Brother giving bipolar niece alcohol as a treatment

By Kristina Randle, Ph.D., LCSW

Q. I need help trying to convince my brother and his wife that it is dangerous for their daughter who is 18 and has just been diagnosed with bipolar to not allow her to drink or for that matter encourage it. My brother was diagnosed himself about 10 years ago and since starting on his medication he rarely drinks. His wife is a chronic drinker and some in the family are convinced she is an alcoholic.

My niece was just diagnosed and she is still in her first manic period. We were all at a family party over the weekend and I noticed that my sister in law was giving my niece cocktails. When I approached them about it to let them know my concerns they tried to justify it by saying it is better if she stays off the meds as much as possible and that the booze will help her with her manic episode more than the medications.

I was upset, but obviously she is not my daughter to raise. She is taking Risperdal, Choldapin and zoloft. Her doctor wants to include depakote as well. My brother is convinced the medications will make her worse and that the alcohol will calm her nerves. I am desperate to convince them that alcohol is not the answer. Her mother already has a drinking problem and I have read that many people with bipolar have an increased chance of becoming addicted to some substance later. Because she has just started taking these meds, my concern is also that they don’t know how the meds will work and if there is other substances that it may interfere with their ability to work. Please help me to convince my brother to get her to avoid any alcohol.

A. You are right to be concerned. Your brother’s approach to helping his daughter, your niece, is not only wrong and irresponsible but dangerous. Alcohol mixed with medications is a dangerous and potentially deadly combination. Many of the medications that you mentioned should never be mixed with alcohol. Alcohol, without mixing it with the medication, indigested by someone experiencing mania can cause the mania to worsen or even cause her to become psychotic. Your brother is certainly taking the wrong approach to helping his daughter get better. But you already know this.

There may be great difficulty in getting your brother and his wife to listen to your concerns. I do not know what your relationship with him and his wife is like. If it’s a good relationship and they respect your opinion, then the best way to handle this is to clearly state your opinion. If the relationship is not good, and it seems that they have already made up their mind on how they are going to approach their daughter’s treatment, then you may have a much more difficult task. The best that you can do in the latter situation is to say something like “I know that you may not want to hear this from me but I am coming to you out of concern for (her name). I know that you love her and you are trying to do the best that you can to help her and I love her too, that’s why I am here. You don’t have to like what I have to say or agree with me but I want to tell you that I have informed myself about the dangers of mania and drinking and I am very concerned with your daughter’s drinking. Alcohol may help you soothe yourself or calm down and that’s fine but it can have the opposite effect on someone suffering from mania,” and so on.

Your main goal is to approach your family calmly and respectfully and not in a confrontational manner. If you confront them and yell in anger, this may serve to shut down all lines of communication. As irresponsible as their advice to their daughter has been, they probably know no other way to help her. You may have to show them a new way. If you approach them with understanding and compassion, expressing your concerns, you may be able to get them to listen to you long enough to hear your message.

You can also try talking to your niece. If you come to them with compassion and share your message, and they still reject what you say, you must realize that there is nothing else that you can do. You will have done all that you can. You do not have the power to force anyone to do anything (neither does anyone else) and that is a fact of life. I hope this helps you in your difficult situation. Take care.

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Last reviewed: By John M. Grohol, Psy.D. on 4 Sep 2007

APA Reference
Randle, K. (2007). Brother giving bipolar niece alcohol as a treatment. Psych Central. Retrieved on August 29, 2014, from http://psychcentral.com/ask-the-therapist/2007/09/04/brother-giving-bipolar-niece-alcohol-as-a-treatment/

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