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Welcome to CareNotes. In this special section we will feature a reader's letter and provide an opportunity for an interactive exchange that will help find some answers and possible solutions to concerns. If you wish to respond to this letter, simple follow the link provided at the end of the letter and add your comments and thoughts to our CareNotes Board.

This Week's Carenote - 11/02/10
I have a 25-year-old bipolar daughter and I need help.  These are my issues:

1. I am torn between working (which I need to do to sustain us) and not leaving her at home alone.

2. I am frequently subject to her rage attacks.  I have had to call the police on several occasions.  She perceives that I think thoughts about her that I do not.  I am not trying to be critical when talking to her; I am just trying to help her make better choices. Her tendency is to have a rage attack when she is upset about the failure (or perceived failure) with a boyfriend.  She has never been able to have a valid relationship with a man, but views this as a way to gain self-acceptance. 

It is significant that my daughter's rage attacks are only directed at me as her primary caregiver, her older sister (who does not spend as much time with her), and perhaps a boyfriend—those she feels safe with. Outside of the home, she is like a mousevery unassertive, quiet, and has difficulty trusting people enough to make friends. She spends a good deal of time on Facebook with people she barely knows or has never met.

It is my belief that the "mania" in my daughter's bipolar is expressed through these rage attacks, not euphoriaalthough I guess there is an initial euphoria in beginning a relationship with a new man.

3. She says I am crazy because I overreact to her poor choices with men and in other areas of her life.

4. She processes any sort of negativity from others as a rejection and goes into a state of depression and self-hatred.

5. She refuses to do what I ask of her—routine chores, being on time—and I become angry, which only gives her an excuse not to do what I ask and state that I am "crazy" and overreacting.

6. I have tried all my life to help my daughter and wish to see her function in society as an independent individual. I don't know whether she is unable or unwilling to do this. I do not know to what extent my protective attitude toward my daughter is enabling her failure to become independent.

7. My daughter has been treated by psychiatrists and counselors for at least the last ten years and does take medication for her disorder. Both she and I are still having great difficulty.

Please try to connect me with others who are dealing with the same illness so that I can better help my daughter.


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Date: 11/08/2012
Time: 10:47 PM


Your description of your daughter's behavior sounds very consistent with borderline personality disorder (BPD). Many clinicians are relunctant to diagnose BPD because 1) it has traditionally been viewed as a "personality disorder" and therefore untreatable (that is incorrect--there are now treatments), 2) the label BPD is stigmatizing, and 3) most healthcare plans will not reimburse for treatment of a personality disorder. It is common for a person who actually has BPD to be diagnosed with bipolar disorder and at times, individuals with BPD actually show improvement with meds typically prescribed for those with bipolar disorder which further confuses the diagnosis. There is also the possibility of a co-occurring disorder bipolar d/o and BPD). Whatever the case is with your daughter, I would encourage you to read the Walking on Eggshells books by Randi Kreger and Paul Mason. (They also have a website, BPD Central). The most hopeful treatment for BPD (which can be helpful for those with other illnesses, including bipolar disorder) is dialectical behavioral therapy (DBT). There are a number of manuals and workbooks available as well as a DBT self-help website. Marsha Linehan is the psychologist who first developed DBT and she has written books on the topic. One of her former associates, Shari Manning, wrote, Loving Someone with BPD, which is an excellent resource for family members of individuals undergoing DBT. DBT is becoming more widely available, although it is important to ensure that anyone who claims to do DBT is actually certified and adheres to the treatment model. Appropriate treatment can make all the difference in the world. Whereas BPD was once thought of as untreatable, many clinicians will tell you now that it is, in fact, curable with DBT. Best wishes!

Date: 11/03/2010
Time: 01:37 AM


I am taking care of my significant other's son who is bipolar ADHD. It is very time consuming and a great challenge. His mother passed away in July who in her self was bipolar. She did not try and recieve help and self medicated with alcohol, in which killed her. Though she is being medicated she also needs therapy to deal with the poor selfasteme and depression. Also, she should not be so manic when being medicated it is possible she isn't totally honest with the doctor and they are giving her the wrong dose or the wrong medication for her disorder. It took 2 years to get proper treatment treatment and a good doctor for my son. There is a thing called an emergency petition, here it is through the police department, you can have them taken by force to a hospital and evaluated and possibly temporary induction to a mental facility for evaluation to get her meds correct. She should not be violent towards you if she is properly being medicated. It won't take care of all of the problem, some of it is the child learning the proper way to control themselves during a breakdown.I struggled for 10 years to get my wife properly treated and she refused to obtain the correct meds. She became so terrible that I was the only one that didn't abandon her, everyone else couldn't stand her and refused to come around or deal on any level with her. It all boils down to the proper meds, learning self control, having limits, and lots of therapy. Good luck and I wish you well.

Date: 11/02/2010
Time: 05:28 PM


Might I suggest you investigate neurofeedback as a therapy for your daughter. This is a very successful form of therapy for all types of neurological disorders and there are several good books on the subject.

Name: Debra
Location: TX
Date: 11/02/2010
Time: 12:19 PM


Sounds like you and your daughter might benefit from education offered through local chapters of NAMI, National Organization for the Mentally Ill. Check out their website to identify the local group; in our area they have offered the 12 week Family to Family workshop. It was great. Education and support all in one. I'm glad to hear your daughter is compliant with her medications; that is a step in the right direction, especially if it is being monitored. Sometimes people w/bipolar tend to stop when they think they are feeling good, and as an adult she can make the decision not to be compliant, which then can be a problem because unless is she harming herself or others your hands may be tied. Sometimes an adult needs to suffer the consequences of their actions before they realize how good they have it. Unfortunately we aren't able to protect our children forever. Hoping a local NAMI chapter is near you and that you are able to work through her being an adult. It may be the hardest thing you've ever done, but may be very rewarding in the end.

Name: Marcia
Location: Rock Island, IL
Date: 11/02/2010
Time: 10:49 AM


I have been dealing with a mentally ill spouse having some of the issues that you have described. I found that no matter how hard I tried that I could not always help him. He would automatically react in anger to what I said. This was terribly difficult for me and about a year ago I ended up in the hospital from the stress. I have been seeing a therapist for support with caregiving ever since and this has helped me immensely - I recommend it.

Name: Lauren Agoratus
Location: United States
Date: 11/02/2010
Time: 10:10 AM


You may want to contact the National Alliance on Mental Illness at They have an excellent class called "Family-to-Famiy".

Name: LL
Location: Freeport, Il.
Date: 11/02/2010
Time: 07:35 AM


SH-I am going through much of the same thing with my 23 yr. old daughter. Unfortunatley there is much misunderstanding with mental illness and very little family or community support. Others think that you have either spoiled your daughter to the point she can't maintain a relationship or that she is just plain crazy. I have come to the conclusion that this is "my cross to bear". My daughter had contemplated suicide realizing that this may be the only way that she can acheive peace. I hate to say it but I can understand where she is coming from. She has a beautiful baby and a fiance, but I don't know how long he can put up with her. I worry that she may outlive me and then who will be there to watch over her? God bless you in your struggles. I hope I can read some solutions to your problem and that it might help me also.



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