How to interact with someone having an untreated manic bipolar episode?
March 18, 2021 10:00 AM   Subscribe

My sister is breaking up with her boyfriend this weekend and moving her stuff out of his house on the same day due to her boyfriend's month+ long manic bipolar episode which he refuses to acknowledge as an ongoing health emergency. I'm going to help her move her stuff out in one swift event. But he's scary at the moment, and I am anxious about how this will play out. Details below.

My sister's decade-long boyfriend is having his second bipolar manic episode of the past year/all time, he refuses to commit himself to an inpatient care setting and is also not taking medical advice from his psychiatrist, who apparently thinks it's cool to ramble about the Bible, being the messiah, etc and this doctor won't give him an official diagnosis. His dad and brother both have bipolar disorder as well although of varying flavors- his seems to be the REALLY manic sort. He's essentially been not sleeping for a month. He talks about interpreting the Bible, called my sister a "triple goddess", thinks he can solve the world's problems by talking to God, etc. Frankly, he is in a really bad place but seems to be taking this event as a feature, not a bug, and is refusing treatment.

I've never liked him for my sister. He has baselessly accused her of cheating on him many, many times, claims he is watching her when she is out with friends, is obsessed with his ex-wife of 10+ years ago, makes her buy her own Christmas presents on his credit card, and then wrap them up for herself and put "To Sister, From Boyfriend" on the tag instead of actually putting in the effort to be thoughtful, has yelled at her on many occasions, etc. I could go on. Basically, I have tolerated him because she has refused to leave him. He's controlling, demeaning, condescending, and arrogant. But now, she's at her rope's end.

She has been staying with friends for the past month during his most recent episode because it's literally intolerable for her to listen to his nonstop rambling. She decided since he refuses to seek treatment that it's time to put the kibosh on their relationship. She hasn't formally ended this relationship yet and he keeps alternating between begging her to come back and telling her to get her crap out of his house and bring back the phone/keys (he pays for the phone in its entirety).

All of the following is being planned discreetly, so he's not tipped off:
I'm renting a U-Haul truck and we are planning to roll up with several friends (MASKED UP) to do the move-out whilst she breaks up with him in person. She opted for this because she is worried that if she breaks up with him before getting her items, he will either change the locks or chuck/destroy her stuff. She does have a friend-couple of theirs coming to act as a buffer.

But I am worried. He hasn't been explicitly violent before (although I consider his emotional abuse and coercion prior to any bipolar episode to be violence), it's likely that he will not take any of this well, especially given that he has been obsessively hating his ex-wife of literally years ago up to the present day. He will be overwhelmed- I mean, he already is overwhelmed- and he's already very frayed due to this ongoing mania. I don't want him or my sister or anyone to get hurt.

We have a plan to let only a few people into the house to pack up stuff at a time, set it outside the front door, and let the remainder of the people move that to the truck for COVID-sensitive purposes.

Is there any other option or thing I am overlooking about this situation? Although I am not his biggest fan, I wish we could get him help but he is an adult and legally there is nothing anyone can do, short his dad getting an emergency court-ordered power of guardianship, but his dad is not close and won't be there. I would rather not call the cops unless ABSOLUTELY necessary, but maybe it would be good to have them on standby? I really don't know, this situation is way beyond me and I'd like this to be as harm-reductive for everyone involved as possible. This is happening in a major east city with a not-great police record for managing difficult situations, although the boyfriend is a white man, which I guess works in his favor. What resources are there available for him during this move-out event (if any, if he'd take the help), and for my sister, during this time? She has no money, but she does have a small job lined up, and a very cheap living situation lined up, and a car. Is there anything she/I/the friend group helping should or shouldn't do whilst this interaction and event occurs? Should I just avoid talking to him and let her handle the talking? (I don't really feel the need to say goodbye or anything.) I don't think he owns any weapons, but motivated people can use many things as weaponry.

Sorry for the broadness/vagueness of this Ask.
posted by anonymous to Human Relations (22 answers total) 7 users marked this as a favorite
 
I'm renting a U-Haul truck and we are planning to roll up with several friends (MASKED UP) to do the move-out whilst she breaks up with him in person. She opted for this because she is worried that if she breaks up with him before getting her items, he will either change the locks or chuck/destroy her stuff. She does have a friend-couple of theirs coming to act as a buffer.

Is it possible for you all to completely move her out before she breaks up with him? It's not clear to me where the boyfriend physically is at. If he's on the property, obviously he'll notice the move and it needs to be dealt with, but if he's somewhere else... move first, break up second. Otherwise if he storms home while you're all there doing a move then you and all your helpers are going to be involved in an altercation as well.
posted by phunniemee at 10:06 AM on March 18, 2021 [28 favorites]


Is it necessary for her to break up with him in person? Can you all just go about moving her out sort of matter-of-factly and then she sends a text or email or something afterwards officially ending it? That seems safer to me.
posted by mcduff at 10:07 AM on March 18, 2021 [21 favorites]


I second both of the above suggestions. Move out first, when he's not there (if possible), then she leaves him a letter or something to do the actual break up. I would not confront him as a group or actually in person at all if that's something that can happen, but also do not leave her alone with him (as I'm sure you've likely already covered).

One thing I would make absolutely sure of is that there's no way he can find out where she's living or working now. Make sure no mail about it will be left at the house, friends/coworkers know not to tell him, etc. She needs to cut him off as fully as possible because this has stalker potential all over it, given his mania and past obsessions with his ex.

In terms of planning for the worst: are any of the friends coming with you physically capable of restraining him, if that needs to happen? Do they know safe restraint techniques? Can you make sure someone is on board to be on standby if this happens?
posted by fight or flight at 10:16 AM on March 18, 2021 [14 favorites]


Yeah, I second the idea of letting him feel in charge of his own space for as long as it takes to "comply with his request" to get all her stuff out of there. Make that the story for the day.

He won't understand that he's being dumped, because that is somebody doing something to him that he's not controlling, and any attempt to make him understand it while he's still unwell carries a strong risk of being interpreted as a challenge and bringing on a disproportionate and ill-considered response.

Move stuff out, get physically away, send breakup text, immediately block all communication channels.

And yes, ideally you'd have somebody there on the day who could safely restrain this guy physically if it came to that.
posted by flabdablet at 10:18 AM on March 18, 2021 [8 favorites]


Coming back to this to add: it might be useful for you and/or friends to make contact with a local mental health charity or helpline if possible. There may be specialised crisis teams who can help plan the intervention and give you de-escalation techniques. Seeing this as an intervention in a crisis as well as a breakup might be useful in terms of finding resources.

One technique I was taught as a mental health first aider is that keeping someone calm and talking can be much more helpful and safer for everyone than trying to control them. I agree with the response suggesting that he be allowed to feel in control of his space. It's also important to make sure that everyone knows not to challenge, laugh at, or question his delusions or things that he talks about -- they will be 100% real to him and if someone pushes back against that, it will escalate the situation.
posted by fight or flight at 10:27 AM on March 18, 2021 [13 favorites]


Hi, psychologist here who works in a hospital setting: really, extremely going to back up the other commenters who recommend making the move first and then telling the soon-to-be-ex. You paint a very detailed and concerning picture of a man in the throes of an active manic episode, who is completely treatment-resistant, lacking insight with elaborate delusional beliefs (some of which appear paranoid in character), a history of anger and relationship conflicts, and what sounds like minimal-to-none in the way of current social supports. This is someone who could be difficult to handle inside a hospital care setting, and so is almost certainly going to be too unpredictable to interact with safely outside of a high-level treatment setting.

If there is any way to avoid interacting with him before/while the move happens, please do that; if not, then try to keep him distracted at a different location while the move happens, without telling him about the break-up. Otherwise, your sister may have to punt on all but the most important belongings (whatever fits in a suitcase/backpack) and hope for the best for everything else (this is often what happens when women are moving out of the home of a violent, unpredictable/abusive partner).

I don't mean to be too alarmist, because this guy may well be so delusional that he doesn't react at all to it, or does so in some very bizarre, unexpected, sideways manner. But given the paranoid flavor you've described with his ex-wife, it seems like a more angry/violent/hostile reaction is also very much in the cards. There's just no way to predict it, for me or you or your sister or any of the friends who've so kindly volunteered to help. As you said, he is already overwhelmed, and in a very bad place, and badly needs help - the process of getting through this breakup will not be without risk for him no matter what, but you can do something to reduce the risk for you, your sister, and the other people helping. Please keep in mind that you're not dealing with someone who is simply hostile, demeaning, or difficult.

To address the harm reduction concern: if the major east coast city you're in happens to be New York, then please reach out to the NYC Mobile Crisis Team and share these details + your concerns with them. They are experienced and trained experts in handling these kinds of situations, and are pointedly not cops. There's no guarantee this guy would end up in treatment even so, but it's probably the best shot he's got, this deep into an episode. If you know the guy's psychiatrist and how to reach them, you can let them know your concerns, although the psychiatrist would not be able to say anything in response to you due to privacy laws; it will, in any case, ultimately be up to the psychiatrist to do what they will with your report (and it may end up being nothing, or he may even end up telling the guy at their next appointment, so just know those are possibilities with this route).

If you do not happen to be in NYC, then try looking up if the city you are in has any kind of mobile crisis response team, or even just any kind of crisis hotline to consult with; the latter may be able to direct you to appropriate resources.

It's commendable that you're able to hold some space for the well-being of this apparently quite difficult man in addition to your sister. This is a really difficult and delicate situation to be in, so the best of luck to you and your sister and everyone chipping in to help.
posted by obliterati at 10:44 AM on March 18, 2021 [40 favorites]


I have a huge amount of sympathy with you, but also with him; bi-polar is truly awful and most sufferers only get help with the support/intervention of others because to the sufferer they're "normal" and the world is weird/wrong/strange. They literally can't understand that they are the problem, especially when in the throes of full-blown mania like he is right now.

That being said, make sure your sister knows:

1. There is nothing she can do to help/cure/save him.
2. None of this is her fault.
3. To not go back to him after this episode recedes, no matter what.

He needs serious medical help but, whilst I hope he gets it, that's not something your sister is or can be responsible for. Seconding the calls to alert a crisis team if you can - his situation is what they exist to deal with.
posted by underclocked at 11:04 AM on March 18, 2021 [3 favorites]


The resource Don't Call the Police is helpful and covers most major U.S. cities.

One thing I'll add is that if your sister's boyfriend is inclined to hurt someone, that someone may be himself. This is one of the harder situations to extract yourself from romantically. It's easier to see violence aimed at you as a reason to leave, but it may really pull on your sister's values as a human to see or hear about boyfriend attempting to hurt or hurting himself, and then to continue leaving or not return to help him.

What someone did for me (so helpfully) was to name this as a possibility in advance and get my agreement, at a time when I was calm and not in the middle of interactions with my partner, to not go back to him but to have some resources on hand that I could call on his behalf. Good luck to her.
posted by cocoagirl at 11:27 AM on March 18, 2021 [5 favorites]


Another vote for move out while he's not home (if possible), and then break up later either over email/text or in a very public place.

I'd also prioritize beforehand - what is the stuff that your sister absolutely wants to get back? Grab anything of material or sentimental value first. Because ultimately most stuff is just stuff, and not worth what appears to be a really serious physical/emotional risk. Good luck.
posted by coffeecat at 11:30 AM on March 18, 2021 [4 favorites]


Mod note: From the OP:
Hi all, thank you for your responses. Reading some of the answers, especially from obliterati, has me even more stressed, overwhelmed, and alarmed, because I agree that this man is a huge risk to other people at the moment. I have never really gotten a sense that he would do anything to hurt himself, but I do get the sense that he has some emotional blackmail tricks up his sleeve where he says he will harm himself if my sister attempts to leave, and then not act on it. That would be a calculated move, and I am not totally sure how lucid he is at the moment, or how intentional he can be. However, the situation is growing more terrifying by the minute as my sister SPONTANEOUSLY decided this morning to drive to his home (my sister has no legal rights over it), to pack up her stuff in advance, and break up with him TODAY. She is so motivated to "do the right thing" that it is absolutely blindsiding her to taking her personal safety seriously; I also think it's somewhat paradoxical that she is trying to be respectful even now when he has never treated her with respect.
I am still planning to go there this weekend, I have work and school so I can't really not do those things until the planned extraction date.
I found the alternatives to the police site very handy, thank you for that.
There will be mutual friends there who will act as a buffer on move-out day.
I have been calling my sister this afternoon after our conversation this morning to check in on her and I am not able to reach her, although the phone is ringing. I spoke with her best friend a bit ago and she hasn't been able to contact her either.
I am going to call the police to do a wellness check shortly if I don't hear anything.

I am miffed that she decided to go break up and start packing up today, alone, with this psychotic man, and I am absolutely heartbroken at the moment about this whole situation.

Recommendations and advice welcome if anyone has further suggestions or thoughts.

Oh and finally- I really don't want anything bad to happen to him, and I wish there was some option for him to seek help/care, but this is not my priority at the moment because I can't save people and I can't wait for the door to hit him on the way out; people who abuse don't get a lot of my sympathy.
posted by loup (staff) at 12:09 PM on March 18, 2021


This is not your fault. I know you know this. But if anything bad happens, it is not your fault. You are doing what you can.

Please keep us updated.
posted by Omnomnom at 12:32 PM on March 18, 2021 [11 favorites]


Does she actually need her stuff? Just take the minimum in a big suitcase and go.
posted by St. Peepsburg at 12:42 PM on March 18, 2021 [2 favorites]


I am not ordinarily one for calling the police, especially when mentally ill people are involved, but under the circumstances I would not wait to call the police.
posted by praemunire at 12:48 PM on March 18, 2021 [8 favorites]


Additionally, if you'd like to go the soft route (he obviously probably does have some mental concerns, though it doesn't sound like BP, (sounds like BPD, I am not a doctor), consider lining up a civil attorney to threaten with a letter for an RO (restraining order, which she could easily get at this time).

It is incredibly firm without being formally legally reprimanding. A local modest means worker may do it for free, if you present the situation well and she expresses a sincere need (it sounds as though she does). This is one method of saying, "batshit assholes, stay genuinely and sincerely away," without enacting more litigious redtape.
posted by firstdaffodils at 1:21 PM on March 18, 2021


Is there any possibility that your city has an emergency response team for mental health crises? If so, put that number in your phone and the phones of anyone who would be on site that day (should you pursue the original plan).
posted by sugarbomb at 2:23 PM on March 18, 2021 [1 favorite]


You know your sister and I don't, but I'd be _very_ disturbed at not being able to reach her under these circumstances. Maybe she set the phone aside for some reason or her boyfriend took it and hasn't otherwise been a problem, or she doesn't want to talk to anyone (has anyone texted her "we're really worried about you, pleaese just check in?"), but maybe...not.
posted by LadyOscar at 3:08 PM on March 18, 2021 [2 favorites]


Mod note: From the OP:
Hi everyone, so I went ahead and called the city's PD to file a concern and request a wellness check. My sister's best friend and I are in communication and the best friend drove over to the boyfriend's house to suss out the situation. Just as the bestie arrived, the PD did too, and the PD called me to say, "are you sure this is the correct address? Whoever answered the door says that there is nobody here by the name of your sister and her boyfriend" and I practically screamed, "YES THAT IS THE ADDRESS, WHOEVER ANSWERED IS LYING AND PSYCHOTIC, PLEASE CHECK AGAIN." So the police guy checked again and went into the house, and the best friend called me to give me live updates as she watched this happen. The PD guy me back to say that "nobody was injured" and that my sister was in the house and that the boyfriend "seemed a little weird" but that there's nothing they can do, and left.
A minute later my sister texted me to say, "Hey, I'm packing up my stuff, all good."

So since I was calling my sister nonstop, as was her friend, as was my sister's own dad (diff dad), and none of us were hearing anything, but then I got the text after the cop left, I think that the boyfriend took her phone from her and only gave it back when the cop came. I mean, that alone is a win to me, her having her phone is so important. And knowing she is physically OK right now at least is bringing my stress levels back to manageable.
posted by Eyebrows McGee (staff) at 5:19 PM on March 18, 2021 [12 favorites]


I don't have advice other than make sure that you are taking care of your own nervous system and body in this awful situation, this kind of stress can get in there deep (for your sister especially, with the chronic nature of it.) And I am placing a protective charm on my altar for your sister and for her boyfriend, and sending a wish for their safety.
posted by fairlynearlyready at 11:07 PM on March 18, 2021


The PD guy me back to say that "nobody was injured" and that my sister was in the house and that the boyfriend "seemed a little weird" but that there's nothing they can do, and left. A minute later my sister texted me to say, "Hey, I'm packing up my stuff, all good."

Eyebrows, if you could get the OP to post an update after their next f2f encounter with their sister, those of us who understand that you can't actually know whose fingers sent any given text would rest a lot easier.
posted by flabdablet at 11:46 PM on March 18, 2021 [17 favorites]


Did the police officer actually see your sister with his own eyes or could he have just taken the boyfriend's word that she's ok? Did he speak to her directly? Did he speak to her directly when the boyfriend wasn't also present? Did the best friend who was sitting outside the house see your sister, even if only through a window? Did the language and syntax in the text sound like her?

I'm sorry, I don't mean to alarm you when your stress levels are just getting back to manageable, but your update raised my alarm meter rather than lowering it. Praying your sister is ok and that you've spoken to her (heard her voice, seen her face through facetime) since she's left the house.

If you haven't, I would call in another wellness check and make them aware of the urgency of the situation. And please update us, if you are able.
posted by Nickel at 5:43 AM on March 19, 2021 [13 favorites]


OP, I've been worrying about your sister all day, and, while you may have your hands full at the moment, I hope you are able to make a follow-up comment at some point.
posted by praemunire at 1:48 PM on March 19, 2021 [14 favorites]


Mod note: This is a followup from the asker.]
Final update: thank you everyone for your concern, I understand the concern and wish I could have done more to ease the anxiety. My sister is OK! I spent the night at the manic ex-BF's house with her last night while she packed up so I could be a buffer. I slept with a metal flashlight next to the bed. The ex-BF is absolutely not OK but there is nothing we can do except hope he gets what he needs, from a great distance, sans our intervention. The move was supported by several friends and the ex stayed out of the way.

My sister is in a good rent situation and he does not know the address, nor will he. I helped with a lot of the moving costs so she can save her stimulus check to start her new life. Today was a LOT and I am very very tired, angry, sad, but hopeful for her. If she can develop good boundaries and begin to advocate for what she wants, I think the future is infinitely bright for her. Either way, she's better off. Thank you all for your support.

posted by cortex (staff) at 6:11 PM on March 20, 2021 [36 favorites]


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