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Q:   Dear David,

After a failed suicide attempt, my dear sister-in-law was recently diagnosed with bipolar disorder. She has chosen to move across the country to my home town soon, but has no confirmed job, very limited financial resources, and is in major debt to a variety of institutions and friends.  She will lose her medical coverage within a month. She has been able to rent an apartment despite having credit problems.

I am very concerned for her, but am at a loss as to how I can best help her. I am still trying to understand what bipolar disorder is all about. What are my responsibilities? I have been emotionally supportive, but fear that if I commit to any further involvement (e.g. providing financial help, providing accommodation in my home) my family and I will be consumed and overcome by her needs. I might add that because of her behavior in the past, my sister-in-law is estranged from most of the other family members who live in this area.

I would appreciate your insight and any guidance that you can provide. Thanks so much.

Dear C,

     The answer to your question and concerns could and has been the subject of entire books.  To cut to the chase, let me recommend what I considered to be excellent advise for my own situation several years ago and what I believe to be practical, caring reading for those with bipolar disorder but especially the families of same:

         Loving Someone With Bipolar Disorder, Fast, Jane A., 2004.

     Try to keep in mind that the more your sister-in-law can actually do for herself, perhaps with the support and guidance of others, the better she will feel AND the less likely you are to become entangled in her direct affairs.  Encourage her to speak to her health care provider about the possibility of applying for disability.  Together they can also discuss free or reduced-cost medication programs offered by many drug companies for those on fixed or low income.

     Encourage and support your sister-in-law to keep her doctor's appointments and stay on her treatment.  Support her efforts toward adopting a healthy lifestyle including getting sufficient rest, exercising regularly, eating a balanced diet, working at managing her stress level, and avoiding alcohol or other drugs.  Research has shown that individuals with bipolar disorder who are able to maintain a daily and regular routine are better able to avoid relapses in their disorder.

     Learn to identify symptoms that can trigger relapses (see "Loving Someone With Bipolar Disorder").  Have an action plan in mind when you notice these signs.  Here lies the importance of developing a trusting relationship- your sister-in-law my learn also to respond to your warnings as well as those signs she herself sees and trust your judgment regarding a possible relapse to catch it early.

     Your responsibilities are only what you can handle.  Please understand that these few suggestions are important ones but just the tip of the iceberg as far as what you can offer at your own choosing.  I strongly urge the recommended reading which will also talk about your limitations and boundaries.  Good luck.

David Schafer, M.Ed.
Staff Psychologist

Published July, 2006

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