Ok, Cary, you get a pass for your own public descent into madness earlier this week. Very good, sensitive and practical advice today.

"Cary". She didn't write to us. She wrote to him.

The ugly little secret about involuntary commitment, or a 72-hour hold or whatever they may call it in your state is that any patient can check themselves out against medical advice as long as they can behave for a short period of time.

My ex has narcissistic personality disorder. She's reasonably intelligent and very, very charismatic, unless you cross her. When we broke up, she had a little break with the reality that most of us live in. She tried to run me over with her car. She threatened to kidnap my children. She threatened to kill me. She followed me everywhere. Then she "tried" to kill herself with a nonlethal dose of antihistamines. I say "tried" because it's very likely she knew (1) the dose was nonlethal and (2) the drug was nonlethal. She just wanted attention.

She was put on a 72-hour hold. She walked out of there within 24 hours, with a diagnosis of "depression" and some sort of prescription. She had a whole new list of rules for me and how we would be continuing our "relationship" in the future. All she did was sweet-talk the shrinks and walk away. Less than a month later she broke into my home and literally stole everything of value, from furniture, to my kids' Harry Potter books, to family heirlooms. She continued to stalk me for years afterwards, despite an active order for protection.

It sucks, but get the police involved because of her criminal activity. Don't go the mental health route.

Two things sprang to mind reading this:

One, sudden personality changes can result from injuries, small strokes, and tumors in the prefrontal cortex. So an MRI should be done.

Two, adding my voice to mad cartoonist, bipolar disorder is frequently misdiagnosed, and this sounds classic. My husband was misdiagnosed as having chronic major depressive disorder with anxiety, and was put on Prozac and Wellbutrin for depression, Buspar and Klonopin for anxiety, and lithium to "enhance" the effectiveness of all these. Over time they tried Paxil and Celexa instead of Wellbutrin, and upped his Klonopin to 10-12 mgs daily (the maximum recommended dose for psychiatric purposes is 4). Throughout all of this he grappled with classic manic and hypomanic symptoms, as well as unusually severe depression.

The problem is that SSRIs, and Prozac in particular, exacerbate the manic state. Sometimes the mania can persist long after the meds are out of the system; they serve as a trigger, throwing the mind out of balance and into a loop it can't escape by itself.

In Type I, mania can take a very negative form, including psychotic symptoms and danger to self and others. In Type II negative symptoms can include irritation and sometimes rage attacks. For my husband, the fact that 10 mgs of Klonopin didn't even make him drowsy should have been a clue to his doctors; the Prozac was exacerbating the mania, and the Klonopin was barely keeping it under control.

Type II is frequently underdiagnosed, and it's only in the past few years that better inventories for detection and treatment have appeared. For my husband, struggling with changing and over-prescribed meds for over two years as different doctors tried to treat him for depression, misdagnosis has been hellish. We had to move to find a doctor who could properly diagnose him, and he's in the process of adjusting his meds now.

If you want to read the diagnostic criteria for bipolar and related disorders, try this as a starting point:

http://en.wikipedia.org/wiki/Current_diagnostic_criteria_for_bipolar_disorder

Good luck, LW!

Your mother is a danger to herself and others. Because of her illness, she is not going to accept treatment.

In cases like this, the law allows her to be taken into custody and treated against her will. The next time she does or threatens something dangerous, call the police. They will come out and question her. If she's as out of control as you say, she'll be taken into custody. At that point, she'll get the help that she needs.

This probably seems extreme, but it really the only way to deal with a mentally ill person who is out of control and violent.

Remote diagnosticians the lot of them. I don't know what's wrong with your mom. Neither do you. But I'd take the advice here like I take chemistry tips from a meth chef.

Short history: I grew up with a mother who was violent and manipulative, alternating rage, violence, and control with brilliant creativity and wonderful support. She has beaten my father so badly he landed in a hospital; she has also been the most significant supporter of my own writing; she burned my father's immigration papers in a rage; and she is also the most brilliant and insightful person I know.

Several years ago, after my father left her, my mother self-diagnosed bipolar disorder, in part because she is an artist and it's known as an "artist's disease." It makes her feel special.

Increasingly, it's been my experience that psychiatrists and doctors diagnose bipolar disorder when it doesn't actually apply, and especially diagnose it when the patient (usually very intelligent) knows the symptoms by heart and can retrofit them for their own condition. Not all medical professionals are bright enough to see through it.

In truth, my mother very likely has borderline personality disorder, a condition that is characterized by unpredictable bouts of rage and by a deep talent for manipulation (or what we people close to them perceive as manipulation). They redefine their own realities and are so terrified of finding faults within themselves that they devote all energies to blaming every problem in their lives on the people closest to them.

Borderline people are almost overwhelmingly women, often mothers.

Because borderline people are so frightened of not being perfect, they are rarely successfully treated because they will not admit that anything is wrong with _them_.

A borderline mother, or any loved one, will suck you dry of energy, love, money, and your own life. If this is your mother, you have to realize her capacity to wreck your life completely in an effort to keep her own whole.

If this sounds something like your mother, there are several resources for helping you deal with it. "Stop Walking on Eggshells" is a book that helps people keep mental stability around their borderline relatives. There is also a website for BPD relatives: http://www.bpdresources.com/supportnons.html

Unfortunately, none of these will help cure your mother. It sounds like her violence has gone beyond the point where it is manageable, meaning you and others might have to involve police. It can't be helped. The important thing is to keep yourself sane and only give as much as will allow you to keep your own life intact.

Whatever is wrong with her, you are never alone. Good luck.