Expert: Libby Bonner - 8/31/2006

Question
Our daughter is 35 years old and was diagnosed as bipolar 19 years ago. It has been an emotional roller coaster for her father and I. She won't take meds on a reglar basis(hardly ever uses them at all), drinks alcohol and smokes pot. She has been hospitalized several times but does not follow through with treatment afterwards. She has a few good months here & there during which she can be so endearing and promises to get help but does not.She has a hard time holding on to a job although she is very intelligent (she is a paralegal).When she does work she doesn't handle money well and still gets behind on bills. Then we have to have to pay to have lights cut back on, etc.  She is sexually promiscious and hooks up with some real scoundrels. Her husband now has custody of the two children ages 10 & 14. They no longer wanted to live with her. She is out of work a lot so we wind up having to cover expenses. It has reached the point that my husband and I can't afford to keep up two households. I just sent money for rent today because she quit her job. It would be impossible to have her live with us because of her mood swings and behavior. We have tried that. I feel we are enabling her actions but how do we stop? What would happen to her. HELP US PLEASE!!!

Answer
So sorry about your situation.  I hear it often.  I wish the solutions were easy.

Much of her 'bad' behavior is because of her untreated illness and/or her substance abuse.  [Many bipolars use drugs as a way to feel better, rather than primarily to be high.... to feel not as bad as they do w/ bipolar illness.]

Do keep loving your sometimes endearing child; just don't believe her very often.

Here are some things you can do to begin to make changes FOR YOURSELVES.  They may, or may not, cause some good, or bad, changes for your daughter.

Get the book - BUY IT - by Woolis called When someone you love has a mental illness.  You will regain some control over your situation and you will find ways to talk w/ your daughter more effectively.  This book is a life-saver.

Other life-saver.  I hope there is an active NAMI group near you.  Go, and esp to any family support group they may have.  Find one at www.nami.org  Lots and lots of folks who started from where you are now, w/ practical experience and ideas.  Take the free NAMI class when/if you can:  Family to Family, taught by trained family members.

Here are some things NAMI people will suggest.  Identify the social service agencies in town who can be of help to your daughter.  Find out how she can link up w/ them and write all this up for her.  Absolutely find out if she is eligible for Medicaid.  [If you are in a city, a large hospital may have a program for indigent patients.]  Offer to help her find cheaper housing.  Tell her how long you will be able to help, and w/ what.  [You might want to keep her car in good repair.]

You don't need to defend your financial decisions.  Stick w/ some version of "Helping you has turned out not to help you."

You may want to offer a bit more help IF.  If she begins seeing a doctor regularly and taking meds regularly.  [You probably will need to fund the first couple doctor's appts and the first couple months of meds - a large sum, but we hope that Medicaid or something else will kick in for her.  Don't overlook free clinics, either.  She will still need Rx from a psychiatrist, but some meds will be available, some of the time, from clinics.]

If there is a community mental health center in town, she can get psychiatric care there, but also utilize their programs and social workers.....  Perhaps she can.  It's likely there is a waiting list.  But she certainly does need more than just a docor.

She will have trouble getting on disabiliy because of her age and her drug use.  There goes her best shot at income.  Ask the same people that you ask about Medicaid whether she is eligible for SSI --- it's not disability, but income, not much, for the very poorest.

You may also want to get an atty.  Not sure what he can do: perhaps you can become her guardians, which would allow you to have her hospitalized.....but find out whether you would be liable for the bill.   ---  You will have many problems doing things for her because of her being a legal adult.

IF you should end up paying for any doctor visits, insist, if insistance is possible, on taking her there so that she can sign a Release of Information....enabling you and the doc to exchange vital info.

As you see, I have already decided, for you!, that you are going to cut her loose.  You have no choice and, as you have seen, helping has not helped.  She will have some very rough times ahead....and she may sink or she may swim.       

Certainly, talk about this first w/others and GET THE WOOLIS BOOK - it has a section on setting limits, which one can do to a limited extent.  Then take these steps logically and in order, w/ plenty of info to her about her future....and that you will help her find some of the things she needs [food pantries, etc.]  Tell her YOU are not going away - but the money mostly is.  And when the money is used FOR her, make sure it is that: pay the mechanic's bill, or the utility bill [now and then] but DON'T provide her w/ money [except when all good sense would say to do it.]

Pls be sure that you have a clear picture of bipolar disorder --- much of the chaos of her life she only appears to have chosen:  mental illnesses cause changes in thoughts, moods, and behavior, changes of which the person herself is often unaware and cannot alter.

You and she are going to still be together a long while, I hope.  But w/ you less stressed and, one hopes, her finally seeing a path and getting care.  I said "less stressed" but probably "stressed differently" is more accurate.  If you are involved in the life of a loved one w/ a mental illness, there will always be many worries, many concerns.  But - w/ some better information [through NAMI, I hope] and w/ different goals for her, for yourselves, I hope it will be a better life for all of you.

What will happen to her?  I don't know.  With luck, she may find a new circle of friends in circumstance like hers - and find people who care about her and for whose welfare she will come to care.  That would be a good outcome, truly.

You don't mention suicide and I gather it has not been attempted.  Do be quick to intervene - call 911 or haul her to the hospital [if she will let herself be hauled] - but be hopeful and don't borrow trouble, if this has not been a past issue.   Do also check www.psychlaws.org to see whether involuntary treatment is permitted where you live.

Must go.

Pls write again.