It is often the case that those around a person with bipolar disorder spot the disorder before the person themselves does. That’s pretty understandable as our actions are always louder from the outside. Not to mention our brain, which is supposed to be paying attention to our behaviors, is the thing that’s sick. So, you know, we miss stuff. Crazy tends to obscure reality.
But what if you think a person has bipolar disorder and the person won’t listen? In this case, there are really only three things you can do.
I’ll illustrate using my fictitious, suspected bipolar, Joe.
I Told Joe I Thought He Was Bipolar, But He Wouldn’t Listen
Understand that no one wants to be bipolar. I am bipolar and I don’t want to be bipolar. The societal stigma around mental illness is strong and it’s extremely hard to admit that we might be one of them. People don’t even want to admit to grey hair, so admitting to a mental illness is generally right out.
Use Logic When Talking to Joe About Bipolar
People are scared to talk about mental illness and everything tends to get emotional before the first word is uttered, but if you’re trying to make Joe come to a realization, you can’t afford that. If you’re emotional, Joe is going to get emotional. That will not help.
Try to educate yourself about bipolar disorder before you start the talk. Print off the diagnostic criteria for bipolar disorder and figure out why you think Joe fits that diagnosis. Confirm your thoughts with others around Joe and enlist their help. Name specifics.
An example would be:
Joe, I think you might have been exhibiting hypomanic symptoms two weeks ago because you barely slept for a week straight and didn’t eat. Then, right after, you got really depressed and didn’t leave your bed for days.
Use logic and reason when talking. Try to take the emotion out from your end as there will be more than enough coming from Joe. (More advice on this conversation will be in a future article, but until then, avoid saying these things.)
Joe Didn’t Listen. He Still Refuses to Get Help.
Honestly, that is Joe’s right. We crazies don’t have to see doctors. True, I would recommend seeing a doctor, but this is a free country which means Joe gets to be as crazy as he wants to be. Joe has to see a problem before he sees any value in a solution.
Now there is only one question that matters: is Joe a danger to himself or others.
Joe Isn’t Endangering Anyone
In most cases, Joe isn’t doing anything except ruining his life. Well, that’s his right. If you’ve talked to Joe and tried to encourage treatment without success, it’s time to decide if you want to stick around and watch Joe possibly self-destruct.
Sorry, but you can’t change anyone, bipolars included.
Joe Is Endangering Someone
If you really think this is the case then you have to call in the cavalry. You’re going to call his doctor, or a helpline or even 911. If there’s serious danger, you have to take serious action. It’ll be really unpleasant and might destroy your relationship, but in extreme cases that may be the only option.
Some Bipolars Don’t Want Treatment
People with a mental illness are just like everyone else – some of them want to change, some of them don’t. Some heroin addicts want to change, some don’t. Some people with bad fashion sense want to change, some don’t. But you can’t change any of these people unless they want to change.
No matter how much you care about Joe, this might just be something you’re going to have to accept.
You can find Natasha Tracy on Facebook or @Natasha_Tracy on Twitter.
While I totally, totally hear you on not being able to change someone, the attitude that “he gets to be as crazy as he wants to be” upsets me. When my husband had his first manic/psychotic episode, he didn’t WANT to be crazy, he had no idea that he WAS crazy. Had he been thinking clearly, OF COURSE he would have gone to the doctor and gotten help for himself.
I found that logic wasn’t the thing that convinced him to get help. It was telling him how his behavior was hurting me. He still thought he was fine, but he recognized that I was not fine, and that by going to the hospital, he’d be helping me. So that’s another tack someone could take when trying to convince a friend/loved one to get help.
You can read more about our story on my blog: http://heatherwhistler.wordpress.com/
Hi Heather,
I can understand the upset. Free will is an upsetting concept, really, particularly in the area of illness. I could never understand why my father would throw away his family over alcohol, but the truth is, he got to be as drunk as he wanted to be.
And you are right that people aren’t thinking logically. Unfortunately that is the nature of this and many other diseases. But honestly, that doesn’t mean they don’t have the right to refuse treatment if that’s really what they want to do.
I certainly appreciate that your husband responded to your communicating the effect he was having on you. I suppose I consider that part of logic. It’s a bit more of a bomb though because as soon as you start involving emotion, this can ramp up and get out of control really quickly and trigger the mentally ill person. Not to mention you might not be able to communicate this type of information without getting really emotional yourself, possibly inflaming the situation. Instead of listening, the ill person just runs, or worse.
But, of course, if it worked for you, that’s great. There are many challenges when someone we love gets sick and you know your partner best so obviously you knew what would work for him.
It’s definitely something to think about. Thanks for bringing it up.
- Natasha
Hi Natasha,
Thanks for your reponse. I agree that staying calm whatever approach you take when talking to someone who is struggling with mental illness is definitely key.
I think my problem with the free will idea in the case of an acute and sudden psychotic break (vs. ongoing alcoholism or bipolar symptoms that aren’t quite as severe) is that the affected person actually isn’t choosing to stay sick; he (or she) honestly doesn’t know he’s not well. It’s not about denial or stigma at that point—it’s that the delusions, hallucinations, and/or paranoia feel like reality. I don’t have any good solution for this problem—I just think it’s a sad and frustrating situation, and one that takes a big toll on the mentally ill, their families, and society as a whole.
You’re right that sometimes you have to accept that someone who is suffering may not be willing to get help, and at that point you have to decide what your boundaries are. As you put it, you have to decide whether you want to stick around and watch your friend “self-destruct.”
I also wanted to point out that, in your example, you can call your friend Joe’s doctor (if he has one) to let the doctor know what you’ve observed even if Joe isn’t endangering anyone. It may cost you your relationship, but that might be a price you’re willing to pay if you think it will help him in the long-term.
Again, thanks for the post and the response. You really got me thinking!
Hi Heather,
It’s no doubt it’s a really tough situation. I don’t think anyone can argue with that.
I’m glad I caused some thinking, that’s one of my goals!
- Natasha
Hello,
I have been dating a man for 8 months and I fear he has BiPolar Disorder.
He was the best guy ever, we started dating in the Spring, all was great until the winter.
He has the most irrrational anger and rage, and the anger is unrealistic, he has pretty much lost every person in his entire family as they have given him an ultimatum to get help or he will not see his grandchildren or anyone else until he does so.
They told me they put up with this for 30 years. He blames me for this also as I reached out to them during one of his rages. I was scared,and I’m scared for him, he already had bypass surgery a few years back and almost died from a Staph infection.
Each time he has the rages, he breaks it off with me, insults me, says don’t call me ever again, uses my past against me and then I find myself being the one to need help. BUT after its passed, he is the most loving man on earth, until the next rage, and I can feel it coming, I know its coming when it gets closer. he also told me at the beginning of our relationship that I would see a bad side. At the time i couldn’t picture anything bad coming out of his mouth as he was so funny and loving.
How do I help this man, I love him, even if I can’t be with him.
and his male friends have all told me to dissapear when he has the bouts, leave him be, he’ll be back, always comes back, some of them said its sometimes days and others sometimes months, and he has done some crazy stuff to them as well.
I exhausted.
Hi Diana,
That certainly sounds very exhausting. Living with such unpredictability is like that.
I can’t comment on your boyfriend’s (sorry, I’m not sure how you refer to him) mental status, but I wouldn’t necessarily assume he’s bipolar. He may simply have some very serious anger issues. A doctor/therapist would have to take a look at the whole picture to make a determination.
Honestly Diana, this isn’t about him, it’s about you. You need to make some decisions. You need to draw some lines. You need some boundaries. This person is _hurting_ you and _scaring_ you. That is not OK, no matter what the reason.
Yes, I would say your boyfriend needs therapy but if his family has made an ultimatum about seeing his grandchildren and he hasn’t gotten help it seems pretty clear that he _doesn’t_want_help_. You can’t make a person want help.
You need to decide if you can live with his behavior. I certainly couldn’t, but that’s a choice you have to make for yourself. Decide if you want him in your life. Decide in what capacity. What behavior will you accept and what won’t you? Then communicate this to him.
Right now you are letting him and his anger run the show. That isn’t right on any level. You deserve better. Don’t let someone else’s problems destroy you.
You can lead a horse to water but you can’t make him go to therapy.
- Natasha
N, As I said, your love story came off a bit melodramatic-but hey what do I know about Lesbians (I do not mean that in the perjorative sense); my wife was a cutter too, she has since stopped; I don’t understand cutters but my wife said it was the only way to relieve the pain (emotional/psychic pain that I inflicted). As for my friend Dave (unfortunately the flip side of the coin called genius is insanity;somehow the coing got flipped. And as I said, “Just being so close to the flame of insanity/b-polar depression…I got burned badly, and had to whithdraw from his presence for fear of joining him in the far away land he lives inside his head.” Every time we had a plan to get him addmitted to hospital-he took off in his Lexus; I didn’t see him until a day and a half later. Sad, but true. His mother comitted suicide (she was bi-polar, and her husband-the Jerk-pusher her over the edge; she did the deed with a bottle of Valium). I gathered up his musical equipment for storage and sale of some items, but the really good stuff (Les Paul guitar w/P90 soap bar pickups, et. al.) to give it back to him if he ever comes back from LaLaLand-he likes it there. I felt like a heel, but I had to save myself and get back to my wife and kids. If you get a chance read my submission: Conversations with a Mad Man-it tells the whole story in detail. I respect your opinion having delt with mental illness. I Kicked OxyContin-Cold Turkey in December of 2004-it very nearly killed me, the rehab gave me Suboxone (wich has Narcan in it) which threw me into complete withdrawal with no turning back. NY State Troopers took me out in handcuffs and I spent the night in a padded cell, then 10 days on a Detox Unit of a Hospital. The episode of “Sleep Paralysis,” and a Near Death Experience (I left my body and went into a great blinding white light of love & serenity, but was sent back. Freaky Deaky, Huh? Your feedback would be helpful. Bye, Thad
Hi Thad,
I’m not sure what kind of feedback you’re looking for, but I have a couple of general comments.
“Cutters” or people who self-harm do so for several reasons, for some it’s to distract from the (worse) pain they are feeling inside, for some it’s a way of externalizing the pain and there are many other reasons too. Cutting, or self-harm, is a way of releasing endorphins so, neurologically, inducing that pain does make sense. (Of course, you are not to blame for that behavior. No one “makes” a person self-harm.)
Yes, genius can come with insanity. Insanity can come with genius. I understand that. Our brains are wired differently and sometimes that comes with positive effects. I know of someone who suffered brain damage and seizures and seems to have come out _smarter_. It’s a brain wiring thing.
Unfortunately, mental illness does run in families so having a mother be so ill that she committed suicide would certainly put someone at a high risk for having their own mental illness.
It’s hard to convince some people to get treatment; sometimes it’s impossible. You can’t beat yourself up about that and you can’t beat yourself up about saving yourself either. You aren’t good to anyone, yourself, your friend, your family, if the illness destroys you too. We all want to help people, I do too, but we all have boundaries, and those boundaries keep us safe. You deserve that.
Congrats on kicking drugs. That’s something many people don’t do.
If I have a chance I’ll take a look at your doc on Scribd.
Thanks for dropping by and your comments.
- Natasha
ch getting dust out of the house is important. When I approached hiI need some advice on my bi-polar husband. He lays in bed all day demanding we wait on him since he worked all those years to put food on the table we OWE it to him. When he is up he is still demanding no matter how close he is or how far away we are.
Since I go to school my daughter-in-law helps me clean the house when they visit. Last night I forgot to tell her his computer room was off-limits to everyone. He is very secretive about this room, but his e-mail sent my e-mail a virus and now I am getting ads about on-line dating and he has about 15 pictures hanging on his wall of naked women so I know what he is up to. Anyhow she went in and cleaned and dusted his desk not throwing away anything just getting it straight and dusted. I have not been allowed to dust it and he has severe lung problems whim about her getting so upset he yelled at me and told me he was so tired of all my
sh- -. Any suggestions before I go crazy myself??? Thank you
Sorry about the last post. My pointer jumps and I forgot to change it. Please ignore all areas up to approached. And add after lung problems:
When he saw what she had done he just flipped out upsetting her very much.
Natasha,
My girlfriend has many traits of bi-polar disorder. I have known her for over a year, and we have been together ever since. I am slowly starting to realize more and more that she needs help, but every time I gently try to bring it up, or a fight gets escalated for no reason (mostly because it’s all in her mind), she refuses to even discuss it.
I have spoken to her sister about things that have happened with her, and she agrees with me. She says this is how she has always been. Is this something you could have your whole life but never notice?
I have done research, I have looked up places she could go talk to someone, but she is a compulsive liar, and I feel that if she “talks” to someone, she won’t tell the truth.
What should I do?
Hi Melinda,
You can only help someone who wants to be helped, that’s true of everything including mental illness. Until your girlfriend recognizes a problem, she’s not going to be interested in looking for a solution. You can try to help her see the issues, but in the end, she’s the only one who can say whether she considers those a problem.
You may have to decide if you can support her the way she is and wait for her to be ready to get help – if she ever chooses to.
- Natasha
Hi!
Hey, flip side…I have anorexia nervosa and also have been diagnosed schizoaffective and am refusing to go to therapy and am getting off meds. Everything folks on her have said rings a bell with me because people around me, the very few that still bother with me, are frustrated with me. I do see it in them. I’m not deliberately torturing them or manipulating them and hate seeing them suffer and feel helpless.
I did go to treatment. Lots of treatment. It didn’t help. Hospitals, doctors, therapists, meds…nada. The available “treatment” doesn’t seem to work at all. The treatment people threatened to put me in the state hospital, that is, my insurance resources are exhausted and I have no family…this is the place where society disposes of those they don’t want around anymore, those that embarrass the mental health practitioners and institutions because they don’t fit the mold or the stereotype and aren’t “happily ever after” success stories and don’t write recovery testimonials. We are hidden.
I can see that others are frustrated, too, because they’ve heard my stories about the injustices I faced in the mental health system and why I choose to refuse therapy and am getting off meds. Most of my current friends (I tend to lose them) have heard my stories of gross human rights abuses in treatment and just plain disrespect and they agree that what’s out there for me in terms of so-called treatment, in a word, sucks.
Every now and then I look for a therapist and I can hear people around me sigh with relief. I am on public assistance…you get the idea…phone call after phone call and the answer is no, I don’t take Medicaid, or occasionally no, I do not treat severe cases the likes of you. I am on a two-month waiting list at a community clinic. I am scared to go, really scared. I think I have maybe a month more to wait. These people have legal power to have me locked up…then within about six weeks I could become a ward of the state, lose my dog, lose my housing, lose my credit cards and control over my finances, lose access to a computer and the Internet, and of course my freedom just to walk the dog and be in sunshine and go to places like church and the library. I don’t want to turn into the drugged person that I used to be that sat in front of the TV all day and smoked and had hand tremors and pimples and was treated with utter disdain and disgust and was no happier than I am now. Even my ex-friends would consider this a tragedy.