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Mending a broken family

When mood disorders play a part in relationships, uncertainty looms, chaos erupts and trust can be eroded. Can the damage be repaired?

When Josh stopped taking his bipolar medications last fall, he soon became manic. Without consulting with his wife Molly, he announced his plans to quit his job and use the family’s savings to start a business. He bought things they couldn’t afford. Over the next few weeks, he started drinking heavily and went out dancing with a woman from work. He ignored his two teenage sons. Molly felt cut out of his life, fearful about the family’s security and bewildered by his behavior. When she tried to talk to him, he raged at her. That’s when she and the kids left to stay with her sister.

Six weeks later, as his world crumbled, Josh agreed to go back to his psychiatrist and to see a therapist with Molly and the kids.

“Family-focused treatment is essential when one member of a family is struggling with a mood disorder,” says William Shryer DCSW, LCSW, Clinical Director of the Diablo Behavioral Healthcare in the San Francisco Bay Area. “It’s also important to have the psychiatrist and the therapist working together.”

Shryer starts with education. “It’s important that family members understand that bipolar disorder is a neurobiological chemical disorder that can be treated with medication and therapy,” he says.

Each family member must be committed to the process. Josh also agreed to stay on his medication treatment.

“If the family is committed to change, there is no place for wallowing or blaming,” Shryer says.  “It doesn’t help to keep focusing on what’s happened in the past. It’s time to roll up one’s pant legs and begin making changes.”

In therapy, family members can learn more effective ways of communicating with one another. Molly needs to let Josh know she has been hurt, how she has been hurt and what her expectations are for change. Shyrer suggests she might make a statement like this one:

“I am feeling angry that if I speak my mind you’ll discount me instead of hearing what I have to say. So I shut up and stay angry. I need you to hear me.”

Josh could respond with, “I don’t want you to feel that way. What can I do differently, so that you’ll feel like you are being heard?”

Josh and Molly’s sons were hurt, angry and confused. Shryer often says to children, “You don’t hate Dad, you hate his behavior.  But, together, you’re going to learn how to build a new relationship.”

Family members are encouraged to make time to be together. They may need to relearn how to talk to one another. Dad may be prompted to talk to his sons, not by asking “How was school?” but by asking, “What are you learning in history?”

Josh, Molly and their sons are learning in family therapy how to take better care of themselves and each other. Josh knows the risks of stopping his medications. Family members often recognize signs of mood changes first, and Josh is willing to be receptive when they point out possible signs of mania or depression.

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