Melanie: Trying to Help Her Brother

Melanie continues to offer support to her brother Paul, diagnosed with bipolar disorder in his 30s. Following her father’s death, she took a National Alliance on Mental Illness (NAMI) class in the early 1990s. Since her brother Paul lived in a terrible housing situation and Melanie had recently divorced, she told Paul he could live with her for a while. However, she did not like his habits. Although he did not use alcohol, he smoked non-stop, which Melanie viewed as self-medicating. When she told Paul that he needed to get a job, he found a job washing dishes at a restaurant. After two years, she asked him to find another place. At that point, Paul found resources to help him survive on his own. He obtained Social Security disability, which other family members viewed negatively. Melanie supported his choice, because he was looking out for himself.

Note: NAMI (National Alliance on Mental Illness) is a mental health advocacy organization at national and state levels that offers a multitude of informational material, classes, and support groups.

Paul has since moved into public housing but continues to struggle with symptoms of mental illness. He no longer drives his own car after driving erratically and having two accidents in one day. Unbeknownst to Paul, Melanie and her youngest brother, concerned that Paul might kill someone, sent a letter to the Department of Motor Vehicles about his driving behavior, resulting in the revocation of his driver’s license.

Recently Paul experienced “a revolving door” of going in and out of the hospital. Melanie described how a nurse used “tough love” with Paul during one of his hospitalizations.

The nurse said, “You are not taking your meds and this is what happens.” She said, “You are going to have to take this injection every month and if you don’t, you’re going to end up in [the regional hospital for people with mental illness].” She didn’t mince any words. We started to see him taking responsibility. He was going down and taking his injection.

However, after discharge Paul had an accident in which he scalded his feet with extremely hot water; he needed skin grafts and is now in long-term care for healing of third-degree burns. Melanie hopes Paul will be able to go back to his apartment. Even though he has caused some disturbances there, “the management has been patient.” He self-medicates with a lot of coffee and she wonders if that contributed to the manic episodes, leading to hospitalization.

When one of his medications went missing while he was in long-term care, Paul did not receive his medication and as a result, became more depressed. Melanie speculated that his depression interfered with his recovery because he was lying in bed rather than practicing walking with his walker. He will not be released back to his apartment unless he can function on his own. Melanie’s other brothers would like to see Paul move into assisted living where he would receive meals and other needed assistance.