My sister was 16 the first time I remember her going really over the edge. She didn't get out of bed for days and when she spoke, she demanded I make the person with the bells stop walking outside our (2nd floor) bedroom window. It was the 60s. I figured she was on something. We tried to hide it from our parents. She just really never came down.
She would go years without obvious bouts with whatever the diagnosis code was. Then, it just got worse. Alcohol didn't help and she could drink her weight, day in and day out, straight up, no chaser. She finally showed up on my doorstep (naked) with no where to go. I took her in. She's my sister. My other sister and mother were pretty pissed off and sick and tired of her shit, so I guessed it was my turn. I could do it. I'd find her help. yeah, right.
She didn't want therapy. She didn't like medication. She didn't like being schizophrenic. She wanted to be bipolar with psychotic episodes. Fine. Can we just call it whatever she likes and medicate however we can? The third time she totally pissed of a psychiatrist who started screaming angrily at me that my sister was 'JUST FUCKING CRAZY' I pretty much lost it. As if that fact absolved him of responsibility to help, to medicate, to be compassionate, to not blame her or me for her genetic brain chemistry. How did fault help? Even if we could point a finger and say "Yes, this did it", it still doesn't make "it" disappear.
She gave up. I didn't. If she didn't want therapy, if she wasn't crazy, then surely to God I was. I got therapy. I learned a lot. I was crazy. I grew up. I carried her when I could and when she became combative, I put her in the local mental health care unit for 3-14 days or however long I could convince them to keep her so I could get some sleep and peace and quiet. Then she would be let out, she would find a bottle, she would crawl into it and the cycle continued. Until I left.
She ain't heavy, she's my sister and I can carry her so long as she isn't fighting and kicking and biting and screaming every fucking inch of the way. Then I can't. I tried. Maybe she tried too. Maybe she gave up too. I did. It just reached the point where she was going to drag me down with her and I just wasn't going to go there. She did find some other help. She did straighten it out a little and for a while, but one medication would work for a few months and then it wouldn't and she was in no way able to figure that out. Eventually, a quart of alcohol a day took its toll and she is gone now.
Our mental health resources have improved dramatically in the twenty years that this went on. I would have a lot more resources now than I had then. She would no doubt have social security and back up and a safe place to live where she could have freedom and supervision. I know now what I would do differently. But absent patient, kind, compassionate people willing to take her mean blasts of shit repeatedly, she would get nowhere. I'm not so sure we have enough people who understand that about mental ill health. Mean is often just sick.