Expert: Ivan Goldberg, M.D. - 8/9/2008

Question
Dear Dr. Goldberg,
I am not sure where to turn to and was surfing the web for treatment facilities and came across this website.  My father is 57 years old and has been manic depressive all his life (first episodes beginning in college).  He has been married 5 times, never holds down a job, always blames others, become obsessed with various things (gambling, lotto cards, baseball cards, TV purchasing), never has any money, may have had some prescription drug dependencies, and his cycles are usually 1-2 years long.  My mother tried to get him help before she divorced him (he would wonder off for weeks at a time), but his family denied anything was wrong and so did my father.  To make a long story short - he never has admitted his problem and as he gets older, it is getting worse.  He is now becoming angry and paranoid during his manic stages and has recently begun to divulge in strange sexual tendencies and online poker (thanks to the new technology age and him getting a lap top).  My current step-mother is about to leave him and take my younger half brother away from him.  My sister and brother and I want to try one last time to get him help.  We want him to go to a treatment facility and get on medication.  We don't know how to approach him or how best to confront manic depressives and get them to see their problem.  I would GREATLY appreciate any advice.  
Thank you,
Carter

Answer
Hi, Carter . . .

The situation you describe is essentially a hopeless one. Unless your father is clearly a danger to himself or others in a physical sense, he cannot be forced into a psychiatric hospital in all the jurisdictions I know.

People with bipolar disorder are very impulsive and show poor judgment. That is a very dangerous combination as aggressive , sexual, financial, and other impulses may be acted out without any consideration of the potentially devastating long-term consequences of such behavior. Multiple marriages, financial irresponsibility, sexual involvements of a self-destructive nature, speeding tickets, and worse are all possible because of the problems with impulse control and impaired judgment.

If your present M-I-L is going to leave your father she might first give him an ultimatum. Either he checks himself into a psychiatric hospital for treatment of his mood disorder or she is history. I doubt that he will hospitalize himself as a result of this ultimatum and she should have her bags packed when she discusses this with your father.

Best regards . . .

Ivan
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