My brother is suffering from bipolar disorder according to the doctor and he is taking medicine since 8 years but now a days his position is very critical he couldn't sleep talking anything. Suggest some options what to do.

Dr. Saul PereiraPsychologist47yrs exp

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The mistake your brother is making is that he is not combining therapy with the medication. I hope the doctor has been constantly reviewing his performance with the dosages to make corrections periodically. You must make sure that the person cooperates because many times they do not believe that there is something wrong and would love to quit the medication. Complying with all the medical prescriptions and working in tandem with a counselor for a long time and learning coping skills and techniques to handle the daily challenges the person will face is very important. There are certain adaptations that will suit him during the elation phase and there are certain behaviors that are required during the depressed phases. In the meantime he can do certain things that will give him benefits anyway. Emotional therapy will alleviate a lot of the problems faced in this condition because it is a mood disorder. He needs to particularly look at his levels of anger both for its reasonableness and to express it in appropriate manner. I suspect that much of this anger may have origins in early childhood that he may never be aware of it now. Let him talk to your parents and explore that angle. This information will help the counselor too. Also he will need to check whether there is any genetic factor involved. He must exercise regularly, eat healthily, reduce stress and sleep normally too. If his motivation and cooperation is good much can be achieved. He must have a time-structured schedule filled with interesting and reasonable activities and it must be monitored for compliance and delivery. The reason I say this is that many times he will be inclined to have grandiose notions and confidently believe that he can do without the medication. This will set him back many months in the treatment and delay and sabotage the recovery: forewarned he is forearmed. If this combination of medication with therapy is maintained for at least three years without any episodes or breakdowns, it is possible to taper the medication in consonance with the doctor. Bipolar is characterized by two extreme poles i.e. feeling very high (mania) and suddenly feeling very low (depression). You can ask the doctor for the symptoms he noticed in him for a personal understanding. 

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