Tough Love and Bipolar Disorder

Tough love isn’t always tough. It also isn’t always love. How do you decide to take a tough stance with a loved one who suffers from mental illness?

There is usually a history of dysfunction before a family member or loved one decides he needs to take a firm stance with another family member. Lapsing into a mood of despair and broken promises, a parent may have to confront a mentally ill adult child about his behavior before the household deteriorates into a pattern of chaos and disorder. How do families regain their composure in the face of a loved one who loses all sense of boundaries? What do you do when a household is impacted by irregular sleep hours, isolating behavior, staying behind closed doors for days at a time, or becoming belligerent when confronted? How do parents present a firm stand against losses of personal hygiene, or threats of violence that threaten the normal functioning of the family? It is at times like these, especially after reported incidents, that family members must consider the prospect of taking a stand. This is no easy decision.

So what is tough love and does it work? Tough love comes into play quite often after a family has repeatedly attempted to resort to a moderate approach of reasoning with their loved one, with poor or no results. The household is close to being held hostage to the erratic and/or aggressive pronouncements of a family member who is out of control, firmly in denial, and may have lost a grip on reality.

Tough love is a response to the non-response of a loved one to recognize the need for treatment and acceptance that they are ill, mentally ill. It is about forcing a loved one with little or no insight into facing their situation. Sometimes it means giving an ultimatum of going for treatment or leaving the family home. It is often a last desperate attempt to reaffirm family normalcy and to bring balance back into the household. It is anguish for the family member seeking to regain boundaries.

Does it work? The prospect of turning out a child from the home is a heartrending decision a family naturally shrinks away from. It is only a last resort after repeated steps to get the mentally ill member to seek treatment. Often, tough love begins by making it clear they must see a doctor, take medication, and go into counseling. There are consequences for non-compliance. This is a long way from the assumption the loved one can no longer live with family or have touch with loved ones. Tough love is saying, “We’re not going to pretend any longer that there is not a problem.” It is taking the tough stand that you won’t allow denial to go on, and that there has to be a resolution. You know they need treatment, and you must take the loving action of forcing them to get better. It’s not a cure-all; it’s a beginning