Dear Cary,
I have a dear friend who has battled bipolar disorder since her early teens. We are part of a close-knit group of friends and as several of us have moved back to our home state in recent years, we have been seeing each other fairly regularly. My friend, who has been on medication since her diagnosis, has had a great few years -- she's enjoyed success in her job and has been with her husband for six years. Unfortunately, quite recently, she has started to exhibit the telltale signs that she is entering a manic phase, which for her includes wildly spending money, an increased libido, and substance abuse. While myself and our mutual friends have been through this before, her husband has not and I'm very concerned.
The mania can sometimes be hard to spot, but over the past few weeks it's been pretty clear as my friend has started spending money without regard, has openly flirted with a married co-worker while extremely intoxicated, and purchased a new car without informing her husband -- she just showed up at home with a brand-new car! The last serious manic phase she had was over eight years ago, when she stopped taking her meds, disappeared for three days (where she had sex with several different men), and ended up with over $25,000 of credit card debt. At that time she was living with her boyfriend, and their relationship was destroyed. I tried to explain to her boyfriend that these were traits of her illness, but he had never witnessed this behavior before and left her.
My immediate concern is for her marriage. My friend has a wonderful husband who is supportive of her in every way, but he has never seen her manic before. My question is, what role do I and my friends, who have been through this many times before, play in here? I've considered meeting up with her husband to see if he understands what's going on, but is it my place? In the past her parents have been in extreme denial about her illness, so I don't feel comfortable involving them at this point, but if her marriage and job are in jeopardy because of erratic behavior, should they be informed (they do supply her with most of the money she blows through)? My friend has never reacted well when we have confronted her in the past about a possible manic phase -- she gets extremely defensive and has severed communication before. Should I risk this and just gently confront her?
This is a much harder now that we are older and the "life stakes" are higher. When we were younger, I could easily miss work to be with my friend during her times of crisis. Now, many in our group of friends have spouses, children and demanding careers. How can we try to support her in what amounts to our spare time?
Any advice here would be greatly appreciated.
Friend on the Lookout
Dear Friend on the Lookout,
Somebody you care about is in danger because of a disease. Not only is she in danger, but her husband is in danger and her family members are in danger and complete strangers are in danger.
You have special knowledge about the situation that could alter the outcome, and so you have a duty to alert those who might be harmed.
This is a disease that can be controlled. If she can get back on her medication, then perhaps she can avoid disaster. So I think it is right to intervene, however uncomfortable it may be to raise this issue with the husband.
Some may object that you are intruding into her private family life. If this were something from her past with no bearing on the present, or if she was the only one affected, then such objections might carry some weight.
But when a bipolar person goes off her meds and decides it's time to go shopping, or have a drink at a new bar, or look up an old high school boyfriend, or begin currency trading, or travel to Basel, then bartenders are in danger, cops are in danger, children, co-workers, pedestrians, banks, store clerks, married men, jewelry salesmen, car dealers, credit card agencies, loan officers, hotel employees ... we're all in danger. Think about how you would feel if she crashes her new car into a tree, or into a child.
Now, it may be a difficult and uncomfortable conversation to have with the husband. But it's got to be had. How you present it to the husband is an issue but should not be an impediment. Just be sincere and frank.
If possible, arrange to meet with the husband at a cafe or restaurant or a park, where you can talk privately at some length if need be.
Tell him only what you know to be true. Offer whatever help you can provide. If he does not seem to believe you, you may then have to take other steps. But start with the husband.
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