Expert: Libby Bonner - 12/7/2007

Question
Hello Ms. Bonner,
I have a 19 year old stepdaughter who my wife and some doctors believe has Bi-polar disorder. I've never considered her personality very nice but when she had her first "episode" a few years back, she turned into one of the nastiest persons I've ever had to associate with. She was extremely rude, disrepectful and belligerent. Along with using unbelievably foul language towards us including wishing that my wife(her mother) and I would die! Even though her mother has a heart of gold and I have never done anything mean to her.
She did get on some type of medication which seem to "stabilize" her but ever since then I've believed that the medication simply helps her control what she says and does even though she still thinks bad things and generally is not a nice person. It gives her the mental contol she needs to hide her true feelings and thoughts.
Do to financial reasons she decided to stop taking the medication and is now back to her nasty personality which I believe is her true personality.
So finally, getting to my question, does bi-polar "make" you say and do bad things towards others? Or is it like a truth serum, where you don't have the control needed to keep things to yourself.

Answer
Yes, bipolar causes one to do, say, and think bad things and to behave badly to others.  In addition, some bipolar pts are mainly depressed as well, while other will experience periods of wild, unruly behavior; most will cycle between these to some extent.

Mental illnesses are caused by disorders of brain chemistry that cause uncharacteristic and unusual thoughts, moods and behaviors, and mask the true personality of the ill person.  The diseases also remit and relapse, so that even a person stabilized on meds will experience periods of unusual wellness and other times when they become more ill and symptoms start to reappear.  That's when the doc needs to make changes to meds...can take quite a while to get restabilized.

It is very painful, emotionally, to have a mental illness, to be young and have any chronic disease, to be unlike one's friends, and to have one's future change drastically in unpleasant ways.  It is also upsetting and horrifying to feel your mind sliding out of your control - I have seen this many many times w/ my daughter:  a good mood will disappear before my eyes as a very depressed mood descends on her.

Pls do 3 things.

1.  Buy the book by Woolis called When someone you love has a mental illness.  It will help all of you, when she is sick and when she is not so sick.  It changes lives.

2.  NAMI.  Find a local group [nami.org] and start attending; esp attend a support group for families if they have one.  Do plan to take their free 12-week class Family to Family; this will change your life still more.  I have sat in a Family to Family class and watched an enraged father change - and he is now president of our NAMI affiliate.....and is able to love his son again.

3.  Do whatever you can to get her back on meds.  Episodes of untreated illness will cause damage down the road.  Try PPARx.org, where med manufaturers offer many meds at no/low cost.  Or she may qualify for Medicaid, or whatever the program is called in your state - contact the Dept of Human Services.

It is horrible to be the target of a bipolar's rage, even if you know and believe that you are seeing illness, and I am so sorry that your family is having to experience it.  Having her on meds is the best bet for everyone.  She - and your family - will still have many challenges to meet even if she has the good luck to get good symptom control w/ meds.  She is going to need your good thoughts always.

Thank you very, very much for writing.