How to Support a Family Member with Bipolar Disorder and Depression

Q: How to Support a Family Member with Bipolar Disorder and Depression

Hello： If there is a confirmed history of mental illness and hospitalization, it is advisable to schedule regular follow-up appointments to discuss the management of the condition and ways to interact with family members. <br>If the patient refuses to attend follow-up appointment

Please help our family?

Hello Doctor: My sister has bipolar disorder and depression.
She was forcibly hospitalized for several years and has been back home for a year and a half.
She dislikes seeing our parents engage in religious activities because she believes they are wasting money that could be saved to buy things they want, which would alleviate their financial worries.
However, before her illness, our parents took her to that religion for spiritual healing and to provide companionship, allowing our family to work.
I believe that religion helped my sister improve, but she has since lost interest in it.
Our parents have told her that they do not intend to stop attending, as they initially got involved because of her.
Recently, due to work shifts and lack of sleep, combined with my mother misleading her about going shopping with friends when they actually went for spiritual healing, my sister became suspicious.
I knew my mother was going for spiritual healing that day, but I was unaware of what my mother told her that raised her suspicions.
When my sister found out, she expressed her anger, saying, "How can elders deceive their children?" and complained that our family neglects everything to attend that religion.
Since that day, she has not spoken to my mother.
A few days later, she confronted my mother again, and both sides were very emotional.
My sister suggested that my mother should not go there, and if she didn’t listen, she would not care anymore.
However, later she yelled and cursed at our parents about their involvement in that religion, claiming she felt very pitiful, and then rode off on her bike.
She also took her cards and identification documents from our family.
No matter how we try to reason with her, she does not listen.
She even mentioned that she would bring someone more powerful than that religion to our home.
Doctor, how can we help my sister? Our family is aging and is already exhausted with worry about her.
I know she is ill and remember that she had good times in the past, but why does she focus on controlling our parents instead of taking care of her own issues? Why, at almost 30 years old, does she still not understand? I have told her that our parents supported us until our twenties, and they should be allowed to do what they want as long as it’s not harmful.
Yet, she still cannot let go.
She even said that if our parents had not gone there, she would not have mentioned that she could get better!
I apologize for the lengthy message.
I would like to ask, what should we do when my sister is yelling outside? (I know she doesn’t want to act this way, but she is yelling so loudly that the neighbors can hear, and I feel embarrassed and wonder why our family is like this.) I am also worried that my sister might harm herself or others.
Thank you, Doctor.

tiānkōng, 20~29 year old female. Ask Date: 2022/04/23

Dr. Tang Jiahong reply Psychiatry

Hello: If there is a confirmed history of mental illness and hospitalization, it is advisable to schedule regular follow-up appointments to discuss the management of the condition and ways to interact with family members.
If the patient refuses to attend follow-up appointments or declines other treatments, the only option is to contact the authorities for assistance in transporting them to a medical facility when there are self-harm or harm-to-others behaviors or risks.
Take care, and best wishes to you all.

Reply Date: 2022/04/23

More Info

Supporting a family member with bipolar disorder and depression can be incredibly challenging, especially when they are experiencing heightened emotional distress and conflict with family members. Your sister's situation appears to be complex, involving her mental health struggles, family dynamics, and her feelings about religion and finances. Here are some strategies to consider that may help both your sister and your family navigate this difficult time.

Understanding Bipolar Disorder and Depression
First, it's essential to recognize that bipolar disorder is characterized by extreme mood swings, including manic episodes (where a person may feel overly energetic, euphoric, or irritable) and depressive episodes (where they may feel hopeless, lethargic, or sad). Depression can also occur independently of bipolar disorder. Your sister's reactions, including her anger and frustration about your parents' religious practices, may stem from her current emotional state and her perception of control over her life and finances.

Communication Strategies
1. Active Listening: When your sister expresses her feelings, especially during moments of anger or distress, try to listen without judgment. Acknowledge her feelings by saying things like, "I can see that you're really upset about this." This can help her feel heard and may reduce her defensiveness.

2. Stay Calm: During heated moments, it’s crucial for family members to remain calm. If your sister is yelling or expressing her frustrations loudly, try to maintain a composed demeanor. This can help de-escalate the situation. You might say, "I understand you're upset, but let's talk about this calmly."
3. Set Boundaries: While it’s important to support your sister, it’s equally vital to set boundaries regarding acceptable behavior. If her outbursts become too disruptive, you might need to gently remind her that yelling is not an appropriate way to express her feelings.

Encouraging Professional Help
1. Therapy and Medication: Encourage your sister to continue her treatment, which may include therapy and medication. If she is resistant, consider discussing the benefits of therapy in a non-confrontational way. You could say, "I know things are tough right now, but talking to someone who understands can really help."
2. Family Therapy: Sometimes, involving the whole family in therapy can help address underlying issues and improve communication. A therapist can facilitate discussions that may be difficult to have on your own.

Managing Crisis Situations
1. Safety First: If you ever feel that your sister might harm herself or others, it’s crucial to seek immediate help. This could mean calling emergency services or taking her to a hospital. Safety should always be the top priority.

2. Crisis Plan: Work with your family to create a crisis plan. This plan should outline steps to take if your sister becomes very upset or if her behavior escalates. Include emergency contact numbers, preferred hospitals, and any specific interventions that have worked in the past.

Supporting Yourself and Your Family
1. Self-Care: Caring for someone with a mental illness can take a toll on your own mental health. Make sure to prioritize your well-being by engaging in activities that bring you joy and relaxation. This could include exercise, hobbies, or spending time with friends.

2. Seek Support: Consider joining a support group for families of individuals with bipolar disorder or depression. Sharing experiences with others who understand can provide comfort and practical advice.

3. Educate Yourself: Understanding bipolar disorder and depression can empower you to provide better support. Read books, attend workshops, or consult mental health professionals to gain insights into your sister's condition.

Conclusion
Supporting a family member with bipolar disorder and depression requires patience, understanding, and sometimes professional intervention. By fostering open communication, encouraging treatment, and taking care of your own mental health, you can create a more supportive environment for your sister and your family. Remember, it’s okay to seek help for yourself as you navigate this challenging situation.

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