Q: I am 16 and my 15 year old brother has been diagnosed with bipolar for 3 years. He is on medication and sees a therapist but I often feel that it isn’t enough. He is mostly depressed right now, and often goes into extreme rages. He threatens to brutally murder myself and my younger brother (12) generally at least once a week. Sometimes it gets so bad that he is holding
a knife and i threaten to call the police because I am scared for my youngest
brother’s life, but then he will put down the knife and walk away, right after a
horrible rage. Every few weeks I will have to lock myself in my room and he will be banging on it threatening to beat me/kill me…He is so verbally abusive and physically menacing towards myself and my younger brother that I have become extremely anxious and have been feeling sick (stomachache) almost every day due to the anxiety, and it’s affecting my schoolwork, sports, and social life. After one of his rages (the bad ones usually every week/2 weeks) I often feel so badly about myself and him that I want to hurt myself-I feel like he’s ruining our family, making me and my younger brother anxious and depressed. My parents don’t really know what to do other than continue treatment-any suggestions for coping without going to extremes?

A: You are in a very difficult situation. Hopefully your brother will get better with continued treatment but there is also a very real risk that he could hurt you and your family. He has threatened to and has shown physical signs. It’s hard to make suggestions without knowing more but he may need a more intense treatment program such as residential treatment. In this case, he would go live in a facility that is prepared to handle these kind of situaions until he is more stable. It’s difficult to get insurance companies to pay so unless your parents are wealthy or the county helps out, it can be hard to make it happen. You may want to talk to your parents about this option. If its not possible or they don’t seem to be listening to how scared you are, you may consider living with another family member yourself so you know you are safe. I would keep talking to your parents, to the therapist involved, to your school counselor, or to any adult who will listen until you feel safe. And if you need to call the police don’t hesitate to do so. Sometimes getting another system involved can help too. I hope this helps and I hope your brother never hurts you. I also hope he improves soon. He has a geniune disorder that is causing this but you need to feel safe in your own home. Good luck.