I would fly to CA. Ask your brother to schedule an appointment with the doctor so the 3 of you can sit down and talk face to face. Ask to speak with the doctor alone too, if necessary. Forget about his family issues, his mental health should be the focus.

Has the SIL even been covering child-care costs with her jobs?

OP, seconding the PPs who said you need to establish healthy and safe boundaries and stick to them. This situation is not going to resolve itself over night, so you need to preserve your energy for when it is absolutely necessary.

Also, do you have support for YOU?

Anonymous wrote:

Anonymous wrote:

Skyeblue wrote: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.

BPD is borderline personality disorder. Not sure what physician is trying to say here.

Mom of a seriously mentally child. Protect your family. Don’t fly across country - your
Brother won’t be in a position to accept or act on anything you say or together decide. And his wife is part of the problem which you can’t fix.

I’m sorry. But you can’t fix it. And likely you can’t make it better in except for periodic short term bailouts which would keep them from homelessness and you aren’t in a position to do this.

And get yourself some good support. This could get far worse before it gets better.

BPD is an abbreviation that is used to refer to both bipolar d/o and borderline personality; that's why I wrote out the words in the first sentence.

Not wanting to engage in a debate or negate your advice. But BPD is not used as an abbreviation for bipolar. It is definitely the abbreviation for borderline personality disorder.

So SIL, not SOB!!

1) diagnose will always be fluid; just know he has issues but only he can truly help himself

2) addiction is rife in finance, sob SIL may be right

3) boundaries. you can’t save him or his family. Protect your own. No money. Maintain calm neutral voice in conversation, give no advice and no promises.

OP it sounds like you are actually seeing things clearly and holding good boundaries to me. It just feels REALLY bad to you. I would recommend you go to a therapist for a few appointments. I really think that would help you organize and compartmentalize the stress of this on you. Just 4-6 appts would make a HUGE difference.

Anonymous wrote:

Anonymous wrote:I've been in your SIL's shoes.

Aside from everything else, taking the kid out of child care in this situation is a really dicey proposition. A., the kid needs some place to be that is not filled with the drama in his home life. B. whichever adult gets a job--and especially if it's your SIL--she is going to need a solid child care provider to buttress her while your brother is going through whatever he's going through.

Stop trying to talk her into giving up the child care right now. That's not helpful.

It is VERY difficult to access intensive outpatient treatment, by the way. I don't think that is your problem to manage, but that is not bullshit.

Second everyone else on NAMI and/or Al-Anon.

Should the daycare provider work for free? OP says they have no money.

That’s between them and the day care provider. If she dislikes what they offer, she’ll quit or kick them out of the center. Not OP’s problem. Also not your problem.

Anonymous wrote:

Skyeblue wrote: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.

BPD is borderline personality disorder. Not sure what physician is trying to say here.

Mom of a seriously mentally child. Protect your family. Don’t fly across country - your
Brother won’t be in a position to accept or act on anything you say or together decide. And his wife is part of the problem which you can’t fix.

I’m sorry. But you can’t fix it. And likely you can’t make it better in except for periodic short term bailouts which would keep them from homelessness and you aren’t in a position to do this.

And get yourself some good support. This could get far worse before it gets better.

BPD is an abbreviation that is used to refer to both bipolar d/o and borderline personality; that's why I wrote out the words in the first sentence.

Skyeblue wrote: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.

BPD is borderline personality disorder. Not sure what physician is trying to say here.

Mom of a seriously mentally child. Protect your family. Don’t fly across country - your
Brother won’t be in a position to accept or act on anything you say or together decide. And his wife is part of the problem which you can’t fix.

I’m sorry. But you can’t fix it. And likely you can’t make it better in except for periodic short term bailouts which would keep them from homelessness and you aren’t in a position to do this.

And get yourself some good support. This could get far worse before it gets better.

my guess is they have probably already racked up more credit card debt after your dad paid of $50K worth and that's how daycare is getting paid. So many selfish users who expect everyone to bail them out always. and I'm also sick of how everyone in wealthy American society has the luxury of claiming a diagnosis of some sort. It's absurd.

Anonymous wrote:I've been in your SIL's shoes.

Aside from everything else, taking the kid out of child care in this situation is a really dicey proposition. A., the kid needs some place to be that is not filled with the drama in his home life. B. whichever adult gets a job--and especially if it's your SIL--she is going to need a solid child care provider to buttress her while your brother is going through whatever he's going through.

Stop trying to talk her into giving up the child care right now. That's not helpful.

It is VERY difficult to access intensive outpatient treatment, by the way. I don't think that is your problem to manage, but that is not bullshit.

Second everyone else on NAMI and/or Al-Anon.

Should the daycare provider work for free? OP says they have no money.

Anonymous wrote:I've been in your SIL's shoes.

Aside from everything else, taking the kid out of child care in this situation is a really dicey proposition. A., the kid needs some place to be that is not filled with the drama in his home life. B. whichever adult gets a job--and especially if it's your SIL--she is going to need a solid child care provider to buttress her while your brother is going through whatever he's going through.

Stop trying to talk her into giving up the child care right now. That's not helpful.

It is VERY difficult to access intensive outpatient treatment, by the way. I don't think that is your problem to manage, but that is not bullshit.

Second everyone else on NAMI and/or Al-Anon.

+1

I also don't think that flying out to talk to your brother will help. He's under the care of a psychiatrist, it's not like you need to light a fire under his butt to get him to see someone.

Anonymous wrote: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.

This. ESPECIALLY the bolded sections.

I have similar challenges in my family and I've been in therapy, which has been tremendously helpful for me in learning what healthy adult relationships could and should be, versus what I experienced growing up and therefore continue to subject myself to now. In case it's helpful, here are a few things that are touchstones for me:

- My first, most important priority is my own nuclear family. Setting boundaries around what I want my kids to experience and expect is much easier than setting boundaries for myself but I'm helped in the process.
- I cannot make another adult do anything they don't want to do, become someone they are not, or take my advice. Nor can I get groups of adults (like parents, or spouses, or entire family units) to behave differently. Any time and energy I spend on that kind of futile activity is wasted, and is a huge emotional and psychological drain on me.
- There are things I can do - and I will offer and do those freely if my offer is accepted. That might be researching options, offering a listening ear, taking kids overnight, sending a meal, saying a prayer, handling logistics around family gatherings that typically would be shared, etc... What I can do may not be what my sibling wants, but that doesn't mean my offer isn't valid or generous. Nor does it mean that my sibling's demands are appropriate or reasonable.

Two things my therapist always tells me:
- Changing my behavior to more healthy, appropriate, adult, boundaried responses injects health into a dysfunctional family system.
- The guilt and outsize sense of responsibility I feel for others in my family is a function of the distorted dynamics of my family. (When I examine my emotional reactions to chaos in a sibling's world, versus the dynamics I have w/ my closest friends in supporting them through hardships, it becomes immediately apparent how distorted my "lens" is around my sibling.)

I am glad you have geographical distance, clarity on not sending money, and a nuclear family of your own to help you draw some lines in the sand. Hang in there and trust your instincts to protect yourself and your immediate family from the ongoing craziness in your brother's world.

I've been in your SIL's shoes.

Aside from everything else, taking the kid out of child care in this situation is a really dicey proposition. A., the kid needs some place to be that is not filled with the drama in his home life. B. whichever adult gets a job--and especially if it's your SIL--she is going to need a solid child care provider to buttress her while your brother is going through whatever he's going through.

Stop trying to talk her into giving up the child care right now. That's not helpful.

It is VERY difficult to access intensive outpatient treatment, by the way. I don't think that is your problem to manage, but that is not bullshit.

Second everyone else on NAMI and/or Al-Anon.