Let's Talk Life - Bipolar dilemma

• Bipolar dilemma

Dear Counsellor:

My brother has bipolar disorder and gets very aggressive whenever he is ill. He smokes ganja and cigarette, and refuses to take his medication. I am at my wits' end.

- Maxine

Dear Maxine:

People who have chronic illnesses are faced with many obstacles. They have to contend with the side effects of the many medications and the frequent doctor's visits. It is costly and the patients become depressed and anxious.

Many patients are in denial about their illnesses and do not understand the manifestations of their illnesses. Patients with bipolar disorder tend to get aggressive when their condition flares. This is usually the frightening aspect of the condition for the patient, the family and the public.

These problems can often be dealt with by providing close supervision in a residential setting for some time. Facilities are available for assisted living in group homes. In these facilities, the medication is given as prescribed and a routine is adhered to. Patients are encouraged to attend to their activities of daily living and their hygiene. Group meetings are held daily and patients are taught how to cope with their illness.

In such settings, patients and their families are educated about the illness and about detecting early relapse. The intervention is intense and patients have to abide by rules. Some patients can maintain their jobs while living in a group home. The group homes provide a therapeutic milieu that will facilitate recovery, maintenance of good health and normal living.

Some patients who live at home receive monthly or biweekly injections. A specialist nurse can visit at home and administer the injections. Most of the medication for mental illness is on the National Health Fund list of subsidised drugs, and visits to public hospitals and clinics are free of cost.

If a problem arises, you may take him to the emergency room or to a private doctor. Physical health needs to be addressed, as well. He will require an annual medical check-up or will need to be seen more often, if there are other health challenges.

Smoking is bad for you and so a residential facility, where he can be detoxified and rehabilitated, would be good for him. The ganja is making his condition worse. Not everyone can smoke ganja and remain well.

• Temper tantrum

Dear Counsellor:

My three-year-old son is having problems in managing his anger and frustration. He will break his toys and spill things on the floor. He screams whenever he doesn't get his way and he is quite stubborn.

- Elaine

Dear Elaine:

All children go through a phase when they are trying to exert control over their environment. At this stage, he has to learn self-control and you will have to help him. He needs to learn boundaries.

What he is learning now will be used for the rest of his life. He needs to learn to use words to express himself, and to choose appropriate behaviour for different situations.

Teaching techniques have to be age-appropriate and repetitive. As a parent, you have to maintain a calm mood, as you are his role model. He needs to be shown that some things are dangerous and that he will not always get his own way. Don't give in to the screaming in public places; you may even have to leave him at home for a while. Constant dialogue is needed as you teach him these necessary life skills.

I am sure you have heard about emotional intelligence and so you need to teach social skills. Remember that he won't understand most of what is being done and said, but you will need patience and tolerance.

Catch your son doing good things and reward him with praise, hugs, kisses or a favourite treat. Give him plenty of love and tender care, and don't feel guilty about disciplining him. He needs to learn to soothe himself when things go wrong or when he doesn't get his way.

Time-out is a helpful technique for tackling temper tantrums.

For advice on personal or family problems, email questions to Dr Yvonnie Bailey-Davidson at yvonniebd@hotmail.com or call her at 978-8602.

Yvonnie Bailey- Davidson