Expert: Libby Bonner - 7/25/2008

Question
My next door neighbor has bi polar disorder.  She is a dear person, except when she is "down."  She becomes angry and complains to me, calling my home sometimes 2 or 3 times and sends angry emails.  She is 43 yrs old and lives with her father.  Her 13 yr old son visits e/o weekend and plays with my 10 yr old.  She can be very sweet and giving, but when she is depressed, she talks non stop and says nasty, negative things about life, her father and others.  She sees a therapist once a week, but is on no medication. Since she is not a family member,  I am finding it hard to relate to her when she's miserable.  I don't have anymore energy for her today anyway.  What should I do?  I've encouraged her and tried to hint that there is "help" out there.  I cannot believe her therapist hasn't suggested meds.

Answer
I have some questions.  Who made the diagnosis of bipolar - therapist? family doc? psychiatrist? -- and how long ago?  And - she has said she is depressed, or how did that impression start??

When you say she talks nonstop, do you just mean so no one else could get a word in edgewise, or do you mean very much faster than most people talk??  If the latter, then this has a bearing on her "depression."

The two paragraphs, above, have to do w/ whether she is experiencing an "angry, agitated depression" or whether, if her speech is abnormally rapid [and she maybe changes subjects abruptly?], she is experiencing hypomania and not depression.  If hypomania should escalate to full mania, that would not be good....

If she is hypomanic and not depressed, it becomes more important, for her and others' safety, to be taking some sort of mood-stabilizing med - could be something as simply and inexpensive as lithium.  The therapist, who cannot write prescriptions but who could recommend that she see a doc, may not realize that she is hypomanic [if she is - this is just my impression from the very little that I know of her.]  Therapist probably HAS recommended a doc....she may not wish to go, to acknowledge her illness, or to be medicated.  And no one can force her to go, or to take meds if they were given to her.

I would try to not take her angry calls, and would never respond to angry emails.  Do you have a speakerphone, or voicemail/answering machine?  It will be inconvenient to stop answering the phone, ever, but I myself would not want to hear angry calls, nor try to get her off the phone when angry.

Apparently you have no contact w/ the dad, either to get info or give support?  IF you have the chance, pls suggest he find a NAMI affiliate and see if there meetings are helpful....locate on at nami.org   Can't be fun for him.  [He may already by going, and getting support....we don't know.

IF a time should come when you sense that she is much much worse, and can know it before she shows up at your door, I would keep my doors locked - storm or screen doors - and NOT admit her to your house, regardless.  If she should behave violently within your sight or hearing, I would call 911.  Nor would I go to her house for any reason under those circumstances.