how to help mentally ill brother, his wife who is sick of it
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Anonymous
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I learned last summer that my late 30s brother had apparently been diagnosed as bipolar roughly two years ago, started taking meds for it and while working a high-profile financial job started having panic attacks after the birth of his first kid a year ago. He ultimately lost his job last September and has been getting disability payouts from former employer. His wife, meanwhile, is trying to make it as a screenwriter and got her first big break in January to write for a network show that put her on unpaid leave two weeks ago with no clear idea of if/when she'll find employment again.
They live 3 blocks from the Pacific Ocean in a very tony part of Orange County. They rent. They can't afford it. They still have their child in part-time daycare. My brother had been taking care of their son roughly 20 hours a week while SIL worked, wrote etc. Now they have no income. Brother has apparently become quite dysfunctional, not getting out of bed, panic attacks over slight setbacks like fussy kid at Easter Sunday church etc. He refuses to apply for work, saying he can't mentally handle it -- his psychiatrist has told him he needs to start PT work bare minimum to help get through the rut. SIL has usually worked, but lower-paying jobs for most part which my brother had told her was fine so she could focus on her writing. SIL kicks him out two weeks ago, calls me to tell me that -- I primarily listen. He goes back, I don't hear from either of them for 48 hours and hope all is improving -- instead, SIL calls me sobbing to say she thinks he has addiction issues but doesn't have firm proof, just has caught him in financial lies etc. Brother says no, instead he's been staying in a hotel for 2 nights while his MIL was in town because didn't feel comfortable being around them amid this stress. He goes back home. another week passes, psychiatrist allegedly trying to get brother into mental health outpatient program but those aren't easy to access or something. Brother sends me nonstop messages throughout work day yesterday lamenting how they are bleeding money. I tell him that if nobody is working they need to take their child out of daycare. Nonono, that just isn't an option because what if he gets into a treatment program and SIL needs time to write, then who will take care of kid? I tell them to find cheaper place to live -- no because they can't afford the $6k fee to break their lease. Inevitably, brother contacts my Dad, saying he needs emotional support. My dad (correctly I think) reads email as seeking handout -- he gave them $50k two years ago to get out of massive credit card debt (which makes me nauseous) and also an old car. My dad responds that they're two adults in 30s with a kid to support and advanced degrees, so time to get some sort of job and cut expenses, or worst case scenario put stuff in storage and move in with family for a bit. He ccs SIL on email and my brother flips out, calls it invasion of privacy, why he can't trust my parents. Long story short, I have no idea how to help -- I live in DC area with two young kids and a demanding job of my own. I have spent 7 months using kid gloves with my brother, but yesterday hearing him complain about my parents I couldn't take it anymore -- told him off, time to figure life out and stop blaming everyone else. What should I be doing to help in this situation? I am not sleeping, it is affecting my own job performance and ability to focus on my own kids/husband. I have reached out to psychiatrist and established line of communication with the guy, who seems genuinely interested in helping my brother. Dr also thinks my brother may not even be bipolar, which obviously creates a huge issue since if that's the case he's been improperly medicated for 2 years -- at direction of his wife who insists he takes his meds, blew me off last summer when I said i have never seen my brother in worse shape than since starting meds. Bro also feels like SIL has taken advantage of him for years, pushing him to work stressful jobs, long commutes that resulted in him having panic attacks, getting in 2 car accidents during a 2 hour-each way commute to prior job so they could live near SIL's mom, developing stomach ulcers and twice getting pneumonia, while she worked assistant-type gigs, spent time on the beach and worked on her writing. I told him those are decisions he and wife made together, and should resolve in marital therapy, not with me. I want to help, but also not at the expense of my own family, job or health. |
Anonymous
| Wow. That's a lot. No words of wisdom here, but just sympathy, OP. It seems like there's a lot to untangle. |
Anonymous
| I'm so sorry, OP. They are adults and they do not need to put any of this on you. You do not need to be giving them money, either - they need to a) take their child out of daycare, and b) get whatever jobs they can to make ends meet. Both of them. Immediately. They are parents first and foremost, they cannot afford to be "starving artists". Giving them money will just enable their bad decision-making. |
Anonymous
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You can't help people who don't want to be helped.
But any financial help you offer needs to come with heavy strings. Personally, I'd make one offer. I'll pay for them to break their lease and move to a more affordable home. BUT this means I get a say in where they move and get to look over their finances to help them make a budget for their new reality. I'd want to manage their life in the short term essentially. If they can't manage it, I will, but I'm not just giving hand outs. If they don't like that deal, fine. But that's my only offer. |
Anonymous
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OP, I have a sibling with a whole host of psychiatric disorders. Your instinct to focus on your family, etc., is a good one, and you'll need to hold fast to it.
You need some support, whether it's from a NAMI support group, therapy, etc. Don't respond to messages from your brother unless it's convenient and they're appropriate. You can come up with a list of local resources for him, but he and his wife need to sort things out on their own. So, provide the name of the psychiatrist with whom you've been in contact, and back off. In some ways, it's easier that he's so far away; my sibling is local and the boundary intrusions can be out of control sometimes. This stuff is exhausting and draining. Hold those boundaries. |
Anonymous
| Such a sad situation. I'm not sure that you can do very much except to listen. I wouldn't offer suggestions except to research programs that may be able to assist them. Sorry to hear that you are dealing with this! |
Anonymous
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You have no idea what's really going on, other than that your brother obviously has some kind of mental issue (even if he was misdiagnosed) and the family is financially strapped and apparently refuses to do anything to mitigate it. You should not get involved in their marital issues. Maybe his wife did push him, maybe he's rewriting the past now to blame her. (I can't blame her for insisting he take his meds--she's not a professional, and if he was diagnosed, then it's entirely reasonable to insist that he comply with treatment. He should have addressed any problems with the meds with his doctor, not gone off of them on his own, which can cause problems.)
I don't think there is anything you can do to help. He has a doctor, which is good. You should encourage him to talk to that person. And don't give them any money. They need to make some hard choices, but if they had $50K of credit card debt a few years ago and are still living beyond their means, anything you give them will vanish into the black hole. Suggest a financial planner--again, this is for the professionals to handle, not you from 3,000 miles away. You can express love and sympathy, but you are not equipped to do anything else. Also: Your brother's doctor should not be telling you details of his care or diagnosis, however. You can reach out to him to provide information, but he shouldn't be sharing that with you. |
Anonymous
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thanks so much all. we are not in a place ourselves to financially help and I wouldn't feel comfortable doing so even if we were so cannot assist in that manner.
was wondering though if I should fly across country and try to talk sense into him, get him into some sort of treatment center. not even sure that I could do that. Bro is still taking medication, there are just apparently dr questions about whether it is accurate so they are slowly adjusting since can't quit cold turkey. bro gave dr permission to speak to me about his health issues as he tries to establish family history, long-term perspective on brother's behavior since childhood etc. |
Anonymous
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+1 to all the PPs. I’d establish if he has bipolar before going through an outpatient program. I believe they can use MRI or ultrasound to look at the brain and determine if that is the case. I would want that objective diagnosis.
As a side note-you mentioned that he started having panic attacks around the time his child was born-how old is this child now? Anyway, I do know of both woman and a man (not same couple) whose childs’ births triggered the onset of bipolar disorder and also postpartum psychosis. The PPP never resolved (it normally does, but the people I’ve known have never truly fully recovered) and the BPD escalated over time, compounded by other issues (job loss turned into alcoholism). I hope that is not the case for you but consider them. The stress of job loss would also make it worse. |
Skyeblue
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MD here, Bipolar disorder is a clinical diagnosis, meaning it is diagnosed by symptoms and behavior, not by imaging. It also, in my experience, can be something of a "bucket" diagnosis, meaning if it's at all unclear what the issue is, BPD sometimes is used as the diagnosis code and sometimes sticks.
What matters more than the label however, is how he is doing. And it sounds bad. If the meds aren't helping something needs to change. That may be his provider, his treatment, etc. Know that you are likely not getting the whole story and that SIL's concern about addiction issues may have merit; addiction and mental illness are often coexistent. Hard to say what to do here. They're geographically far, they both seem in financial denial, and there's a kid involved. To the extent that you can reach your brother I'd work on helping him make a practical plan (diagnosis/med reassessment, 12 mo budget that involves moving or not, etc.). I would not bail him out financially. SIL may need to move in with her mom (who is nearby?) with kid for a while and let them both take a breath. Who knows if their initial arrangement was that he'd earn and she'd spend, but that plan clearly soured. They both need to contribute to their financial solvency, or call the marriage quits. Good luck OP. |
Anonymous
| OP: Could you volunteer to have the kid stay with you temporarily if your brother gets into a treatment program? That way, they can pull him out of daycare w/o worrying about what will happen if...? That worry may just be an excuse your brother is using (in which case, you would find that out) or it may be a real worry (or just something he is needlessly anxious about) where having a backup plan in place would allow him to make the change/make him feel better? They clearly need to cut expenses and this may be one concrete way you could help, but only IF/WHEN your brother actually went into treatment? |
Anonymous
| I didn’t read all the other comments but just wanted to day I’m sorry you’re going through this. I’m glad you told your brother off. Using kid gloves is going to just keep the cycle going. I don’t know that you can do much from afar, or that you should. They are adults and need to figure it out, however that looks. Be there for him and listen, but draw boundaries to protect yourself and your family (not giving money, they can’t live with you). It sounds like he’s intelligent and working at least part time can help him get back on track. I sincerely hope they figure it out. It sounds like SIL has pushed him to the edge and he’s given too much of himself to keep her happy. Hopefully they can find a balance where they are both happy, together or not. |
Anonymous
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Time for them BOTH to man/woman up, get boring stable jobs and move somewhere affordable. Either somewhere cheaper in CA or somewhere different altogether. They are not 25 and childless anymore. They gave “the Dream” a shot, now time to get real. Most people come to the realization at some point they are not going to be famous athlete/musician/hedge fund manager whatever.
Maybe your parents would agree to loan them the $6k to break the lease IF they present a suitable alternative. |
Anonymous
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It sounds like depression rather than bipolar disorder. But not necessarily from a medical cause , just from a crappy marriage and stressful life.
I’d get him into a good psychologist, not psychiatrist, get him to describe honestly his feelings about his wife and marriage and see what they say. She sounds awful so maybe divorce is the best option. I wouldn’t let your parents give them any more money til after the split in that case. He may feel a lot better after that even without any medication. |
Anonymous
I think you're over-reading the OP, which I'm sure was naturally more pro-brother if anything. SIL seems to genuinely believe brother is having addiction issues, which from the description he absolutely could be. I'm not saying it isn't time for her to pony up and get a real job, but she actually did get a break recently (so it's not like this is a total pie-in-the-sky fantasy) and she seems to be trying to support brother through real issues. Think about the OP that could have been posted from her side of the family about her good-for-nothing husband who became a man baby as soon as his kid was born. That would be 100% unfair, but reading this all as SIL's fault seems a bit crazy too. (This is not a dig at OP, who seemed to give SIL a fair shake.) |