I have learned a lot while caring for my sister, who has bipolar disorder. The first thing I learned? There is no guidebook for caregiving. Bipolar disorder affects everyone differently, and each situation has its own obstacles and hiccups. But after dealing with my little sister’s condition for the last six years, I think I’ve pinned down four steps that apply to all struggling caregivers.
1. Start the Conversation
The tough thing about getting help for someone with a mental illness is that it’s virtually impossible to force them into getting the care they need. Most institutions and rehabilitation centers require that the individual check in of their own volition.
Know this going in: more often than not, your loved one isn’t going to like what you’re trying to do. When they’re in mania, they feel great, invincible, creative and brilliant. They’re going to say and do some nasty things. Just remember that your sister, your brother, your husband or wife-they’re in there somewhere. This person flinging insults and acting irrationally is not who they really are.
When things are rough, remember that your goal is to get your loved one well-and if you keep working at it, it will happen. When it was time to approach my sister about her problem, my siblings and I gathered together everyone who loved her, sat her down, and told her that we were concerned about her and wanted her to get help. She reacted furiously, rejecting our suggestions and our pleading. But even though she didn’t get help immediately, starting the conversation kicked things into motion. Eventually, my sister willingly agreed to enter a mental health facility just to get us off her back. But the main point is that she got help.
2. Find the Best Treatment
Even while your loved one refuses treatment, you should be researching facilities, because it may take a while to find the right place. More often than not, bipolar disorder comes with some sort of addiction, because drinking or using drugs is usually the only thing that quiets a bipolar mind. But this self-medication isn’t enough, and it can harm the person further. It’s important that a bipolar patient with an addiction problem undergo treatment for both their bipolar and their addiction through a dual diagnosis program. The problem is that there are very few facilities in the U.S. that treat both issues. Often, someone will enter a treatment program for their addiction, but they won’t be treated for their mental condition, so the underlying problem is never solved. My sister became a patient at Skyland Trail, a nonprofit mental health treatment organization that offers this dual diagnosis program.
When researching, I sought out leaders in the mental health space-writers, bloggers, speakers and doctors-and asked them for suggestions for next steps. Do your research, so that when your loved one finally consents to treatment, he or she will be in the right place.
3. Put a Support Team Together
The support team was the most important aspect of this process. As a caregiver, you’re likely to burn out in general — and the months and years of begging your loved one to get help will wear you down. Having the support team of my little sister’s family and friends was so important. It made convincing her to get treatment a little easier. We had conference calls where we’d plan our talking points, assign certain comments to certain people, arrange how we would approach topics and who would approach what-we decided who would take the lead on the conversation and who would back that person up. It was important also to understand the different roles we all played in her life. While my older sister and I structured the support team’s mission, we downplayed my role because we knew my little sister reacted strongly to my involvement in her life.
Part of our support team was also the local police. My sister had been living so recklessly that we got to know the police in her community, and they knew to call us if anything happened. One night, we learned my sister was back in town, and we alerted the police. They picked her up immediately. She’d wrecked her car, proving she was a danger to others, which was the only reason we were finally able to check her into an institution. She was furious, as we knew she would be. The only way she agreed to go to Skyland Trail was to get out of that first institution.
4. Don’t Give Up
Because we were planning how to help my little sister, my older sister and I talked often. One time, we felt so helpless that she just said, “Maybe we need to let go!” But I knew that couldn’t happen. I couldn’t let something happen to my little sister without doing all we could to make sure she was well. When I was exasperated and exhausted, the support team helped me through. It wasn’t just one person taking on this burden, it was many. Eventually, my sister entered Skyland Trail, and she’s so much healthier now. She’s my beautiful, brilliant, extremely funny sister again.
Of course, I know all this in hindsight. The process of getting my little sister help was a time of confusion. If I could go back and do it again, I wouldn’t have taken things so personally — I know my sister wasn’t herself. If I hadn’t tried so hard to not hurt her feelings, I think the process would have moved quicker, and she would have gotten healthy sooner. But now that she’s my sister again, I’m focused on the here and now.
Diana is the CEO and editor-in-chief of ShareWIK Media Group, a health and wellness content production company. She lives in Atlanta with her husband, her four sons, and her sister.