How can I best help my sister with Bipolar I?

Hi All,

I discovered this site today, and am looking forward to hearing other peoples accounts and advice. I'm a concerned sister (32), and would really appreciate it if I could get a better guage on how I can best support my sis.

My dear sis (28) is currently experiencing her 2nd manic episode in under 18 months - her first manic was her diagnosis point - and we're recieving less medical support this time around. She has done herself and her family very proud by recognising the early symptoms this time, and asked to be taken to hospital a little over a week ago (Sunday). She was admitted immediately, after a massive anxiety attack in the hospital car park, and was sedated promptly. The emergency department were fantastic (which is more than I can say for the first hospitalisation - over 2 days in emergency with no bed/admission and no medical assistance). As she was considered only slightly manic (true), she was moved to the hospitals psychiatric unit for observation. Over the 3 days on the ward, her mania heightened and the staff seemed either unwilling or ill-equipped to continue looking after her. I say this as we all witnessed 2 members of the nursing staff unnecessarily aggravating my sister by arguing and cornering her. She was then moved over to a hig-dependency unit at the mental health hospital at 9pm that night (Thursday), and by midday Friday she was given weekend leave to spend a couple of days at home. At the time, even though I believe she was only hypomanic, I don't agree that she should have come home. Saturday was uneverntful enough, but by Sunday she was in her own world again. I contacted the hospital and told them that I would probably be bringing her back in that night, rather than wait for Monday morning as she was advised, and I was told that her bed had been given to someone else for the weekend. So we had to manage.

My youngest sister (24) took her back to the hospital on Monday morning. We were all told on Friday afternoon that sis was going back on Monday to be taken off her usual meds and trialed on a different medication. We were under the understanding that the transition would be monitored, and that she would stay in hospital until they were sure the mania was under control. Apparently my sister plays the part well - she was discharged at lunchtime on Monday. I was shocked. The doctors had spent all of about 6 waking hours 'assessing' my sister, and she is now at home, largely unmonitored, and still in hypomania. And of course, when I asked my sister about what advice/instructions the doctor had given her on discharge, she either couldn't remember or refused to tell me. I spoke to her 'treating' doctor this morning and he didn't give me much comfort. At one point, he even giggled about the fact that "she certainly pulled the wool over their eyes". In all honesty, I'm a little discouraged by this latest hospitalisation. This time, the family members who see/speak to my sister daily weren't consulted as to her usual behaviour, nor were we asked about her unusual behaviour. Last time she was hospitalised there were family meetings weekly, and update phone calls from her treating doctor. Thankfully, the mental health team in our area is going to visit her tomorrow and will continue for a few weeks, so I've spoken to them today and asked them to be mindful that she will do her best to appear 'fine'.

So, this brings me to a few questions. If anybody is able to offer advice, I will be very grateful -

1. Has anyone/everyone (parents aside) sought legal guardianship/power of attorney, so that in these events you are legally entitled to information from the doctors?

2. Can hypomania/mania be safely and effectively managed at home, when 24/7 monitoring is not an option? If this is something we just have to get used to, then so be it. I'm not sure if we have been treated incorrectly by the hospital/s in this instance.

3. Has anyone else witnessed hospital staff treating patients in a far-less-than-compassionate manner, and is it worth contacting the hospital? The original hospital staff are my main concern; for a dedicated psychiatric unit, they didn't seem very well equipped to care for my sister.

4. Am I possibly just being over-protective because I'm a 'newbie' to Bipolar...??

Thank you for reading my long post. I'm sure this will get easier (if that's the word to describe it) as time goes on, but at the moment it's all very fresh and unnerving...

Cheers all 🙂