AbsoLUTly! That is a very good thought, and I completely agree with you.

Yes, I agree with you that she should come along.

Also, I have relatives with bipolar disorder. I don't know if you have any influence over this, but it sounds like she needs a doctor's appointment for an adjustment in her medication.

It seems reasonable... to a healthy, sane person...but considering she's sick (in one way or the other), it may not be.

I would definitely offer what you have suggested, but still pick up her child regardless. For whatever reason, the chore of picking up her child may be a stessor for her, and generally stressors can make health conditions worse. It's a fine line, but you are probably not enabling her. It's not easy for heathy people to understand illnesses especially mental ones. Most of the time, people can not just snap out of it...no matter how easy something seems to be. Others often think if you just act normal or do normal things, you will be normal...but the fact is, she probably won't and she probably isn't normal... so don't put normal/sane expectations on her.

Either help her and accept her as is or don't...but doing a favor and putting your own conditions on it, is not really a favor.

You are a smart cookie! You can't make her depression go away, but it can't hurt to stimulate her by getting her out of bed and out of the house. Can you make this a little fun for all of you? Stop at Dairy Queen or pick up some sweet corn or something?

I'm so sorry that your sister seemingly isn't able to benefit from any of the new meds out there. Would it be intrusive for me to ask what she takes and if you think she has a good psychiatrist? (She's not overdosing on benzo's or something?)

I think it sounds completely reasonable, but what was her answer? Did she agree, or will she be asleep when you go to pick her up?

Bipolar is HER diagnosis? Has she seen a professional?

Sue

Yes, I'd make her get up and ride along.

It sounds to me like her meds need to be adjusted. Has she had a full thyroid panel done? INCLUDING thyroid antibodies? There are lots of people walking around feeling bad because they have hypothyroidism and haven't been diagnosed because the doctors only check their TSH. Depression and sleeping too much are 2 major symptoms of thyroid disease. Bipolar people also have a better chance of being hypothyroid (especially if they are on Lithium).

Here is a link that might be useful: Abstract - hypothyroid in bipolar

I did make her get up, and she grumbled for awhile, but didn't go off into a screaming rage, which was good. She and Chloe live with me, btw, so I didn't have to pick her up.

As for her diagnosis, all of the doctors over the past 20 or so years have agreed. This includes doctors at the mood disorders clinic of two major hospitals, plus her current psychiatrist (who is very well-respected, though I don't particularly like him). And yes, she's had full thyroid panels regularly. Our internist always sends copies of the test results, so we know what tests have been done.

It's not a matter of adjusting her meds, it's a matter of them not being enough. She's been on virtually every psych medicine (except those for schizophrenia) to come out in the last 30 years, yet she's always depressed. It's really awful for her, and she's had dozens of psych hospitalizations.

Anyway, thanks for the feedback.

Are you sure she's taking the meds? I know that sounds like a silly question but sometimes people on depression medication start to feel better and think they no longer need the medication and stop taking it. Do you go to the doctor with her? It definitely sounds like she isn't getting the right dose. My heart goes out to you. It really isn't easy to deal with someone with mental illness. They seem so normal and it is easy to get impatient, but they really can't help their mood swings. I think it's wonderful that you took them in.

My husband had an employee who had a lot of issues, including being a lesbian,battling alhoholism, and severe depression. One of her symptoms was that she couldn't wake up for work. She'd call in sick many times and either show up in the afternoon or miss the whole day. He finally had to fire her, even though they were friends and he felt sorry for her.

Yes, she's taking the meds. I watch her. I am in touch with her therapist, her psychiatrist, and her internist. Everyone agrees that she is just very difficult to treat.

As for not being able to help the mood swings, that's true to a degree, but not entirely. As with any chronic illness, there is a lot that a patient can do to help himself or herself - regular sleep hours, decent diet, daily fresh air and exercise. There's a reason that they *make* you wake up and get out of bed at psych hospitals, and a reason that highly-structured day treatment programs help mentally ill people.

If she were suffering from cancer or any other disease, would you tell her to get up? Would you put conditions on helping her if she had any other kind of illness? I completely agree with Carla's post.

I agree with Carla to a point but anyone who has lived with a bipolar person knows you must set conditions and boundaries.

You were right to wake her up. But had she started fussing it would have been best to leave her be. One day at a time.

DH was recently behaving rather impulsively. Nothing major but enough that it was really starting to get under my skin. We had a huge argument about him buying something I felt we could do without. The next day we talked. Turns out he been taking his anti-depressant med on schedule but has been taking his anti-anxiety meds quite late in the day sometimes forgetting until he went to bed and getting up to take them. I had to remind him that the doctor said to take them right after work and that if he needed to he could take more than one dose in a day. Of course that was a blank to him. The pill bottle says one in the evening so that's what he did. So it's peak activity was while he was sleeping. I need it to work while he's around me. LOL When the doctor recommends another medication schedule without a new prescription it leads to stuff like that. Many bipolar people have memory issues which makes it difficult for them to learn from past mistakes or remember verbal instructions. He's been taking it at work before he leaves and in just 3 days I can see the improvement. The second day he came home and asked if we could go out with friends soon. That is HUGE as his anxiety doesn't exactly make him Mr. Social. Happy days ahead as long as he doesn't lapse into forgetting again.

It's hard for them and it's hard for those that live with them. Medications helps a lot but it is never perfect. You can't cure bipolar illness, you can just control as best you can.

Carla, I really like your post. Although, I have never had to live with a bipolar person. I can't imagine the frustration that must come with that!

good luck, cause I can't offer anything

The conditions and boundaries are absolutely necessary, no question. And yes, I think they're also necessary with other chronic illnesses like cancer, though they look different. You always have to balance the needs of the sick person with the needs of the caretakers and family. And you have to balance the short-term and long-term needs of the sick person.

Anyway, I already knew when I wrote that I should wake her up. I only doubted myself because I was being lazy. In the short term, it's much easier for me to just take care of Chloe and let my sister sleep and eat and watch game shows and be a non-entity in our lives, but it's the wrong answer for all of us, When she's not feeling as awful as she is now, my sister recognizes this.

Jannie, I worry that what happened with your husband's employee is going to happen with my sister. She's had a full-time job now for more than two years, which is great, but she misses a lot of work with made-up excuses. (Just this year, she's faked pneumonia, bronchitis, a stomach bug, conjunctivitis, and fainting. She also made herself fall down a flight of concrete stairs to get out of work, which is another issue.) She works in the local school system, and is due to start a summer job next week, but I don't know whether she'll make it. I feel badly for her, and I feel badly for them, because they'll be in a terrible bind without her.

Wildchild, I appreciate your posts, because I know you know what it's like. My sister's memory has been terribly affected, either by the illness or by several rounds of ECT, or maybe by both. She does all right with taking medication, only because she portions it out into a daily pill organizer, but you're absolutely right about not learning from the past. She doesn't even remember the past, unless she makes notes. We have an agreement that I will email her therapist to tell her how my sister is feeling and what issues she's facing that week, because my sister doesn't remember, and will sit at the therapist's office and say nothing for an hour if I don't.

I have nothing to add, as I have never had to deal with anything like this. All I can say is how wonderful it is that she has you!

Trish

Joann23456 I think you're doing absolutely the right thing. Comparing it to cancer is a copout. A better analogy is an injury requiring rehabilitation. Just like when someone has to go through therapy after an injury, it's not easy for the person. It can be painful. But you know what? You SHOULD NOT just cowtow to them, feel sorry for them and let them not do what they need to do. in that case, you might as well lock her up in a nuthouse and be done with it because treating her like she has a disease like cancer is only playing into her hand.

It's often hard to force yourself to do something that hurts, even when you know you need to do it and I know that from experience. And yes, I've been through severe depression and mood swings so maybe I'm bipolar too, IDK. And I know people who've been there and a former GF's son was bi-polar. But I know if you want to rehab yourself, you have to do some things and not use other people.

When I read your post, right before I read your idea the same thing popped into my head. Make her come with! Not unfair at all. I think I might require her to do something extra too, perhaps something as simple as open your mail on the way or tear coupons out of the paper (whether you intend to use them or not). It's not punishing her, but reinforcement that there's sometimes more effort to try to take the easy way out. You're teaching her a valuable lesson. And yes sometimes people like this need to be treated like children. People of all ages often take the path of least resistance or more accurately the perceived path of least resistance. When she gets the idea that it might be less work to do what she should instead of sluff it off onto someone else, she may well take the responsibility, and help herself.

Sleep can beget sleep. And it doesn't necessarily give rest and therefore isn't good. Often it's easier to roll over and say "I don't wanna" but you're not doing her, yourself or her daughter a favor by letting her get away with it. Help people help themselves. Don't be a condoner or the politically correct term, an "enabler".

I notice with myself when I'm inside too long I don't feel like going out. Just a little breath of fresh air helps. Walk to the mailbox, go to the store. Even something simple like sitting outside. Trim the bushes or some light chore of some sort. Straighten the doormat, sweep the steps, wash the front doorknob or whatever. There's times I'll just go stand outside no matter the weather. Stand under the eaves when it's raining (and with the negative ions, it's very good for a number of ways), or a foggy morning, even in a snowstorm, a breath of fresh air makes a world of difference, even when the windows are open. Seeing the outside world gets the mind more active.

Some people believe in hemispheres of the brain and different activities working on different parts. I won't go into the debate but a lot of experts agree that the mind needs exercise and activity.

If you don't do the right thing, her mental condition could easily develop into a physical condition by lack of exercise and more.

I agree that most of the time, people can not just snap out of it but when people start with this, they will not help themselves very often and you're just making it worse for everyone involved, including her daughter.

Doing a favor and putting conditions on it? Done all the time and totally reasonable! Unless you think people should do you a favor and loan you a million dollars... and not put a condition that it be paid back in a certain period of time. Not having conditions on a favor is sometimes synonymous with getting used or abused.

Hang in there Joann23456. Kudos to you! You're doing what's right and you're doing it creatively. You're not just doing the bare minimum, you obviously want to help her help herself. Don't second guess yourself.

cynic,

I think you're making things too black and white. What works one day for a mental illness may not work another day. Sometimes it is like cancer, and others it can be more like rehibilitation. Sometimes sleep is bad, but sometimes it is needed and is good. Granted exercise is generally good for depressives, but pushing too much or not getting enough sleep could also cause manic episodes.

Bottom line, similar to an alcoholic, her sister needs to want to do the things and do them herself...Maybe her meds need to be adjusted, maybe she needs a better shrink... but Joann making the deicisions for her or putting conditions on things is probably not going to help in the long run. It's a short term/bandaid fix if the problem still exists.

And, sorry I don't put conditions on favors. I say yes or no...Sometimes I may ask to alter the favor if I can't do it as asked, but not conditions...I don't tell someone they have to pick up my kid, if they ask me to pick up theirs. If they ask me to pick up their laundry, I don't telll them they have to go with me. And, if someone asked for money --I would say yes or no... I wouldn't say they have to pay me back if that wasn't part of the original favor..(generally, that's not a favor, that's a contract --- plus, I'm not dumb enough to "lend" money anyway). If you can't say no, I guess you could get abused by people. But if you can, I see no reason why doing favors unconditionally is abusive.

I don't know if Joann's stipulation was a condition or a mere request. I mean she "won" (and her sister did go with her), but I'm not really sure what she won or what the benefit was.

Joann, I think you're absolutely doing the right thing. It's not a matter of a favour every now and then. Your sister and your niece live with you, and if you didn't provide structure and expectations, you would be doing absolutely everything for your niece.. which wouldn't be good for anybody.

It's so true that even the most severely mentally ill people are expected to get up and have structured days even when they're ill enough to be hospitalized. And it's not like you expect that lifestyle changes alone are enough to help your sister, you keep good communication with her specialist to make sure things stay on track.

And Cynic is right, that having her move around some will help to keep her from getting more deconditioned. Leaving her alone to sleep and avoid life would be the cruelest thing you can do.

You're a good woman, Joann, and your sister and her daughter are very lucky to have you.

Cynic, you definitely get it! (And thanks so much for taking the time to write your post. It helps a lot.) That's been my experience with serious depression, too. You want to sleep and sleep and sleep; but it only makes things worse. It's not restful, it's just a way of avoiding ... everything.

And Susan_on, you're right that if I didn't push her, my sister would opt out of everything in life that's the least bit difficult for her. (She did that for years, living with my mother. She did little more than eat and sleep and watch television for years.)

Carla, you're certainly entitled to your own opinion, but from the way you're writing, I don't think you understand at all what I'm talking about, especially when you talk about not getting enough sleep or pushing too much for exercise. I'm talking about her getting maybe 10 hours of sleep a night instead of 19, and the only exercise I suggested was walking to the car.

By the way, I have no problem whatsoever saying no, yet it's very easy for my sister to take advantage of me, if I let her.

Well, thanks to everyone for taking the time to post.

carla35, frankly, you're sounding much like the sister here. Making excuses to not do what needs to be done. Exaggerating things, making erroneous comparisons and the like, nitpicking and avoiding obvious needs. Let's make a few things clear:

Nobody suggests depriving her of sleep.

Nobody suggests depriving her of needed medication.

Nobody is suggesting pushing her to overexercise or anything like it.

And to people with the dreaded cancer you analogys minimize their situation and suffering by saying that this is the same. I have yet to see a mental illness treated with chemo. Let's come back to earth, OK?

"Bottom line, similar to an alcoholic, her sister needs to want to do the things and do them herself..."
Yup. Exactly what several of us have suggested. Now you can either provide the alcoholic the booze or you can say nope, stand up and quit that. Doing what you suggest is tantamount to putting the bottle in their hand. Somebody has to make a decision to help people. With your philosophy there wouldn't be enough bridges by the river for drunks to live under.

You don't put conditions on favors but you alter the favors. C'mon, what's the difference? Nothing. To make you happy, the favor was "altered" to have her accompany her. After all, you coined the term "condition". Sounds like a syntax argument and not a very good one at that IMO. OK, I'll happily concede she "altered" the favor to have her accompany her. Now everyone is happy and you're in agreement with us, right? It should also be pointed out that the favors you quoted weren't even comparable. How about this one? An alcoholic (with or without cancer) asks you to pick up a case of booze and some insulin for them? What will you do? Alter it or put a condition on it? Or just say no? We all know we're talking about synonymous terms. "I don't tell someone they have to pick up my kid, if they ask me to pick up theirs. If they ask me to pick up their laundry, I don't telll them they have to go with me." Not even comparable "favors". Not even close. How about this? Someone you know has to walk daily for therapy to be able to walk or their muscles will atrophy. They won't get out of bed and ask you to go pick someone up for them. You honestly wouldn't try to get them to do their therapy?

Too many excuses being made. Someone needs to be strong enough to stand up and cut through the BS. Thankfully for her sister and niece, Joann is that person. I shudder at the thought of what would happen to the sister and more importantly the niece if someone else were living with them.

God bless Joann - you've been a loving, faithful sister. All I can do is send along some >> that's all I can offer.
Maire