My boyfriend’s sister, father, and I are extremely concerned with his reckless disregard for the people closest to him. We have met a few times with his MD and would like to schedule a meeting with his doc (he previously gave us permission while he was going through ECT - he had 9 treatments w/o success). I really believe he needs an intervention, he is manic yet he displays borderline, and narcissistic disorders even schizoid. He hasn’t worked in over a year and a half and has manipulated everyone including his doc to keep his disablity longer (like flattening his affect whenever we went to the doctor). He now recklessly borrows money, uses credit cards, and is down right vindictive to everyone who took care of him. He is an alcoholic in recovery and he talks the talk but doesnt walk the walk. He thinks that he is unique and that only superior people can tell him anything. He is confrontational and hypercritical and we don’t know what to do.
I am worried about his future functional status and I have separated from him but is there some kind of intervention like for what you can do for substance abuse. I am worried his life is spiralling out of control and because he is manic, he is convinced he is the happiest in his life and in the process has alienated long time friends and family. Please help.
A: The special challenge of mania is that the person who is manic feels on top of the world, superior to others, and perfectly fine. From his point of view, he is right and you and his family are utterly wrong. Complicating things further is that your boyfriend has a substance abuse problem and a personality disorder. I’m sure he could defeat any attempts to help by those who love him and by the professionals.
I don’t know of any community or family “intervention” that would force him to look in the mirror and see what he is doing to himself and others. Sadly, it may be that he has to spiral all the way to the bottom before he questions his own perceptions. Paradoxically, it may be that the kindest thing you and his family can do is to stop trying to protect him and let him hit that bottom (doing what you can to keep him safe). When he is homeless, friendless, and broke, he might finally be willing to accept some help.
Meanwhile, find a consultant for yourselves. A therapist who has years of experience working with major mental illness, substance abuse and borderline personality disorder can provide you with perspective, practical suggestions, and much needed support. Further, meeting regularly with that therapist can lay the groundwork for when your boyfriend finally is open to getting some therapy.
I wish you well.
Dr. Marie
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