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How to deal with extreme anger from a family member who is bipolar?
January 4, 2012 6:31 PM   Subscribe

I need some information about coping with a bipolar family member whose personality/behavior has changed drastically since she began getting treatment. Specifically, she has been going into hurtful rages and tirades (all verbal). I'm her closest family member, and I don't know if she's just really really angry with me about stuff or if her medication/treatment is a factor. This is very long, I'm sorry.

I'm going to try to give as much info as possible, since this is anonymous.

My older sister is in her early 30's and was recently diagnosed with bipolar disorder. We lived together last year, and I noticed really odd behavior on her part for several months. Whenever I checked in with her, she said everything was fine, but there were disappearances and outright lies. She's in a very long-term relationship with a partner who works on the road, so she was able to completely change her behavior when necessary, but was still being odd. At times, she would lash out at me or say cruel things to me or my boyfriend, and sometimes completely ignore hers. Finally one day out of the blue, she tearfully confessed that she had been doing terribly self-destructive things, such as occasional meth use and random promiscuity, and that she was seeking help to stop. I was shattered and stunned. This was completely uncharacteristic of both her and any other family member (as far as I know) and I was totally at sea, but promised I would do what I could to support her. She begged me not to tell her boyfriend or the family until she had worked through the shame and got up the courage to do it on her own. I reluctantly promised on the condition that she stayed in treatment and had a plan for coming clean.

Well, she relapsed, but I still couldn't bring myself to betray her. I covered and lied for her to her partner whom I consider a brother-in-law, called every treatment center in the city to find out how to stop her from killing herself, begged her to come home when I knew she was out using or worse, and checked in on her whenever I had a free moment between my two jobs. It was the most stressful, difficult time of my life, and I still feel like I let her down in some important way.

When she finally came clean to her partner, it was such a relief for everyone, and I was really proud of her. She was soon diagnosed with bipolar disorder, was put under the care of a psychiatrist in addition to her regular therapist, and was looking forward to having medication. The two of them were happy to have an understandable medical explanation for the weird behavior (manic episodes were pinned as the culprit), and were going to work through things together.

I moved out shortly thereafter to attend grad school in another city. We parted on good terms, and I kept in touch with my sister as much as I thought she would welcome. She said she and her boyfriend missed me and had enjoyed having me there. But, I have to admit that I was happy to have a break from the whole thing, and to focus on my own life and relationship for a while. A month or so after I left, she mentioned that her medication dosage (I don't recall the name) was going to be increased. I didn't really think much of it.

A few weeks later she called me terribly upset about a (truly) trivial family matter that I hadn't even heard about from my notorious busy-body mom. She got more and more agitated and insistent to the point where she was repeatedly dictating the inquiring email I should send out, over my objections that I could write it perfectly well on my own. When I pointed out that she hadn't contacted said family member herself she flew into a rage and accused me of being uncaring and thoughtless, hung up on me and refused to answer when I tried to call back. Nothing like this had ever happened between us; we've always been the closest siblings in a big, blended family. I got super depressed after this episode and didn't really talk to anyone in the family for weeks.

Not long after, her boyfriend wrote me a long email detailing all the ways I had pissed them off both before and during the time that I was living with them, going back two years. He accused me of not paying enough for rent and utilities (even though we'd agreed on a fair, market-based amount when I first moved in to their condo and they'd had ample opportunities to renegotiate), not thanking them enough for allowing my boyfriend to stay over for three days to help me pack and move before I left (he wasn't usually allowed to stay the night--in my room-- if they were both there because they felt the place was too small), etc, etc. Even though I was indignant and disagreed with a lot of what he said, I wrote him back and apologized, and asked what I could do to mend the relationship. I also pointed out that my sister's behavior during our last phone call was very strange and overblown for the situation. Neither of them responded.

Tonight, I got another phone call from my sister. This time she brusquely asked me if the return address on the Christmas gift I'd sent them was the address I wanted my mail forwarded to. When I confirmed it was, she started in on another rant about how she was just going to say her piece about me but she wasn't ready to dialogue. I said I would listen. She vented for about 15 minutes, getting louder and louder about all the things I had done that had angered and insulted her and her partner. When I tried to interject at any point after that, she said she had no interest in hearing me try to defend myself, that she had a lot of rage (she emphasized that word) that she had been holding in and that she was going to get it out and that would be it. She accused me of not respecting or appreciating her, and I asked her to please give me examples, but she wouldn't. When I finally asked her why she was screaming at me when I wasn't arguing back at all, she got even louder. I'm not proud of this, but I finally just hung up. I couldn't take it any more: she wasn't letting me speak, she was screaming in my ear and wouldn't explain what I had done that was so terrible to merit no possible defense. All of this was completely out of character--she's usually very quiet, reserved and mild-mannered.

I tried to soothe myself, but between the phone calls and letter from my sister and her boyfriend I'm feeling like a terrible, shitty sister and person, and I've been crying for hours. I had no idea that I had caused my sister to feel so much anger and hate towards me. I admit that maybe I could have done more for her, but I was so overwhelmed with everything, and felt very alone in dealing with it all, though I know that's nothing compared to what she's going through.

My own boyfriend, while admittedly biased, has assured me that they are really unfairly maligning me, based on what he knows and has heard and seen, and thinks something else is going on. Besides the possibility that I might just be a bad sister (confirmed by her boyfriend), I'm worried that something is terribly wrong or that she's back on drugs. The rest of my family now knows that she is bipolar, but they have no idea about the rest of it, and I don't want to reveal that and draw more of her ire. My older brother admitted that last time he talked with her she was in a manic state, and said that although she promised to check in with the rest of the family, she kept repeating that would not call my mom (whom she inexplicably hasn't spoken with in months, despite lots of overtures). We don't have the most functional family, but we try to be there for one another as much as possible. Basically, she's systematically shut everyone out, but her boyfriend seems to think that's okay--he's close enough with all of us to have asked for help if he thought things were out of control.

TFL;DR: Is my sister's bipolar medication causing her to fly into rages/manic states? And is this normal for the initial stages (first few months) of treatment? Or is it possible she's actually no longer on medication, or is on the wrong kind, or is using illegal drugs and therefore is in some kind of danger? Is there anything I can/should do to help her or heal our relationship, or should I just back away the way she seems to want me to? I'm at a complete loss right now.

Thank you for any advice.
posted by anonymous to Human Relations (14 answers total) 3 users marked this as a favorite
 
I don't know about the medication doing this angle, but I've been around unmedicated bipolar-diagnosed people who were abusing drugs and around a lot of mentally ill people in general (worked for a mental health organization for a summer):

She is lashing out at the people she loves. That's it. Her vitriol is just an indicator that you are a close person in her life, and the fact that she knows what buttons to push is just another indicator that you are a close person in her life.

You do not need to listen to it, though. Hanging up when someone is spewing unfounded hate toward you, their loved one, seems like a generous thing to do, actually, since it will allow you to keep your relationship once this blows over. Don't turn into a doormat due to her sickness, because then you might end up resenting her, which is sad for everyone.

I don't understand the boyfriend's piling on, but you did what you could there by apologizing. Sometimes people really close to mental illness grow to have warped ideas on what normal behavior is.

You know what else will be good in the long run for your relationship with your sister? Maintaining your own sanity and doing what you need to to do that. Find a therapist to talk this through.
posted by vegartanipla at 6:48 PM on January 4, 2012 [4 favorites]


Is my sister's bipolar medication causing her to fly into rages/manic states?

It is far more likely that your sister's bipolar illness is causing these episodes. From your own narrative, they are not out of character for her, they are merely escalating. It's also possible that yes, she is off her meds, or using, or self-medicating in another way, or some combination of all of the above. Regardless, your sister is mentally ill and you should not let her tirades make you feel like a shitty person. Her tirades are pretty typical and are not based on any kind of reality the two of you actually share. You should not accept responsiblity for them or for her accusations. If you let her illness knock you down like this every time, you're going to burn out here in very very short order.

Were I you, I would seek out and attend a NAMI Family Support Group (or call them on 1-800-950-NAMI) because you will learn so, so much, feel much better and have a much better strategy and toolset for dealing with and helping your sister.
posted by DarlingBri at 6:50 PM on January 4, 2012 [9 favorites]


It certainly sounds like she is back in a manic state. Or is using drugs to put herself into a manic state. I have no advice, unfortunately, because people that far deep into mania usually can't be reasoned with. You don't have to just take it though. Don't engage in her illusions or delusions, but just respond with kindness and encouragement (to keep up on her treatment). Good luck.
posted by gjc at 6:59 PM on January 4, 2012


My past relationship with an elderly bi-polar family member (now deceased) was never as stressful as yours, but I can share one sad situation to give you an idea of how challenging this is for the family. Because the prescription medicine for depression and bi-polar can require weeks to reach effectiveness (and/or get the dosage right), seeing significant improvement can take quite a while. Then one day I happened to look at just the right moment and saw my relative palm the medication and go through a big show of drinking the water, throwing her head back and swallowing. I asked her to open her hand and sure enough there was the pill. It broke my heart to realize we would have to start all over again and wait even longer to see results, while my relative thought it was no big deal.
posted by forthright at 7:06 PM on January 4, 2012 [1 favorite]


Have you spoken with the boyfriend since that strange email? In this situation I would be considering the possibility that she sent it, not him.
posted by endless_forms at 7:13 PM on January 4, 2012 [10 favorites]


Is there anything I can/should do to help her or heal our relationship, or should I just back away the way she seems to want me to?

What do you want to do for yourself and for your own happiness and stability?
posted by liketitanic at 7:20 PM on January 4, 2012


Seconding NAMI (or Al-Anon, or DBSA) and therapy for you.

I'm bipolar, and I have definitely been on medications that have made me behave strangely, but I tend to agree that this sounds more like the illness itself or illegal drugs. Maybe she's just taking the antidepressants that were meant to be taken in conjunction with something else - though they don't generally give antidepressants to people early on like that, because, well, lots of things can go wrong with them. I've never had a true manic state or any kind of manic rage, and still every new doctor always wants to drop every stimulant and antidepressant I'm on till I prove that I need them to function. Which is one of the many reasons I've had so many terrific depressive episodes I can't clearly remember, what with the sleeping and the despair and all.

Anyway, you have done nothing that warrants her behaving like this - no matter what you did, you didn't deserve it. And it's frankly likely you did the best you could do, given the knowledge you had at the time.

I recommend that you try to limit your contact with your sister and her boyfriend for a while, till you're in a better place emotionally and are prepared to set boundaries and comfortable enforcing them. It takes a really long time to get that kind of stuff straightened out in your head - I'm working on assertiveness/acceptance/mindfulness stuff and have been for years - and it's important not set yourself up for failure, or expect too much of yourself too soon.

And yeah, living with mental illness can really screw up your sense of what things should be like. Definitely take care of yourself for right now, and put your sister's issues on the back burner.

Oh, and you can never "fix" her. I kind of get the "want to fix this person" vibe from your post, but you don't have that job and are totally and permanently disqualified from having it. This is not the same thing as having a relationship which meets your needs and maybe helps her - that's probably possible once you're secure and confident and such. It's likely, by the way, that your level of satisfaction and her level of being helped will a) never meet your ideal expectations, and b) wax and wane at seemingly random times.

Don't feel guilty for any of this. It's totally not your fault she's sick or that you're not sure how to handle it. There's a reason NAMI has classes and there are support groups and stuff.

But as a general rule do not go out of your way to hide someone's illegal drug use from others. It doesn't actually help anyone at all when you do this, and it is not a betrayal to refuse to keep that kind of a secret. Also, your sister's partner deserved to know that she was exposing him, potentially, to some serious illnesses. You didn't have a blanket, absolute obligation to tell him, but lying for her was a bad choice IMO.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 7:40 PM on January 4, 2012 [6 favorites]


Could be her meds aren't adjusted right, or she's stopped taking them.
Could be her boyfriends dumping on you because he enables her.

However your comment about prior occasional meth use stands out like a sore thumb, especially when they both seem to be not functioning as normal in your relationship.

Hope I'm wrong and totally off base.
Good luck.
posted by BlueHorse at 8:12 PM on January 4, 2012 [1 favorite]


I have three bi-polar family members (one an in-law), another that very likely is and won't get diagnosed, and a friend who is bi-polar. I can tell you from experience that this sort of thing is pretty usual when someone goes off their meds or starts using drugs. It is super shitty and you have my utmost sympathy, and I very much doubt you deserve any of the nastiness you've had to endure. Unfortunately, sometimes odd thoughts persist past a manic episode; two of my family members got entirely outwardly better, then when someone brought up some very illogical thoughts they had expressed (not about emotional issues, but conspiracy type thoughts that required believing two contradictory things at once) they were surprised to think about those things again, insisted that they still made sense in some way, but seemed alarmed that they could not articulate how that could be possible. It seemed they both had vivid memories of those things making sense and it was jarring for them to confront how something could seem 100% true to them and yet not be. I bring this up because even if your sister gets better and would have never thought these things when she was well, it's possible she may still feel how she does now even if she gets better; do your best to prepare for that. Especially since she has seemed to tie her reasoning to stuff that isn't as easy to prove illogical, self-contradictory stuff.

My immediate thought, too, about the boyfriend's e-mail was that he didn't write it. If he did, it seems like your sister is ranting and he either believes you are causing her stress, or else easily buys into any line of argument that lets him feel he's been unforgiveably wronged in some way.

It sounds like you tried to do right by everyone involved and have tried to be fair and consider whether you have done anything wrong. However, sometimes people really do just unfairly blame other people when they are not at fault in any way. Unless you left out major details it sounds like they're being very unfair to you. Do not let this make you feel bad about yourself.
posted by Nattie at 10:21 PM on January 4, 2012


Yeah, my mom is bipolar and this is kind of classic bipolar behavior. She loves me with every fiber of her being but she's said some unbelievably mean shit when she's manic. Try (as much as you can --god knows it's difficult) not to let this stuff get to you. The more important thing is it sounds like her treatment isn't working either because they haven't gotten the dosage right yet or because she isn't taking the medication
posted by bananafish at 11:21 PM on January 4, 2012


It sounds like you are still responding to your sister as though she were behaving predictably and reasonably -- like, you are hurt by her criticisms, and trying to make sense of them. I don't think you're seeing the situation very clearly yet, if you are still expecting her to make sense and behave the way she always has.

I don't have any experience with people with bipolar disorder, but I do have experience with people newly diagnosed with dementia, schizophrenia and meth addiction, and your story is ringing all kinds of bells for me. You need to understand that, for now at least, your sister as you know her is gone. She is a different kind of person, at least right now.

She is lashing out at the people she loves. That's it. Her vitriol is just an indicator that you are a close person in her life, and the fact that she knows what buttons to push is just another indicator that you are a close person in her life.

Vegartanipla is absolutely correct. When people are unable to behave rationally, when their perception of the world is out of whack, when they feel betrayed by themselves in really profound ways, they attack the people they love the most. Maybe it's because it's safe. Maybe it's because either their own senses are betraying them or the people they love the most are, and they can't bear to accept the former. Who knows why. But it's definitely a pattern.

You need to let go of the idea that your sister is behaving rationally. Unfortunately that means you need to park some of the respect and warmth you've always had for her, and view her with more distance. For example, maybe ten years ago you might have lied for her without thinking about it much, because she'd have never needed it without good reason. Don't automatically do that now. Keep your distance, take care of yourself, and do some reading to learn how to effectively support someone with a mental illness and a possible addiction. Your instincts aren't going to be correct: you need expert advice.

(And I am sorry but I also wonder if they are both using meth now. Or, like endless_forms said, maybe she sent that mail herself.)

Good luck.
posted by Susan PG at 1:19 AM on January 5, 2012 [5 favorites]


My take on the boyfriend's email is that your sister might have dictated it to him, the way she tried to dictate an email to you. He might have gone along with it to appease her - if she's lashing out at you, you can bet she's lashed out a lot at him too.

I don't really have anything else to add. Good luck staying grounded and supporting your sister, as you are able to.
posted by subdee at 11:01 AM on January 5, 2012 [1 favorite]


this sounds to me like she is either in a manic or mixed state (my mania is rage/sex, not happyfuntimes). this could be just a thing she's going through, or it could be caused by the meds - but more likely by the meth. even if she's *not* using anymore, her brain could still be scrambled.

she needs more intensive help than she's getting, and she may not be in a position to get that for herself.
posted by unlucky.lisp at 9:39 PM on January 5, 2012


Just adding that I have been in your shoes, especially the vitriol where she rages and you are not "permitted" to respond. When you have contact and she begins a rage calmly say "I will not let you speak to me this way, goodbye.". And hang up. You can't have a normal relationship now because she is not normal. But you can enforce boundaries so that when she is med-compliant you can rebuild a relationship together.

If you get an email from her or the boyfriend ask you own boyfriend ( or someone else you trust) to read it and rely any important information to you. Please get help for yourself, what she did to you is wrong and you did not deserve it. Please talk to your other family members as well. That your sister is ill and addicted is not a shameful secret and you need to strengthen your family network for everyone's benefit.
posted by saucysault at 5:35 AM on January 8, 2012


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