Brought together by their pain

Tuesday, March 28, 2006 | 6:48 a.m.

The middle-aged man had a pained expression.

"If I can just get one of you to tell me how to get her to see a doctor, that would be great," said the man, whose daughter is bipolar and had recently moved in with him after years under her mother's care.

"Bribe her," came a reply from a white-haired woman. "It sounds strange, but you have to do whatever it takes to get her into therapy."

The exchange occurred during a recent meeting of a support group organized by the Southern Nevada chapter of the National Alliance of Mental Illness. About a dozen people from all walks of life meet monthly to discuss how to deal with mental problems of those they love. They offer each other encouragement and advice, or sometimes just a shoulder to cry on.

The youngest person in the room looks as if she is about 30, the oldest is well past 70. The age range is a stark reminder that once mental illness strikes, a family's struggle can last a lifetime.

Members of the group offered the Sun a rare glimpse into one of the private sessions because they want to encourage other people who need support to join them. The Sun will not name the participants in this story to protect the families' privacy.

The woman who told the man to bribe his daughter has a 31-year-old daughter who is bipolar. She has watched the illness develop over several years, and since the diagnosis her life has been an emotional roller coaster.

"We keep locks on all of our doors," she said. "It's a terrible way to have to live, but we have learned we can't trust her."

Though she had never met the man before attending the group session, she found herself sharing intimate details about her personal life with him and the other group numbers. That is the nature of this support group, and the reason, say its members, that they keep coming back.

"Nobody judges anybody here," a group member said, "because we are all really in the same boat."

The family members in this support group have become very familiar with the symptoms of bipolar disorder. The illness is often difficult to recognize, as accompanying symptoms, such as alcohol or drug abuse, are often diagnosed as separate conditions. It is often characterized by alternating manic and depressive episodes.

Manic episodes could include a feeling of inflated self-esteem, a decreased need for sleep or periods of incessant conversation. While experiencing a manic period, people often engage in activities that have damaging consequences, such as unrestrained shopping sprees or sexual indiscretions.

Conversely, the depressed stage is often characterized by extended periods of inactivity, guilt and feelings of worthlessness. Thoughts of death and attempts at suicide are common during this time.

One man in the group has a 50-year-old daughter whom he has watched go through extended periods in which she was high-functioning and productive, only to suffer major breakdowns. Most recently, his daughter had almost 20 years of relative stability in her life. She had found an effective medication and managed to keep a job and save a little bit of money.

All of that went out the window, however, in just a few months. After the death of a close family member and a change in her medication, she suffered a breakdown. Within a few weeks, she went on a binge that saw her go through several thousand dollars and wiped out the money she had spent years saving. She wound up in a local hospital emergency room after overdosing on prescription medication. Her father speculated that the change in her medication might have caused the relapse, and he had no idea why that change occurred.

One of the problems in dealing with adults who are mentally ill is that doctors are not required to discuss their treatment with their families. Often family members must get information from the person being treated. That's not always easy. Patients might be irrational or just might not want to discuss their treatment. They may have persuaded a new doctor to give them medication that the family knows from experience they should not be given.

One woman said her daughter convinced a doctor to give her Adderall, an amphetamine, because she preferred the manic symptoms.

"They're mentally ill, they're not stupid," the mother said. "They can control their illness over a short period of time to get what they need."

The youngest member of the group began crying before she started to tell her story. Her son, a young teenager, suffered a psychotic breakdown during the holidays and has been diagnosed with schizophrenia.

"It's not like he's unresponsive," she said. "Sometimes he's very normal, but he says he hears voices, and some of the things he says they tell him to do scare me to death."

At first, she thought he was on street drugs, but tests for those came back negative. Then he was put on prescription medication, which worked for a while, but recently he started "hearing the voices" again. He has been taken out of school, and she is not sure if he will ever be able to return.

After hearing the stories of the other group members, she realizes she will probably spend the rest of her life coping with her son's illness - a commitment that takes its toll on the family. Several group members admit they suffer from feelings of guilt, shame and depression.

"They're your family and you want to do everything you can for them," said one man. "You reach a point where you have to say no to them to really help them, and it breaks your heart."

Sometimes saying no means turning down a child who has no place to live, or leaving a loved one in jail so they will get the help they need. Often the choice is made to protect the safety, or sanity, of other family members.

The meeting was organized by Sue Gaines, who along with her husband, got involved with the mental health alliance several years ago after their daughter was diagnosed with a bipolar disorder.

"It was a lifesaver for us," she said.

Gaines said there is also a misconception that mental illness of a family member means the entire family is at risk of developing mental troubles.

"That's why these meetings are so important," Gaines said. "In order to erase some of the stigmas attached to mental illnesses, these people have to become educators."

Many in this group admit they have sought private counseling to help them cope. They said some of the best therapy, however, comes once a month in their group sessions.

"It really helps to talk to other people who are going through this," one member of the group said. "Nobody understands it better than us."