Expert: Joyce A. Anthony - 10/7/2008

Question
Dear Joyce -

My youngest daughter (who is now 18) was diagnosed last year with bipolar
disorder. She has rapid cycles, and many delusional beliefs. At the time of
diagnosis she was also snorting cocaine and smoking pot. She took her meds
for 3 months, went to outpatient treatment, but decided that she neither
wanted to be sober or take her meds and left home. She floats from friend to
friend for places to stay - occasionally coming home to get her feet on the
ground - which means she's home for a day or two and then decides that our
rules won't work for her and she's gone again. She calls me frequently so she
does stay in touch.

I don't know how to encourage her to see a doctor or consider an inpatient
duel diagnosis program without her going into a downwards spiral. Since she
is 18 and not suicidal or dangerous, I can't force her to go and I am not sure
if I could if it would "take".

I'm terrified that she will get injured, raped, etc, or turn into one of the
homeless folks you see on the corner. She is so smart and has so many
opportunities to live so much better. We are able to pay for solutions and
provide her with a home, or college, etc.

How do I cope and support her?

Thanks

Answer
Hi Pamme:

You are definitely in a difficult situation.  Once our children turn eighteen, there is very little we can do to help them.  The first thing you must do is realize that she is an adult and is making her own choices.  While it is difficult to see our children destroy themselves, we often must allow natural consequences to take place.

You are correct--forcing her into any type of rehab program would be useless--she has to want to change on her own. It seems your daughter is the type that will have to reach the bottom before she is willing to seek help.

It is time for some "tough love".  This will be difficult, but may be your daughter's best chance at the moment.  You say she comes home every so often.  The next time she does so, sit down with her and express your concerns in a calm manner.  Use the words "I feel" and "I'm afraid" instead of "You are".  This will allow her to know you are not "attacking" or "judging" her.  Tell her she can come home with the condition that she seek help.  Let her know that should she leave again, that is it--she will not be allowed to move back in until she is ready to seek help. Let her know you love her and it is destroying you to watch her do these things to herself.

Now the really hard part--follow through.  If she comes home and then leaves, don't give her any money and don't allow her to move back in until she is willing to get help.  This will be very difficult, but she will have to reach a place where she wants help.  We want to protect our children from life's hurts, but that is not always possible.

Should she call and genuinely want help--by all means, allow her back.  Be there for her when she is ready, and there will be a point when she is, but don't allow her to keep destroying you by the back and forth she has been doing.  Through it all, let her know you love her and are not walking away from her--you are giving her a choice.  Should she choose to pass on help, she will have to deal with natural consequences.  Unfortunately, all too many children need to do this before they are ready to seek help.

             Joyce A. Anthony