Groundhog day

[Genki]

I have a 22 year old daughter with Bipolar 1 diagnosed 3 years ago after a psychotic manic episode landed her in hospital. Since then she has been hospitalised every six months, a different scenario each time, but mostly related to poor compliance with medication and complete lack of insight. She hasn't been able to work or study as she is either recovering from an episode or moving into the next episode. We've mainly been in the public system due to the severity of her episodes and recently got her well enough to go into a private hospital. She managed within three weeks to get two other patients kicked out and then herself kicked out. Only outcome was a new medication that doesn't cause weight gain and a new psychiatrist that she seems to like. Apart from minor glimpses of wellness when she is adorable, she is a nightmare to live with. She can sit and do nothing but pick her split ends for days, she is irritable and angry and sometimes aggressive and suicidal and generally she has poor sleep patterns so bangs around the house when we are all trying to sleep. To top off three years of this merry go round this Christmas Day she became psychotic and tried to jump out of my car on a freeway (to save her soul her dream told her). The only thing that saved her was my foresight to lock the car doors, I then pulled off the freeway and headed to the nearest police station to get help while we called an ambulance. My 13 year old son was in the car and this is not the first time he has had to witness such a distressing scene.

I don't want my daughter living at home with my son, she had been living with relatives who are fed up and have felt threatened by her when she's irritable and aggressive. But I know if she has nowhere safe to live things will only get worse. Some people say she needs to fall and pick herself up and I can't be her safety net all the time but would you let your daughter fall if it meant she could accidentally or deliberately kill herself, I can't. It is an impossible situation.

[Kazzl]

Hello Genki, welcome to the forum. I have bipolar 2 but have friends who are bipolar 1 and who, in the past, have been at a similar level of severity to your daughter.

I think your fear of what could happen if she has nowhere safe to live is very well-founded. As for people saying she should be allowed fall and pick herself up, well that just shows a lack of understanding and it implies that we have a choice about being so difficult. At that level of severity, we don't. We don't have control in any way.

Having said that, there's the rest of the family and you to consider - I know a full-on manic person can be almost impossible to live with, and you can't function properly either if you're constantly on suicide watch.

Have you looked into getting a support worker for your daughter, through a local government health service or community-based agency? Some agencies also have group homes, where people with serious mental illness can live, short or long term, with around the clock carers.

You might be able to get a support service through the NDIS because severe mental illness is now covered under the scheme.

You do not have to manage this alone - there are services out there.

Also, if your daughter becomes suicidal or psychotic (which I'd say she was in the car), you can call your local Crisis Assistance and Trauma Team for help. You probably already know of these services, but I wanted to mention them in case you don't.

Another suggestion is that if things get impossible and you don't know what to do, call our helpline on 1300 22 4636, or Lifeline on 13 11 14. People often think you only call Lifeline if you're suicidal, that's not the case. Lifeline runs excellent mental health first aid courses and its counsellors should be able to provide you with strategies for managing a situation.

There's no easy solution, and you can't be with her every day, nor prevent her non-compliance with medication (which, as you probably know, is a major contributor to psychosis and suicidality with bipolar).

Try the support services, and also check if there's a carer's group in your area. Sharing with others in a similar situation always help.

Very best wishes to you Genki, and I hope you'll keep talking to us here.

Kaz