Expert: Libby Bonner - 5/31/2005

Question
My family and I are suffering with the problems my sister has, being a bipolar. She has been diagnosed as a bipolar and is on medication. I think our biggest concern at the moment is her lack of ability to manage her money. My father has to do all her finances and is afraid of telling her when she does something wrong because she could get depressed, feel guilty and maybe attempt suicide. Although she has never talked about suicide. Another problem is her weight. She has tried to lose weigh even with a psychiatrist and medication, lost some weight but her medications got umbalanced and she had bad depression and had to change medications. She has a small daughter and is divorced, so she needs to be abel to get things under control.
I would appreciate some help.
Thank you,
Her sister.

Answer
You appear to need much, much more ifo about bipolar illness.  Try www.nami.org or www.mentalhealth.com  Also, pls do yourselves a very big favor and get any book by Jack Gorman, who writes on psychiatry and psychiatric meds.  His books would help you greatly. [They are getting old tho, and don't cover some very good new meds.  BUt the info on illnesses will be good.]

You need more info to help you understand the illness and to become more helpful to your sister - AND so you can know enought to go helpfully w/ her to doctor appts, etc., which I would urge you to do.  Would be helpful to doc, sister, and whoever goes w/ her.

I don't have enough info to help you more: your age, her age, where she lives, age at diagnosis, ever hospitalized, when last hospitalized, etc.  I hope you will make contact w/ a local NAMI group [find one at www.nami.org] or, if you are in a larger town, a Mental Health Association office.  You need to talk w/ others who have ill family members to get practical help and suggestions.

I think your sister could use some help other than from a doctor. You probably have a community mental health center where you live or nearby.  The psychiatrist could write an order for her to receive their services - social workers, maybe classes, maybe some helpful contacts w/ other patients.  All would help her to improve. Check out the center yourselves, maybe, before asking the doctor.

IF you are walking on eggshells and afraid of what to say, please BUY the book by Woolis called When someone you love has a mental illness.  Very practical and all about communicating.  Your family will feel less helpless after you all read it.

If your sister has been very recently hospitalized, phone the ward she was on and ask to talk to the social worker there. Ask his/her suggestions about how to go about helping her - especially about groups that would help families or patients.  The hospital may even run a program for families.

Getting local help is your best bet, but GET INFORMATION.

Weight.  I'm sorry to say that many of the effective drugs that your sister MUST be on will cause weight gain.  A couple of drugs that won't, or won't as badly, are Tegretol [Tegretal?] and Lamictal.  See if the doc would use one of those as mood stabilizers, instead of Depakote - I'll bet money she was, or is, on Depakote.

Don't be surprised that meds need changing from time to time, for various reasons.  That's normal.

At some point, you may also need to consider her finances and whether she can work - or should apply for disability.  That's a whole other subject, tho - get local help on that, probably from an atty.  Most first requests for disability get turned down.

Good luck.  Pls get Gorman and pls get Woolis. Life for everyone will improve after you've read them.  Your dad is welcome to write me....