Q. My brother was diagnosed with bipolar disorder about a year ago (4-20-04). He was undergoing his “manic” episode for about 2 months and then everything got back to normal. My family and I, we even had to hospitalize him because things were really getting out of hand. We were started to fear his presence and the unpredictability of his actions. They (psychiatrists) gave him medications and sent him back home. He took them for a certain period of time (do not recall) and then stopped from taking them when everything went back to normality. But, that’s the thing. A year has passed and I’m now (6-6-05) sensing the symptoms in his actions; he is spending money uncontrollably and speaking without making sense…he is constantly missing days from work and college…he is also abusing alcohol. I want to stop him before he destroys his whole lifestyle. How can I do that? He is 20 years old, I cannot take him to the hospital without his approval. He refuses to believe that he has a problem. He is an adult, but he doesn’t know what’s going on. Everybody is noticing his change, and I’m trapped. I don’t know how to help him out. Please reply ASAP, I need advice. Thanks.

A. Your brother is experiencing a classic manic episode. During this period, it’s common for the person who is manic to deny that anything at all is wrong. During the period of mania, he will experience euphoria, a sense that everything is right. All you can do is talk to his psychiatrist, talk to your parents and try to talk to him. And yes, mania is dangerous to him. Someone who is manic is likely to hurt themselves in many ways, spending too money, gambling, drugs, even criminal activity. Try to observe him, try to talk to him, try to make sense to him and then recognize that there is nothing more you can do. The hardest thing to do is to help someone who is in denial of a problem. If they do not believe in their heart that they have a problem, it’s virtually impossible to help them with a problem that “doesn’t exist”.