Here is my dialogue with fellow church members about dealing with one with whom I work closely who is diagnosed with both bipolar and schizophrenia. I thought it would be helpful to see and to read.
OK here's some info I already know - in general, bipolar causes great mood swings, from depressed where you can't get out of bed and want to die because all seems so hopeless, to manic where you talk a ton, are extremely happy, and feel like you can do anything. In the manic phase, you often feel like you can do unreasonable things, like be able to decide all the best decisions for the church, or commit to too many activities and not be able to fulfill that commitment in the long run. With schizophrenia, you see and hear things that are not there and fully believe they are true. Most often it is paranoid schizophrenia, and the things that seem to be true are telling you that others are out to get you. Both are delusional. Both make you believe things that are not true, and they seem absolutely irrefutably true. Also either one can cause you to be incapable of living on your own, even if perfectly managed with medicine. For example, I currently work in a nursing home entirely devoted to the mentally ill - these people have doctors and nurses closely monitoring the medicines and making sure they are taking them, and yet they are still not able to live alone, and they still get in fights and all kinds of trouble. Also, these mental illnesses come in waves - for years they can be more severe, then for years they can back off. They also often get increasingly worse as one gets older - i have seen women who were brilliant and solid in college be overcome by either one of these and end up in a group home or nursing home for the rest of their lives - completely unreliable, and yet still longing for marriage and still wondering why none of the great men at church ask them out, or why they have not been promoted to the highest level of ministry leadership within the church.
Here's what I learned from a psychologist. I went asking for help knowing how to set boundaries and also what to be able to expect from someone who has both of these diagnoses. While everyone is not the same, certainly, then I discovered that the constant 3 steps forward and then 3 steps backward is what life with a schizophrenic is like. We can't necessarily expect that to get better. We can certainly hope and pray, and we can continue to gently point out the lies when they are being believed, but the way it typically works on this fallen sinful earth (and therefore the way that God allows it to work) is that the lies are irrefutable to her and that we are just out to get her by telling her that they are lies. So for example when the same old lie that "(you name any of the many in our church) doesn't love her and is out to get her and so she's leaving the church," then we can just know that this is the mental illness more than it is attention getting or running away from conflict. The psychologist suggested that we do two things: 1. as non emotionally as possible (as you would with a child when you are disciplining them - try not to show anger or frustration but calmly and straightforwardly ask questions and present evidence) get right to the heart of her emotion saying something like this, :"It sounds like you are really hurting because you fear that ____ does not love you anymore." Therefore helping her identify what is at the heart of the matter. And then 2. ask her what has happened in the past when this same emotion has occurred. Then leave the ball in her court to put two and two together to see that this happens frequently and that she may be convinced that a thought is true and then the thought is always shot down in the end. And if she is going to be able to put two and two together, then that will be an amazing work of the Holy Spirit. Then leave it at that and even encourage the person that she is mad at to call her and tell her that they love her. They don't need to apologize falsely for something that they did not do, but it would help to reach out to her to help break the delusion. But we can also set good boundaries with her by saying things like when she says that she is going to quit the church then we are not going to let her keep making decisions in whatever ministry team she is involved. Let her know that the reason we aren't letting her make these decisions is because she is not committing faithfully to the ministry team, she is threatening to leave the church. So that presents a combo of grace where we overlook a lot because of the illness and of personal responsibility where we give her a consequence if she is going to choose the path again of threatening to leave the church where she is a member and has made a commitment.
One last thing - I Corinthians 12:22 says that the weaker members of the Body are indispensable. I confess that I often see her as very dispensable - as a trouble maker causing the same problems again and again, and as one who just takes from the Body! But the Holy Word of God tells us absolutely otherwise. I pray that God will work in all of our hearts to see this truth and to live according to it.
