Expert: Jennifer - 7/8/2011

Question
My best friend (in his 30s)has gone thru a divorce last year and his wife has his daughter. I thought his depression and "oddness" were from that.However, he got worse and worse, quit his job, and I have been taking care of him ever since (gladly, as he is like a brother). He was finally diagnosed bipolar, took lithium for a while, decided he wasn't bipolar, quit the meds, got nuttier, moved in with me, is now retaking lithium. Here's the problem: He has become very verbally abusive, picks fights with me, and says he believes that I have put a "spell" on him that makes him sick! I am walking on eggshells now. Is this normal for bipolar folks and what can I do?

Answer
Dave:

The options available largely depend on what you're willing to put up with and what you're not/what you shouldn't. Sharing a home with others tends to bring arguments and stress for everyone involved; siblings fight, parents fight - and even roommates fight at times, with how often usually determined by how close they are as friends and whether one or the other (or both) have any habits or outside environmental issues that increase stress in the home. The good thing is that he's back on his medication. But it still sounds like he needs to see his doctor to discuss what his options are for controlling his symptoms better than they are being controlled now; lithium can cause serious health problems if it reaches a toxic level in a person's system, so with all of the other medications that are available for treating bipolar disorder there may be better options for him to try. The bad news is, while this is all still occurring or his doctor is figuring out the best medications for controlling his symptoms, you should expect more of the bad behaviors that you mentioned. He's your friend, and right now I'm willing to bet that there are few if any other people in his life that are willing to take him into their home or even just put up with things for a bit while he gets himself the treatment he needs (and will need for the rest of his life - bipolar disorder requires medication to control the symptoms, and that is a life-long situation) - all of us with this disorder do better when we've got people in our lives who are there for us, it's just difficult to keep people around because of our behavior at times. Whether you let him continue living with you is your decision, but even if you decide against it, I'd encourage you to stay involved in his life and as his friend.

When he's a little more stable and capable of having an adult conversation in a rational manner, you should sit down and talk to him about what's going on. Even if you let him live with you, it's not out of line for you to establish some rules and expectations. As adults, no one is obligated to take care of us, put a roof over our head, or support us financially - all of those things are voluntary and can end at any time if we don't follow the rules. Having to learn that living in someone else's home isn't a right but a privilege, or that the only person responsible for providing us with the things we need in our day-to-day living can be difficult but it's part of figuring out what it means to be an adult. Even as his friend, he shouldn't expect you to take his abuse and it's not ok for him to take advantage of you. If he can't have a discussion about what's going on, what his plan is as far as the future and getting to a point where he will be contributing to things, then you'll have to decide whether or not you want to continue living in your home.

Good luck, let me know if there's anything else I can help you with.