Please, bipolar sister, advice desperately needed

[kavv0809]

I don't really know where to start so please bear with me.

My sister was diagnosed bipolar almost fifteen years ago. She has not had an episode requiring hospitalisation for almost eight years, during which time she's had three children.

After her initial diagnosis, her behaviour was erratic. She had about seven significant episodes where she was disinhibited, loose tongued, overly focused on music and art in an excessive and disturbing way, playing loud music in the dead of night, painting disturbing scenes, shutting all friends and family out and focusing on strangers, excessive spending, sexual and drug related behaviour that was out of character.

I remember that time as one of great sadness. It was a strain on everyone. She was hospitalised and hated it, blamed me, our other sister, our parents, she had some bad experiences in there. We were all devastated that she had to go in and had no idea what to do. She had one small child at that point and we all looked after him. Me and my partner moved in with her on one occasion to avert the need for hospitalisation. Each time she started displaying symptoms the protocol changed, it never seemed to be simple, and we had different people to ring or advise or alert. We were drowning trying to keep her safe and getting lost in the system.

She then seemed to go into some sort of remission but it is back now and getting worse. She has more awareness now than before, she has been asking for ages to go away to some sort of treatment centre to get better and rest and sort out her meds. But none of us have the money to fund this. She is seeing a specialist but they have prescribed meds and sent her off, and I'm not convinced she takes them as she should.

She has three small children and now one teenager and I'm concerned for them due to her erratic behaviour. She's fighting with her partner and it is a very sad household. My mum is close by and helps but is elderly and caring for my dad who is even more infirm.

I guess this is a fairly rambling call for help and advice. Is there such a thing as a treatment centre she could be referred to? Would it help? I'm scared she will be taken back into hospital which would destroy her. She is falling out with everyone she knows, getting more and more erratic, I don't see it getting better without something happening. Please, any help or advice would be welcome.

hi kavv0809 sorry to hear things aren't going well. Have you spoken to her partner?

Thanks for responding fluffy bunny. Yes I have, he is not coping well at all and doesn't know what to do, he is being treated for depression and is getting increasingly frustrated with the situation.

Does she have a designated nurse or a social worker? My friend's partner was bipolar and when he had a major hyper episode while they were in Egypt, I had to help from this end, and his nurse was incredibly helpful, and sorted it out to get him home again safely. Is there anyone like that who you can talk to? I would also call Mind and ask them for help and advice. I completely understand why you would want to avoid hospital, but it may be that she does or will need some time there in order to get back on track.
Also she does need to really commit to her medication, my friend's partner, and a relatives partner, both either stopped or became eratic with their meds when they were feeling fine, triggering big manic episodes and crashes.
for you OP.

Thank you SirVix. That is really helpful. She doesn't have an assigned nurse, it was the same before, she was reviewed periodically by a consultant.

Despite this, she deteriorated each time to a point where no one could get through to her and she was behaving in a manner which led members of the public to call police or ambulance and she would end up getting sectioned under the mental health act. I can just see it happening again and need to do my best to help.

Thank you SirVix. That is really helpful. She doesn't have an assigned nurse, it was the same before, she was reviewed periodically by a consultant.

Despite this, she deteriorated each time to a point where no one could get through to her and she was behaving in a manner which led members of the public to call police or ambulance and she would end up getting sectioned under the mental health act. I can just see it happening again and need to do my best to help.

Thank you SirVix. That is really helpful. She doesn't have an assigned nurse, it was the same before, she was reviewed periodically by a consultant.

Despite this, she deteriorated each time to a point where no one could get through to her and she was behaving in a manner which led members of the public to call police or ambulance and she would end up getting sectioned under the mental health act. I can just see it happening again and need to do my best to help.

Thank you SirVix. That is really helpful. She doesn't have an assigned nurse, it was the same before, she was reviewed periodically by a consultant. I'll have to ask about that.

Despite this, she deteriorated each time to a point where no one could get through to her and she was behaving in a manner which led members of the public to call police or ambulance and she would end up getting sectioned under the mental health act. I can just see it happening again and need to do my best to help.

Whoops crazy phone

Her care doesn't sound great, is her partner at all pro-active in getting help for her and supporting her? Call Mind, and ask them what she should be getting in terms of care. She sounds as though she's been left to flounder. Does she have a good GP?

I will ring MIND thank you that's good advice. Her GP is ok but not well versed in bipolar disorder, that's part of the problem.

kavv0809 sounds like her partner is having a hard time himself. What a situation. And kids too. Is either your sister, or your sister's partner willing to accept yours and other members of your family's support in trying to get help? Has she still got insight into what is going on? As obviously it's better all around if everyone is in agreement as to the way forward.

It sounds like the whole family need support. Usually there are crisis intervention teams in mental health who provide intensive short term community support (I have benefited from this). I had always assumed that referral was via GP…generally GP's are 'gatekeepers' to most things. Although her GP is not well versed in bipolar, is there any way that you can get her/her and her partner to visit the GP and request a referral to MH services for crisis support, in order to avoid a hospital admission? Sometimes with MH problems it helps to have a supporting person there to tell things 'how they really are'. I can't talk for your sister, but I know that in the past I have lied about my wellbeing due to concerns that if I told the truth I'd be hospitalised. As you worry that hospital would 'destroy' her it has led me to think that maybe her past experiences were not exactly positive…and so perhaps her consultant might not know exactly how things are going.

Sorry it's all a bit vague. Your sister is very lucky to have you and your family who are looking out for her- it must be incredibly hard for you all

Thanks so much for your advice. I can't tell you how much it has helped to have people who get it.

I've got a number for a crisis team so I'm going to try them tomorrow and see if they can help.

There was trouble again today and the kids didn't make it to school but she is insisting she is fine. It is so hard to work with her when she is like this if you see what I mean.

Well I suppose she really thinks she's fine, and it is mainly those around her who can see that she isn't fine at all. I hope the crisis team are helpful. This must be horrendously stressful for all concerned. Try and find some small things that help you to de-stress and relax, as it is a lot to have on your plate, and you will need a break from the worry.

Kavv0808 - I have had a very similar experience with my children's dad so I really feel for you as the stress of the situation unfolding is just awful.

I found that help was difficult to access unless he was at crisis point and by then it was generally a police/ambulance/section job as he was way too far gone and behaving dangerously. Once he'd been in hospital for a while and back on his meds he was still very poorly but no trouble (depressed, lethargic - just a shell really) and he was then discharged and pretty much left to his own devices. The funding is dire for decent aftercare and so inevitably after a while the cycle would begin again and crisis point would again be reached. There was very little continuity of care so each time it was like trying to access help for the first time and explain everything all over again.

However, after going through this a few times, I (when we were still together) and his family became much more forceful in demanding that something was done when he was still in the earlier stages of the manic behaviour. At least once he was able to avoid a hospital stay as they got him on meds quickly enough. Unfortunately (he stopped taking his meds in the first place, which is what brought on the mania) he could sometimes could fool the cpns into believing he was accepting treatment but was actually spitting the tablets out later so sometimes did still continue to climb in the manic phase and then get sectioned BUT it was possible to avoid it.

Basically, what I'm trying to say, is to shout loud to whoever you can to try get some help for your sister asap. Keep on and pester. Try the GP but also the hospital where she has been admitted before and any other contact details you may still have of cpns etc.

I'm so sorry you and your family are going through this as it really is so distressing. I will be happy to chat more if I can offer anything else useful.

Laa dee da that's spot on and exactly the experience we've had. No one is interested when it starts off until it deteriorates to the point of sectioning which no one wants. I'm seeing her tomorrow so will hopefully be able to make a judgement on how she is doing and what she is prepared to collaborate with, and go from there. I'd really appreciate chatting further in the future if you wouldn't mind me coming back to you, that's very kind.

Anytime Kavv.

Hope you get on ok when you see your sister. Try and find out what meds she's been taking and see if you can get a cpn out to her if she's still able to be reached iykwim?

In my experience, there tends to be a very narrow time frame where my ex is clearly unwell but lucid enough to realise it and will occasionally then be persuaded to see someone at home to try and avoid going back into hospital. If that opportunity is missed, then he's too far gone to listen to reason and insists he's absolutely fine (while doing and saying things that blatantly show he is NOT fine!) Hopefully your sister doesn't spiral as quickly as that and you have a bit of time to try and access some help.

I'm sorry to hear your going through this.
The advice to call mind and the crisis team are excellent.
Is there a GP at the practice who has an interest in mental health? It might be worth visiting them in place of the current GP if so.
Unfortunately, I also have experience of no-one being interested til sectioning is the only option. I guess its down to a cost factor, and difficulty in knowing who will recover, and who will need additional help.

There are a lot of kids in the mix. Could some of them come and live with you for some stability, and to ease things on your sister and her partner? Or will that make things harder for everyone?

Thank you and sorry I haven't been back. Things have escalated a little now, children haven't gone to school for a couple of days and she's just drinking whisky and sleeping once they are in bed or her partner is there.

My mum went round to check on the kids and my sister physically went for her. She is minimising it now and saying my mum is interfering and there's nothing wrong. I rang the crisis team and they have been trying to contact her but she won't answer the phone.

I'd happily have all the children here. I'm about 45 minutes drive away from them and their school though, and I have my own two to get to school and a job to hold down. I also don't think either her or her partner would go for that unless absolutely necessary.

She is lucid in parts and very convincing but I believe my mum. I just hope she will work with us. I'm the only one left that she hasn't fallen out with or cut off or offended.

And Laa Dee Daa again what you said strikes a chord with me. She is aware that she's been unwell for some time and compliant in terms of seeing the consultant. However her behaviour is so erratic and impulsive she is doing dreadful things and then insisting there's sense to them/ explaining them away / minimising them. Her behaviour shows she isn't fine.

Sad update. She has now been sectioned, as of last week. Everyone is devastated, she is miserable and lashing out at everyone. I have found out she was abusing drugs to quite an extent as well which has really saddened me as I thought she knew better - they are a known trigger for her. Those poor children. All she can focus on is herself and her situation right now but we've all been turned upside down. She is not being cooperative either so no idea how this will go. What a mess.

How awful for your sister. Give her a bit of time to be cooperative, she sounds way too ill to be making decisions at the moment. Was she smoking skunk? As triggers go, not advisable.

It's a ghastly tale of not getting medical treatment when required, isn't it - even when your sister has asked for it.

You can hardly blame her, but it must be hard for all of you. Can you use this time to tackle a consultant and get a structure in place in case it happens again?

How grim for all of you, I am so sorry. I hope your sister will start to get better now that she is getting the help she needs. for you.

Definitely weed but not sure if that is the same as skunk? I understand she was smoking ten spliffs a night to herself, she was getting through £40 worth every two days. And mdma powder. That is just what I know of. I can only think how desperate she must have been feeling to have reached for those things to help.

I'm trying to be there and not judge. It was fucking scary though. I had to go with her in the ambulance to hospital and she made no sense and talked shouted sweared ranted and raved non stop for seven hours. We had to go to a and e to be seen and they put us in an isolation room with no windows and security outside. It was enough to make anyone unwell.

She was allowed leave today and didn't return to hospital. They had to send the police to get her.

Sorry for long rambling posting. I'm just so sad.

I have no words of wisdom sorry but just wanted to send a hug. My sister is bipolar and it's torture. Sending good vibes for your sister's recovery xxx