether does not have any H2o (water) in it. As with ether, alcohol is a serious depressant…and indeed can have a profound effect on the depressive part of being bi-polar. Of one thing I am sure, alcohol will diminish the effectiveness of the medication she takes to control the depressive part of her condition. Likewise…any drink that has caffeine in it will result in having a negative effect on the manic side of her illness. I would expect that her doctor has advised her of a number of products that she should avoid for her continued well being.

Depending on how close you are to her, you may want to caution her if she is having trouble stabilizing her mood swings. Alcohol is serious stuff to a person with a bi-polar problem whether or not taking medication.

I hope that I have helped you with my answer, however, I can elaborate if you will provide me with more details. Thank you Rebos


---------- FOLLOW-UP ----------

QUESTION: Thanks for your quick reply Rebos.  First a quick correction to a typo in my original question, 'confronting with the consequences' should read as 'confronting HER with the consequences'

To answer your questions:  

She has attended some AA but finds that she cannot relate to the people there because she is not only an alcohol abuser but also bipolar.  It made her feel isolated because the other people didn't understand her reasons for drinking.

Her regular doctor has been prescribing lithium, however it is not well controlled because of her diet.  And she was also prescribed too much for her body weight.  

She has been trying to get into a local dual-diagnosis program, but has not had much success in keeping her appointments.  At her very first appointment with this specialized program they found her very nearly poisoned by the lithium because she was prescribed too much and it was also not well managed.  She has been trying to reschedule an appointment since then, but because of the holidays there hasn't been any success.  She has also tried getting into a detox program, but again hasn't been able to because it is a busy season for detox centres.

The hope is that she will be able in the New Year to get into this specialized program.  In terms of seeking proper medical attention I think she is on the right path.

My question is in regards to the way that I am trying to help her with this project that she has been contracted for. It's known that people with bipolar can be very productive and creative. This is one of those cases.  I believe very much in the project and I have been devoting my spare time to the work.  I have also been considering footing some of the development costs because she needs the income from the contract.  In this way I fear that I may be an enabler to her alcoholism.  My dilemma is that I fear that if I don't do this the stress of the project will worsen her bi-polar condition.

I hope this is clearer, I do have some personal resources for advice to help me.  However, I did want to ask you specifically about enablement for alcoholism in the case of someone with bipolar as well.  I am not sure which is more important, minimizing stress from the bipolar and helping her to reach her full potential, or not being an enabler to her alcoholism.

It does seem like there is no easy answer to this dilemma...  

Answer
Good morning Rick and thank you for your follow up question with the details that I requested.

Getting right to the point… Alcoholics are known to do anything or say anything to protect their right to drink. If your friend does nothing about her alcohol problem FIRST she will have little chance to manage her bi-polar problem. Therefore it is my opinion that YOUR CONTINUING TO ENABLER HER IS THE WRONG THING FOR YOU TO DO! There are a number of things that I could tell you about others that have faced a dual problem with alcohol and bi-polar diseases, but since you have asked me to limit my response… I will respect that you have “personal resources for advice”. It becomes an unanswerable dilemma only if you make it so. Thank you Rebos