My sister is not med compliant- losing everything
My sister (29F) is currently in a manic episode and I’m at a loss for what to do.
She was diagnosed with bipolar I at 24 and did really well on medication for years—stable, successful career (managed a $1.7M book), married 10+ years, two young kids under 3, just bought a house. She was doing really well.
About 3 months ago, everything changed. She had a lot of stress at once (new house, kids, job changes), started smoking weed for the first time, and secretly stopped taking her meds. She then had a severe manic episode—hallucinations, delusions, violent behavior, completely out of touch with reality. Her first ever episode.
We had to call a crisis line. Police came, she was briefly jailed (charges later dropped), and then she was hospitalized on a 5270 for 32 days.
After she got out, she wasn’t fully herself but was improving. She went through a couple medication changes and was probably 90% stable at one point.
Then about a week ago, she stopped all medication again. Now she’s spiraling hard—screaming for hours, talking to herself, hallucinating, completely disconnected from reality again.
She refuses help because she believes her reality is correct. There’s no reasoning with her.
My spouse and I moved back in with my parents so she could stay somewhere safe, and we’re trying to support her, but nothing is getting through.
Meanwhile, her husband has decided to file for full custody of their kids and is essentially giving up on the marriage. He hasn’t told her yet. He told us first.
I’m terrified of what happens when she finds out, but I also don’t know if I should be the one to tell her.
I’ve tried gently explaining that she’s at risk of losing everything if she doesn’t get help, but she doesn’t accept that anything is wrong.
I guess my questions are:
How do you help someone in severe mania realize they need help when they don’t think anything is wrong?
Is there any way to get through to her without escalating things?
Should I be direct with her about losing custody, or will that make things worse?
Has anyone successfully gotten a loved one back on medication in a situation like this?
I feel like we’re watching her life collapse and can’t stop it.
Any advice or experiences would really mean a lot.