Expert: Libby Bonner - 8/5/2008

Question
My sister has been troubled her entire life.  Recently at age 25 she was finally diagnosed as bipolar. She doesn't have insurance and can't hold or get a job to acquire insurance. She has already been divorced and is now living with and depending fully on our mom.

She might be on some medications but nothing consistent and not what she is supposed to take (b/c she can't afford it).  She drinks and smokes marijuana whenever possible. In addition, my sister is a pathological liar (more so when she is manic).  She steals, manipulates, throws tantrums and lies consistently - day in and day out.  It is hard to know where her brain disorder stops and her personality and free will start.  

We have all been through so much with her that it is difficult to even feign interest, sympathy or compassion - especially since she often uses our emotions to manipulate us further. I have put up pretty clear boundaries and kept my distance lately b/c I refuse to be the codependant sister who continues to get sucked into her vortex of manipulation and narcissim.

My distance and boundaries have finally helped me stay healthy emotionally but I can't help feeling guilty or terrible when she reaches out to me for help and I can't even fake that I am interested. She often alludes to suicide, especially when I don't respond to her initial calls.  This of course scares me.

How do I make sure she doesn't hurt herself, keep my boundaries and salvage the few shreds of respect I have for her?  I have been to NAMI and know that the condition isn't her fault but I really don't understand what all the lying and manipulation is about.  

Can you shed light on the relationship between bipolar disorder and pathological lying? Even when she was receiving adequate treatment, the lying didn't stop.  Can you tell me how I am supposed to maintain a loving and empathetic relationship with my sister, knowing that almost everything that comes out of her mouth is crap?  

Answer
I'm very interest in your question/s and have several comments and suggestions.

But I can do a better job is I have some more info.  You have 'been to NAMI.'  Been to speaker meetings, or family support, or taken Family to Family?  If either of the first two, about how many times?

Other sibs?  How many, and same Q re NAMI about them, and about your mother.

Other crucial Q:  how far are you from a metro area, and what is the pop of the metro???  How far are you from a University School of Medicine?

Will write more same day, or next day, after hearing again from you.