Great advice from Ellie -- these are important, if painful, questions to ask.
From my own experience, things often do get worse before they get better -- part of the whole process of finding the right meds combo and dosages. It's very important that your sis is in frequent contact with her pdoc during this time. Her pdoc may decide that adjustments or additions to her meds are worth pursuing. -- This is all progress, as these meds can work very differently for people and it's rather a trial and error process still. Although it feels like your sis has taken a step back (and in some ways she has) her current condition is all good info for her pdoc to help them find the best route for recovery. Her pdoc may want to sit things out a bit with the meds to begin with -- can take up to 12 weeks for them to work fully (but there will be signs before then that they're right or wrong which her doc will be able to judge from as to their appropriateness).
You might also ask if she wants someone there with her at sessions -- you may be doing this already. Your sis might find it a relief not to go to sessions alone, and you would certainly find it helpful to be there (helping to give a more rounded picture of how things are as well as having someone there to help you and your sister understand strategies for coping, and you could keep a note of things which might also help your sis, as concentration levels can be down at these times). See what she thinks about this: don't push it (at times like this pressure can make people run), but do offer.
The wedding thing is tricky. I can't even get my ex/partner to commit to coming to a car boot sale at the moment (and he could *really* do with getting a bit of extra cash right now!). I think there are a lot of issues tied up here: feeling that others will be depending on her, and that being too much pressure; feeling that this is too far ahead to think about when she's finding each day a struggle; worry about all the extra things that this will entail in the meantime when she's finding it hard to cope (cutting back on everything she does sounds like part of a sense that everything's too much and crowding in on her); worry about standing up in front of people and being on show when she doesn't trust herself.
As always, the number one rule with all of this is that *it isn't personal* -- to her husband, kids, best friend, you. In fact, the number of people/things she's backing away from should help you to see this more clearly, and I hope will help with a conversation you probably ought to have with your sis's best friend. Does she know anything about what's going on? If you think your sis will agree, why not ask her for her permission to have a chat with her best friend and see if you can't work out a less stressful option for her with regard to the wedding? Better to ask so that she doesn't feel that she's being talked about without her say-so ... but if you don't think she'd say yes, perhaps better not to ask, because I think this might be a necessary conversation and if she says no outright it'd be very awkward to go ahead and do it anyway. Ultimately you and her best friend, both understanding that your sis is ill and that this isn't personal, can probably accept that your sis standing *may* be too much for her even in a month's time (and really this has a lot to do with the preparations in the meantime too). I wonder if there's a compromise that leaves the window open for her to be a part of this if she's up to it but also allows the option of her not being so. Leaving the window open is probably a good idea, because subconsciously this may also be something that's keeping her going. Tricky one. Also one that it would be good to talk about with her pdoc... .
Could you invite your sister to yours for the day and allow her the option of coming online and chatting to us here while she's with you. She may not be able to do the whole day in company anyway, so you could invite her over and say that it's just to get her some peace and quiet, that you have a couple of things to do anyway so if she wants to sleep, fine, if she wants to watch tv for a while, fine, if she wants to go online, fine -- you want to give her space and take her away from any pressures she feels at home.
You are a fabulous sister -- doing such wonderful things to help. Please also make sure that you take time for yourself and that you don't burn out with all this worry. I found that having a couple of books around on bipolar really helps me get a better perspective and relax about what I'm witnessing with my ex/partner at times.
Don't kow how much any of this helps, hun, but you are in my thoughts -- as is your sis.
People are not like fish: they do not work better battered.
Co-Moderator, Bipolar Forum