Expert: Libby Bonner - 6/22/2004

Question
My mother was diagnosed with manic depression 10 yrs. after she left her 5 young children (including me when I was 9), which was in 1962. She had mental illness since a teenager, though they didn't know then what they know now. My mother doesn't live with me - she lives with her husband and they are celebrating their 30th wedding anniversary. I called to wish her happy anniversary and she talked for 2 hrs. I didn't know what to say. Her husband knows that her medication isn't helping the way it used to & she's in the care of a doctor & recently out of the hospital. The doctors apparently don't know what to do about adjusting her medication properly. She took lithium for well over 20 years, but it wasn't working right any more, so they changed it. I have no control over it because she lives in another state.

What I want to know is how does one talk to someone who is ranting about things that sort of make sense, but  not really & are obviously the result of their mental illness? Should I just let her rant? Obviously, that's what I did, though I tried to talk calmly and assure her that all is well and we love her when I got a chance to get a word in (I can't tell if she's in a manic state or depressive state because she talks so much like manic, but her thoughts sound depressive and she was crying).

I also don't know what kind of gift to give someone in that situation. I wanted to give her and her husband a gift certificate for dinner out because they don't get out enough, but it might be hard for him to take her out in that condition. He probably could use some respit (sp?), but I don't know how I could offer that either. Her husband doesn't share deep personal things with me and only speaks to me briefly, but he is good about taking care of her. They're living off of social security, which I'm sure does not allow them much luxury. I have my own family, but I can afford to give them something reasonable if I only knew what.

Any suggestions would be appreciated.

Thanks for offering this service.

- Joy

Answer
A PS, something I should have thought of:  if Soc Security is their sole income, it is likely that the cost of your mother's medicines might be a huge problem.  If their retirement is recent, and they have recently lost Rx coverage in going to Medicare, it could be that skimping on meds is what landed her in the hospital recently.

I realize that your wish was for an anniversary gift, but perhaps this is something you, or you and some other sibs, may want to look into.  Or not.  Whether you/you-all can be a continuing source of some support here or not, you might let them know that there are drug manufacturers who make drugs available at very low cost to low income patients.  See www.aarp.com for this.  There is also the option of getting drugs from Canada....

Write again if you'd like to pursue this further.
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An interesting and unusual question.  You sound like a loving daughter who has made her peace w/ things. I hope so.

There is a wonderfully practical book on many aspects of family interaction and especially communication.  It is my desert island book.  Author is Woolis; title is When someone you love  has a mental illness.  It's exactly what you [and everyone] needs re curtailing phone calls, etc.  [I have a vague feeling that it may be under revision and be between editions.  Don't give up if a bookstore can't get it right now.  Meanwhile, use a library copy.  But do get it.]

I'm sorry that she is still so unwell just fresh from the hospital.  Just as an aside, several of the anti-convulsant drugs work very well for mood stabilization, with or without lithium or some another drug.  Lilly also has a new combo drug for bipolar that combines Prozac and Zyprexa, the latter often used successfully for mood stability--

My concern w/ the gift, w/ your mother currently unstable, is whether whatever you send could be mis-interpreted.  And you are right to consider the practical implications of dinner out.

What about a department store gift certificate - or Home Depot - something on that order?  Again, thinking of repercussions.....if you foresee that as a problem - arguments about the money - you could send matching his-and-hers certificates in a single Anniversary card.  That would allow them to pool them, or not.

If there is anything that you still need to do for yourself - or think you could do for other families - you might want to give NAMI a try, if there is a good affiliate near you that runs a nice, helpful support group.  You can find one at www.nami.org

Thanks for writing.  I do enjoy my allexperts time - and have just belatedly realized that they have experts w/ answers for me, so have started using it for home-repair questions.