Caring for partner with Bipolar Type 2

[Littletink_]

Hi,

What are the best ways to help someone when they don't really want to help themselves or take responsibility for their illness? I am caring for my partner who has Bipolar Type 2. I feel like at the moment, I am at the point where she relies on me for everything and I don't want to be in total control of her life, I would love for her to want to do things for herself and have initiative. She doesn't really want to help herself or do anything for herself or take responsibility for her illness. I would love some tips and your thoughts on how to be supportive without having to do everything for the person. I am feeling very burnt out but if I don't do all the things I am doing for her she won't do them for herself. I know she is capable but she doesn't really seem to care about herself as a person or be interested in helping herself get better.

Thanks guys

[Former-Member]

Hey @Littletink_

I care for my husband (Mr Darcy) who has BPii, lack of motivation is a tough one as it can often be a side effect of medication or of depression - is your partner taking any medication for her condition? Does she attend appointments? Mr Darcy is still recovering after an acute episode 19 months ago and motivation has been a problem and in no way do I underestimate the effect MI has on us as carers.

It is well documented that supportive family relationships improve outcomes for patients and prevent relapses but getting the balance can be difficult.  Wanting to be a partner and lover not a nanny. Having appropriate involvement leads to a happy relationship (and I think that the seriousness of this condition is often not mentioned - excluding a carer is shown to have negative effects). For us it means that I dish out the meds (as per instruction from pdoc as he attempted), still monitor when bloods need doing (although he now rings and books the appointments), I will advocate for him but give him as much autonomy as possible, respecting his feelings.

For me, psychoeducation has been extremely helpful and was the start of things improving for the better, understanding about BPii and mental health in general. I found that approaching Mr Darcy's condition as one would a non psychiatric chronic medical condition helped me/us when it came to the management of his health. I came across this statement "It is maybe the most profound disservice of all to tell a patient that their depressive or bipolar symptoms are the result of biology or chemical imbalances and thus absolve them of the responsibility of learning new ways of interpreting and coping with their environment" 

Sadly we cannot force motivation but having realistic expections and slowly encouraging the patient to do things - it might be one small task a day - can often give them a sense of achievement, so often they are aware of the effect their disorder has on the ones they love.  Important though to be firm with what we feel is acceptable or not (also called setting boundaries).   

Getting support for yourself is important too - there are some thread in relation to self care and I encourage you to look at them.

Hope this is a little bit of help, happy to expand a bit more, happy to answer any questions or give you links as to where you can get carer support - just let me know what state you are in.

Darcy

[NotLabelDefined]

Hi @Littletink_,

I hope all is well.

There are a number of approaches that may be useful. I wonder if any other forum users have any thoughts?

I have a suggestion, but it is in no way a gauranteed fix or solution, however you and your partner may find it useful. Its a practical and easy thing to try. 

Would your partner (and even yourself if you feel a role-model approach might help) be willing to write-up some 'to-do-lists' for daily activities, and then she can prioritise the activities, and assign either (1) a particular time period for those things to be done; or (2) if they seem too difficult to do at this point in time, write down a reason why it seems too difficult to do, and then get her to write down what things might help her to do these things (you may like to do this together, to start off with).

This may help as it engages her awareness in what needs to be done. It may also help enhance motivation, especially as things get ticked-off the list more and more; especially if you have small celebrations/recognitions when things have been done. It may also help your partner in creating an 'active' routine and re-gaining a sence of self-determinacy and self-worth.

It means you are still being supportive, helpful, and caring, and she wont think your not willing to help, or that your trying to pass-the-buck, so to speak. It also means you wont be enabling her apathy or percieved lack of responsibility.

[Littletink_]

Hi Darcy,

Thank you so much for your reply it is much appreciated & very helpful information. I am relatively new to this carer role (less than a year) so I need all the help I can get. She is on a lot of medication, I have to remind her to take her meds morning and night and also make sure she has scripts & isn't about to run out ect. She does attend appointments but only because I encourage her to go and take her otherwise she wouldn't bother going herself. She doesn't see the point in going to the doctors or getting help. She told me this herself. I have to get her up of a morning too otherwise she won't get up. The medication makes it difficult for her to wake up properly too. I know that if I wasn't helping her she wouldn't be doing these things for herself but at the same time I don't want to be controlling or to be in charge of every aspect of her life. So it's kind of hard to know what to do and what not to do/what boundaries to set. Yeah I am finding it hard to find the balance. I am in NSW and we have awful Mental Health Services where we are. The doctors we go to at the moment are all locum doctors so they only stay for a bit and then move on. I would really like a long term GP for her it's what she needs. Where do I draw the line with what stuff I do for her and stuff that I don't or shouldn't? I have no idea. I do all of the housework, remind her to eat and make her food I mean I know that she can do these things herself but doesn't want to or won't and then I am so tired at the end of the day and can't even bother to cook properly for myself

[Littletink_]

Sorry @Former-Member I forgot to put the @ in I hope you can read my reply to your message.

[Littletink_]

Hi @NotLabelDefined,

Thanks for your reply 🙂 Those are really good ideas, thank you. And something I have thought of doing previously but haven't gotten around to it. It's so tiring but I really do love her and want to support her. My mind is just always thinking of what things I have to next. It's just never ending

[Former-Member]

@Littletink_

Hearing you loud and clear. Sorry this post is long but it might help.

Lack of motivation and the sedation is something that you could report to her docs as they may be able to do from the medication side. It is something they should be made aware of. This talk really helped me in relation to communication with the docs.

https://m.youtube.com/watch?feature=youtu.be&v=NRO0-JXuFMY

I found having a treatment plan and documented relapse prevention plan very handy. The case worker is the person that does this and providing your partner has given permission you should be included in this process. This is a space where the practical matters of getting up and doing things can be addressed in a structured form. The case worker will also sort with you if the GP or the health service are to be responsible for the necessary monitoring that is needed for psych drugs (bloods, weight etc). It might be that finding a good GP that will provide the continuity care that you are finding lacking, but it is important to have regular pdoc follow up.

Not wanting to take meds is a common theme and the pdoc should be able to explain to you expected benefits of the prescribed drugs, regular reviews should occur. One of my boundaries is that my husband will take meds as prescribed/agreed and any change must be made in consultation with his pdoc. Having said that if any change is to be made or offered we need to be clear on expected benefits - risks and when a review is to occur.

Mr Darcy's brain took quite a battering from his psychotic episode, time and med changes have been the main factors with the motivation factor. Initially I only expected him to do the dishes (he always did them), as things improved he started cooking (badly) and has progressed to the laundry and sometimes some lawn mowing.

Looking after yourself is so important, it helps you cope with the demands.

Carer helps:
https://www.wellways.org - have psych education and carer support
https://www.carersnsw.org.au - offer free counseling for carers
https://www.onedoor.org.au - carer support

This Qld website was helpful for me even though I am not in Qld.
http://mhr4c.com.au

Hope this helps
Darcy

[Littletink_]

Thank you so much @Former-Member. All of that is and will be so helpful for me. Do you have any tips on how I can help her to become more independent? As we do spend a lot of time in each other's pockets and she doesn't have any friends or support I'm all she's got.

[Former-Member]

That can be hard one @Littletink_

Wellways have patient supports Mr Darcy had someone that that took him out for coffee.

There is also a phams program
https://www.dss.gov.au/our-responsibilities/mental-health/programs-services/personal-helpers-and-men...

Grow might also be helpful too - they have groups around the state https://www.grow.org.au/nsw/

These are some services that might take your partner out giving you a break.

Darcy

[Littletink_]

Thanks Darcy. I am so tired all the time there is just always so much to do the list is never ending and some days I get a little overwhelmed. I feel like I barely have time to scratch myself these days. I have just started studying too and am finding it hard because I am so busy doing other things and going to appointments, housework, looking after her ect.