Bipolar Disorder: Signs, Family Impact, and Seeking Help

Q: Bipolar Disorder: Signs, Family Impact, and Seeking Help

Q： It seems that his condition has severely affected the mental and physical health of his family. <br>Could this be a sign of bipolar disorder? Would forcing him to seek medical attention negatively impact his work and make him resent us even more? It sounds like interacting wit

It is unclear whether my father has bipolar disorder or another mood-related mental illness?

Hello, doctor.
It is said that my father has been addicted to drugs since the year I was born.
Fifteen years ago, he managed to quit with the help of a non-governmental organization and found a job.
However, he has difficulty managing his emotions and often blames his family for his inability to get promoted.
My grandmother has depression, my grandfather took medication for bipolar disorder during his lifetime, and I have previously had self-harm tendencies, so I wouldn't be too surprised if my father suffers from bipolar disorder as well.

My father's situation includes:
1.
He can present himself as extremely humble and obedient in public, working diligently and respectfully in front of his superiors, projecting an image of a "good man who doesn't drink at all."
2.
In private, he lives in the past, enjoys acting like a thug (similar to the thugs on TV), sneaks cigarettes and alcohol, and habitually threatens others.
He used to be a delinquent and often boasts about his past exploits in front of acquaintances.

3.
His attitude towards family members is that everyone must obey him; failing to do so triggers his anger.
For example, during meals, he insists that everyone must eat immediately after cooking, and not eating is seen as disrespecting him.
He expects a specific family member (A) to do tasks for my grandmother, and if she allows another family member (B) to do it instead, he perceives it as disrespect.
He also magnifies any minor faults of my mother, expressing his resentment by breaking her belongings.

4.
Two years ago, after a minor dispute, he destroyed many items in the house.
My mother sought help from his boss (who is also his mentor), but my father has since blamed his inability to get promoted on this incident and holds a grudge about it, bringing it up during every argument.

5.
Arguments occur about once a month, often escalating to throwing things, reckless driving, and self-harm, resembling scenes from movies.

6.
Although the family shows concern for him, he blames them for his promotion issues.
During arguments, he emotionally manipulates his children by saying he would leave on his own and that it doesn't matter if no one loves him.

7.
During arguments, he self-harms by breaking things or hitting his head against objects until he bleeds, then writing words like "hate" and "die" on the walls with his blood.

8.
When non-involved parties are present during arguments, he pretends nothing is wrong but aggressively questions who brought them to intervene (if it’s my mother, he might explode again).

9.
Trying to reason with him is completely futile; he becomes entrenched in a logic where everything is someone else's fault.
He calls his actions towards his children "concern," while he perceives similar actions from us as "malicious."
He is very good at playing the role of a good person in front of others, so I don't believe that reporting him to the authorities would compel him to seek treatment.
I can hear their arguments, and my mental state has become so tense that I experience severe heart palpitations and trembling.
I wake up at night from any noise, and both my grandmother and I are on medication for depression.

Q: Given that his behavior has severely impacted the mental and physical health of the family, does this indicate a manic episode? Would forcing him to seek treatment affect his job and make him resent us even more?

Dian Dian, 30~39 year old female. Ask Date: 2020/02/24

Dr. Wu Enliang reply Psychiatry

Q: It seems that his condition has severely affected the mental and physical health of his family.
Could this be a sign of bipolar disorder? Would forcing him to seek medical attention negatively impact his work and make him resent us even more? It sounds like interacting with your father is quite challenging; you have been through a lot! His situation appears to be a long-term issue, and I am more inclined to think it may be related to personality issues, such as a personality disorder.
Since he seems fine in public and does not exhibit classic manic episodes, if it is indeed a personality disorder, forcing him to seek treatment could lead to resentment.
I would recommend discussing the idea of seeking help with him when he is in a relatively stable emotional state and with someone he has a better relationship with.
Dr.
Wu En-Liang

Reply Date: 2020/02/24

More Info

Bipolar disorder, also known as manic-depressive illness, is a mental health condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). Understanding the signs of bipolar disorder, its impact on family dynamics, and the importance of seeking help is crucial, especially in the context of your father's behavior and family history.

Signs of Bipolar Disorder
1. Mood Swings: Individuals with bipolar disorder experience significant mood changes. These can range from manic episodes, where the person feels euphoric, overly energetic, or irritable, to depressive episodes, characterized by feelings of sadness, hopelessness, and a lack of interest in activities.

2. Behavioral Changes: During manic phases, individuals may engage in risky behaviors, such as substance abuse, excessive spending, or reckless driving. Your father's history of substance abuse and his current behavior of "acting tough" or threatening others could indicate underlying manic or hypomanic episodes.

3. Family Impact: The behavior of a person with bipolar disorder can significantly affect family members. In your case, your father's emotional volatility and tendency to blame family members for his work-related frustrations create a toxic environment. This can lead to feelings of fear, anxiety, and helplessness among family members, as you described.

4. Emotional Manipulation: Your father's use of emotional manipulation, such as threatening to leave or expressing feelings of worthlessness during conflicts, is a common tactic used by individuals struggling with mental health issues. This behavior can create a cycle of guilt and fear within the family, making it difficult for members to address the underlying issues.

Family Dynamics and Seeking Help
Given your family's history of mental health issues, including your grandmother's depression and your father's potential bipolar disorder, it is essential to recognize the impact these conditions can have on family relationships. The stress and emotional turmoil can lead to significant mental health challenges for family members, as evidenced by your own experiences with self-harm tendencies.

1. Communication: Open and honest communication is vital. It may be beneficial to express your concerns to your father in a calm and non-confrontational manner, emphasizing your love and concern for his well-being. However, be prepared for potential defensiveness, as individuals with bipolar disorder may struggle to accept criticism.

2. Intervention: If your father's behavior is severely impacting the mental health of family members, it may be necessary to consider an intervention. This could involve gathering family members to discuss the situation and encourage him to seek professional help. However, this approach must be handled delicately to avoid exacerbating his anger or resentment.

3. Professional Help: Encouraging your father to seek help from a mental health professional is crucial. While you may fear that forcing him into treatment could worsen his resentment, it is essential to prioritize the safety and well-being of all family members. A mental health professional can provide a proper diagnosis and treatment plan, which may include therapy and medication.

4. Crisis Situations: If your father's behavior escalates to the point of self-harm or threats of violence, it is essential to prioritize safety. In such cases, contacting emergency services or a mental health crisis hotline may be necessary to ensure everyone's safety.

Conclusion
In conclusion, your father's behavior suggests he may be struggling with bipolar disorder, which is compounded by a family history of mental health issues. The impact of his condition on family dynamics is profound, leading to emotional distress and anxiety among family members. Seeking help is crucial, both for your father's well-being and for the mental health of your family. While it may be challenging to approach this situation, prioritizing open communication and professional intervention can lead to a healthier family environment. Remember, you are not alone in this, and there are resources available to support you and your family through these difficult times.

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