Tuesday, August 9, 2011

Dealing with the Bipolar Rage of a Loved One

I spent most of today composing this post in my head, then mentally erasing it as I decided that I would not post something so personal. I finally decided that if I am going to be completely honest about how bipolar disorder (and S's other disability) affects me, I have to post the hard times as well as the easy or clinical.

S deals with Type I Rapid-Cycling Bipolar Disorder. This means that, unmedicated, his moods shift rapidly from manic to depressed and back multiple times through out a day.

My stepdaughter also suffers with bipolar disorder. We are unsure of the severity of her condition, because she refuses to work with any psychiatrist or psychologist. She was diagnosed when she was placed in therapy through a court order.

One of the most disturbing parts of unmedicated bipolar disorder is the uncontrolled rage. It is for bipolar individuals to become enraged over the most seemingly insignificant things. When they are in a rage, they cannot control their actions. S and others whom I have talked to say that they feel sort of "outside" themselves. They know their actions are wrong and harmful, but they cannot stop until the rage is over.

My stepdaughter, who is 22 weeks pregnant, had one of these rages last night. She threw herself on her stomach on the floor ("exactly like a four year old," she says), punched her boyfriend repeatedly, completely destroyed her phone (arguably her most prized possession) and threatened her boyfriend with a knife. I have been through many of her rages, some of them targeted at me, it is quite frightening.

However, that is not the most disconcerting part of the episodes. What is truly unnerving is the way she can flip from complete rage to laughing and joking like nothing ever happened in the blink of an eye. This switch is why she is never admitted to a psychiatric hospital, no matter how hard we try.

By the time her grandmother got to her last night, the rage was over. My stepdaughter downplayed the entire episode, even though my mother-in-law heard most of it on the phone. She did agree to seek psychiatric help, so we drove her to the hospital, which is an hour away. (In our area all hospitals are at least an hour away.) By the time we made it to the hospital, her story had changed to "she had fallen, and needed the baby to be checked out." We confronted her, and she admitted to the real story, but did not see the need for an inpatient stay.

Because she was so calm and under control, the mental health worker did not see a need to admit her either. She denied any intention of harming anyone and there were no accessible medical records supporting her bipolar disorder. I do understand how he came to his decision.

Unfortunately, a normal person's moods and feelings do not switch that fast. Even though I understand what happened intellectually, emotionally I am still mad as hell and scared for her boyfriend, her unborn child and her.

The rages are increasing in severity, which is also a sign that her bipolar disorder is increasing in severity. I fear what she will do.

I have known one bipolar individual who had a standoff with the police, complete with guns. I know S has done some incredibly stupid things in a fit of rage. Both S and I have gotten hurt trying to subdue our daughter during one of her rages. She has destroyed property, broken down doors and kicked her four year old brother.

Right now, the only thing S and I can do is to refuse to allow her into our home and around our younger children.

This is one of the hardest decisions we have ever made.

It is hard to tell one of your children that she can no longer have contact with you. I truly hope you never have to experience this. But, we have to protect our own sanity, and we have the safety and innocence of our younger children to think about. In this instance we truly have to sacrifice one to save many. Knowing this does not keep me from crying for and worrying about her and her unborn child.

Please understand, before you judge me, this is not a unique instance. This has been going on for the five years that I have been in her life and even longer. Her mother,father and brother have been dealing with this all of her life. At some point, you have to say "STOP!" She is 18 years old, living on her own and responsible for her own life. Everyone needs a break from it. And, if she is not going to get help, she must deal with the consequences on her own. We cannot force her to do anything. Nor, can we stop this. We must now think of our other children and ourselves.

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