Email: how to help someone with bipolar disorder or other mental illness.

Email: how to help someone with bipolar disorder or other mental illness. October 24, 2012

I got this email from Agatha (that’s not her real name).

Hi JT! How’s everything going for you? I’ve been following your blog fairly consistently, and it looks like you’ve been having fun with a wide variety of skeptical shennanigans. We miss you here in [name of state]!

Through all of your blog posts, the ones I enjoy reading about the most are your posts on mental illness. They have helped me become more open and understanding to my loved ones who are affected, and helped clarify several misunderstandings and questions for me.

I was wondering though- you talk a lot about how to relate to people with mental illness, and how to be supportive throughout their recovery/treatment. However, you don’t talk much about what to do when the individual with a mental illness doesn’t appear to want to get better. Do you have any perspective or advice on this?

My sister has been diagnosed with Bipolar disorder, and has several other symptoms that suggest she may be suffering from a combination of illnesses. I would find it much easier to support her if she seemed to be making an effort to get better, but instead she seems to use her disorder as a tool to get what she wants. She’ll do something rude and/or manipulative, but when confronted she’ll act like she has no control. She seems to love the attention from playing off of her mental illnesses. Is there a way to be supportive and help someone get better when they are using their illness as a weapon?

Sending many virtual hugs your way *hugs*

Thanks for reaching out to me on this, Agatha. The first thing I want to say is that because mental illness is an invisible disability, it’s very easy to emulate.  Some people who crave attention, but who are not really sick, can use it as an excuse.  This is unfortunate because it keeps that person from learning accountability and it creates and sustains the very dangerous idea that everybody with a mental illness is a faker.  If you conclude that this describes your sister, I’d give her a very firm lecture on the damage her behavior does to others.

Now, as for how to help someone who is really sick, my friend Lauren wrote her account of helping me get better, which I strongly recommend reading.  It very accurately describes the tribulations that can come with helping someone get better.

The more I thought about my experiences, however, the sadder I got. Helping JT through his dark times wasn’t fun. In fact, it was a lot less than fun, it was pretty fucking shitty. I want to tell all of you to run out there and help those who need it no matter the cost but the truth is that it’s damned difficult.

One of the many downsides of the various mental illnesses is that many of them warp our thinking to convince us that we are not sick.  Or they convince us that if we are sick that it’s better this way.  For me it was a gradual path.  I first had to accept I was sick (er, my friends had to convince me I was sick) and then I had to realize that things would be better if I got help.  The former was the less difficult of the two, and I suspect it will be with your sister.

The greatest things you can do is to be there and to tell them the truth.  They will try to push you away either so they can be alone or to self-fulfill their sordid prophecy that they cannot be loved.  If that is what your sister is doing, condemn the behavior.  Let your sister know that she is better than that.  When she says she has no control, tie her down with, “but you wish you had control, right?”  When she agrees, show her your research on what treatment can do and hold her feet to the fire when she waffles (and she will).

It takes a lot of insistence to get a sick person to the doctor (and sometimes it takes so much that you can’t realistically be expected to do it anymore).  I’d recommend getting more of her friends involved for when somebody needs a break.

Ultimately though, the goal is the same with someone with a mental illness as with any other sick person: to get them treated, which means convincing them to go to the doctor.  Say you’ll go with them.  Say you’ll drive.  Say you won’t judge them (or that you’ll even judge them positively for having the strength to go).  The excuses you’ll hear will be “I don’t want to occupy a doctor with my silly problems” or “I’ll be fine, I just need to satisfy __________ criteria” (in my case it was “lose five more pounds”).  Be firm and tell them that they’re not ok, and that doctors don’t exist to just treat the most sick people.  If what they’re going through wasn’t a sickness worthy of treatment then treatments for mental illness wouldn’t exist.

But they do, and whether it’s through therapy, medication, or both, this is how people get better.  You need to get them to a doctor and go from there, and you get them to a doctor by staying on the points I’ve highlighted above and not coming off of them.

Good luck, Agatha.

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