My son has been diagnosed with bipolar disorder. He’s in his mid-twenties, so it’s the average time for onset of bipolar disorder. No family history that we know of, but if it was just two generations back, it probably wouldn’t have been talked about.
He had his first manic episode early in the year. He spent a brief time in in-patient treatment, followed by a period of out-patient treatment. During the out-patient treatment, his psychiatrist started to think the diagnosis was incorrect and she weaned him off his meds.
He has had another manic episode, and he’s back in the in-patient facility. Luckily he was able to get back into the same place he was in before, so they aren’t starting from zero. They started him back on different meds, and he’s much better much faster than the first time.
His fiancee was talking to a friend and someone overheard. The person who overheard said her mother was bipolar and she had to take her to the hospital six times, and she told his fiancee that she should break up with him.
The only experts I’ve spoken to have been the doctors in the crisis center, and I don’t know to what degree they are trying to sugar coat things to prevent us from giving up hope.
I’d rather know the reality.
If anyone has any personal experience they can share, I’d appreciate it. If anyone has any professional experience they can share, I’d appreciate that as well.
EDIT: Just wanted to add to this that we were able to visit him today, and he’s doing very well.
Now that my brother has found the right medication, his life is actually going really well.
My wife of 14 years has bipolar disorder.
My experience with it as someone caring for someone with it is that, when properly managed with appropriate medications, it’s nothing we can’t handle.
Once we found meds that worked effectively, as long as she’s taking them things are fine. She understands the importance of being properly medicated, I make sure she always has the medication she needs and she takes it.
In our normal day to day I don’t think either of us think too much about it. I do know though that there are things that can trigger a manic or depressive episode. Sleep changes are a massive trigger for her, so we stick to a pretty solid routine. She can tell when it feels like she might be on the edge of a manic episode. We check in frequently when that happens, I provide support, and we get her doctors on the phone if we need to.
But in all our time together we’ve not had to go back to in patient treatment once we got our arms around it.
Good luck to you and your son. Just keep in mind that manic episodes are big and loud and people can feel a lot of shame about things they did while manic after the fact. Care, love, support and understanding are the best context to help your loved one find a path that will work for them.
A happy, full, and healthy life for your son is still more than possible.
My wife of 3 years, together 6, I could basically copy and paste your explanation here and it would be 100% true.
We work together making sure the meds are on track, therapy and psych appointments are regular, and she’s a lovely, bustling, fun individual and our relationship couldn’t be better. We have contingency plans in case things go off the rails. I have phone numbers to her care providers for worst case scenarios.
My greatest fear is economic or political turmoil limiting access to meds, because the meds are key.
I was diagnosed with Bipolar type 1.
I also worked in mental health.
The early stages can be tough because the person diagnosed has not yet learned how to recognize and cope with the issues bipolar brings.
It’s not hopeless. I finished university, started a stable career, bought a home, maintained some stable social relationships for decades, have a long term romantic partner. There were challenges along the way, but you generally get better at managing them as you go through more of them.
In addition to whatever recommendations the doctor makes , there are some things that every bipolar person can do to make things easier. If my illness is flaring up, I have a simple checklist.
If you notice a manic/depressive flare up, have you … Slept well? Eaten a remotely healthy meal? Done anything physical? Done anything social? Done anything productive?
Yes, these things will help pretty much anyone if you do them regularly, but they’re especially important for bipolar. They’re also listed in order of importance.
Thanks for your reply.
There were definitely signs leading up to this. As I’ve mentioned, we were a bit too hopeful that the diagnosis was wrong, so we deluded ourselves into thinking it wasn’t happening. Which is strangely comforting because now that we have no basis for believing the diagnosis was wrong, we WILL pay closer attention.
The biggest sign was he wasn’t sleeping. That would be bad for anyone, but he never has trouble sleeping.
Especially for type 1 bipolar, lack of sleep can trigger mania. It’s also very hard to sleep while manic, which can make the problem worse.
Sleep hygiene and sleep tracking were very helpful for me personally. Tracking helps predict manic phases, and tracking helps see how effective different things are for getting good sleep. Sleep hygiene is a good place to start in terms of trying to find what works well for sleeping better.
Like most things in biology, neurological disorders are on a spectrum. So the bystander who chimed in with their opinion should be taken with a grain or salt. It comes down to the patients neurobiology, care team, meds + the associated regiment, as well as their desire to treat the disorder. Neurbiology is a highly unique aspect of every human, so anothers experience with it will be pretty biased by default. I was in a long term relationship with someone who was bipolar, but the only reason we broke up was because we were in our mid twenties and had no real idea what we were doing. If your son wants to maintain his relationship with his partner, thats fully an option, it’ll just come down to staying in front of it!
Type two here, with depression starting when I was 13. Was diagnosed at 21. Mostly struggled with depression and hypomania, and the rapid change between the two. Being diagnosed was maybe the best thing that happened to me. Everything fell into place. It took about 7 years to get the treatment just right, but the medication was mostly working after a year or two.
I’ve been to a lot of meetings, and I know a lot of bipolar people. The thing with bipolar is that when you get the medication right and you do the work, the disease is really manageable. But one of the most frustrating part of the disease is that many suffering from it are not taking their meds or not doing the work. And you can’t force them to either. You can lead a horse to the water, etc. I have been really focused on getting better, but I see the appeal to just don’t do it. One tends to see the disease through rose-tinted glasses. And it is work to just be “normal”. So just saying fuck it and ride the nice initial waves of hypomania/mania can be really tempting. But there is nothing good coming out of that.
I highly recommend reading An Unquiet Mind by Kay Redfield Jamison (and her other books for that matter), she is an expert in bipolar. Both as a psychologist and as a bipolar person herself. Wishful Drinking by Carrie Fisher was also good. I think it is good to try to understand why bipolar people think and do as they do. I do recommend support groups too. Where I’m at there are group meetings 1-2 times a week. Relatives are welcome too. Sometimes there are meetups for relatives only too.
I wish you all the best, and just know that it is possible to live a full and great life as bipolar. There are medication and life-style changes that does wonders, the hard part is sticking with it.
My personal experience is that when things start getting better, always question whether it is really getting better or is it just the manic phase. I have stopped taking medications twice when I started feeling better, only to crash a month or two later.
What worked for me was fixing the depression phase (the more concerning one in my case). I started working out and it killed my depression. And mania never came back. I am not taking medication since at least 2 years now.
Of course everyone is different but you have to try. I know it is very easy to succumb to hopelessness because everytime you get better, you get worse but it is manageable.
Diagnosed BIpolar 1, mostly depressive, but sometimes manic.
I am deathly afraid of the manic episodes that I’ve got some fear of “being too happy”. I’d rather deal with the lows (even the lowest of the low) because at least with those, I can trust myself to lack the energy to be destructive. I am fairly confident that in my lowest, I won’t even have the energy to commit suicide even if I want to.
Mania is a very different beast altogether. It might manifest on a spectrum from “just too wired up for sleep” to, in a couple of really badly unmanaged episodes, going off to an entirely different part of the country on a whim just because “who cares, I’m dying anyways?” Only through sheer luck did I manage to get home safe both times.
That said, honest self-awareness, honesty to the mental health professionals, and sticking to the treatment plan could make it manageable. It’s no guarantee, but it helps.
It also helps to manage expectations: the treatment won’t be on target especially on the first states, while the doctors adjust the medication and the dosage, deal with the side effects, etc. Some kind of faith in the process is necessary, I think–not blind trust, but trust that if you inform the doctors honestly any effects (side effects or not) to the best of your abilities, then the doctors can manage the condition better than if you think “I feel fine, the meds aren’t needed anymore!”
The treatment–the management of the condition is likely to last until the very end, and that’s fine.
About being in a relationship? It’s really up to the person and their partner: I wouldn’t trust myself to go on in a relationship without at least informing my partner about it–and keeping them up to date with “my mood weather report”. However it probably takes experience, a few cycles to get used to it.
Thanks for sharing!
The thing that makes me most hopeful is his attitude. He really seems to be dedicated to making the treatment work.
Sounds like others covered all the bases already but, if you have further specific questions, I’m bipolar and a therapist, and happy to discuss
Hi, I’m currently engaged to a wonderful man who I love very much. He is diagnosed with both ADHD and bipolar disorder, and has been since he was a kid. He’s had a long time for him and his doctor to experiment with which medications work well for him and get him stable, and so, to be very honest, I don’t think I really notice much of anything that I attribute to his bipolar. If he had never told me about it and had only mentioned his ADHD, I don’t think I would have ever known.
I’ll admit that I don’t know very much about bipolar, so it’s very possible that maybe my fiance is lower on the “spectrum” (if one exists - I personally have depression and autism so this is where my first hand experience lies) than your son, but like you mentioned, your son is early in his journey compared to where my fiance is at. But I want you to know that there is definitely hope, especially with parents who love and care for him - and you must, since you’re here asking about him.
If this is your first experience with mental health care, it might be advantageous to research groups in your area for help. For instance, in my area there’s NAMI, which was a big help for my fiance’s mother when he got his diagnosis.
If you’d like to ask more questions about my experience, feel free to shoot them my way!
Thank you for your response. It is very helpful.
I’ve been hopeful because my son has shown that he wants treatment.
When he was weaned off his meds, we all latched onto the idea that the diagnosis was wrong, and I think we missed red flags because we didn’t want to see them. I don’t think we have to feel guilty about that, but we have now gone back to accepting the reality and we know we have to pay closer attention.
I do think that medication is key, and luckily my fiance is very dedicated to taking his pills diligently. If your son is seeking treatment, then that’s a great step in the right direction. And with your support, I think he will definitely be on the right path. Best of luck! I’ll be rooting for him and you :)
Stepbrother has it and ultimately his mother died from it.
He’s fine on his meds, but finding one’s that worked was apparently bad. But once they did he’s fine. Glad he managed to find them, hope he stays on them.
Hi, Bipolar NOS (“not otherwise specified”) here, more down than up. It’s absolutely possible to do great. Like your son, early 20s onset, spent some time inpatient to get sorted out, and have been in consistent outpatient therapy and psychiatry treatment ever since. Completed a PhD program, got married, job market sucks but I’m still optimistic all things considered. I think consistency in treatment, lots of patience, and a good psychiatrist who you can trust are key.
My spiel on the medication part, and some bipolar stigma: some people want to chase the mania, or get a little hypomania and think they’re doing better and don’t need the meds, or think the medication “stifles creativity,” and they give us a bad name. Think Kanye. For every up, there is a down. Not every up is good. The down is far worse. For me, it’s important to remember how bad things can get, because I don’t want that. Whatever side effects and months/years of tinkering with medications are worth it, to me, over losing my spouse, friends, family, or even my life.
Yes, the process of trying medications sucks, but it’s entirely necessary. Also have a good plan for if things get suddenly worse, because they absolutely can — a dud batch of mood stabilizers from when your pharmacy switches manufacturers, for example.
I could literally go on forever, but the tl;dr is that you can do great, just be prepared to put some time and effort into it. And never stop taking medications because you think/feel you’re doing better.
This is the first time I’ve ever heard of a “dud batch”. How common is that? That scares the shit out of me as a person with decently managed mental illness.
I don’t have any real stats, but out of multiple meds per month since 2007, I had maybe two ever fail on me. The pharmacy fixed it immediately and made a note to only fill from a certain generic supplier.
Also, while generics are technically made with the same active ingredient, the rest of the pill can make a difference. There’s one med that I’ve had from about 8 different manufacturers over the years and while half are good, there’s one that makes me extra tired, another that wears off early, etc.
Thank you for sharing!
It’s interesting that you mention Kanye, because the first time they mentioned bipolar in the crisis center, he said he had been thinking about Kanye.
I can share my anecdote about a girl I dated who had bipolar disorder. Take it with a grain of salt.
She was fine until she decided to get off her medication, and then things got chaotic. Sudden shifts from cheery to outraged about little things (not being included in a short conversation with my roommate about fishing), leaving in the middle of the night to walk home through a sketchy downtown area and convinced she would be fine. I worried for her safety and had to walk her home against her protest.
Then there were arguments about conversations that we never had. I don’t know if that had anything to do with bipolar or something else.
From what I can tell the medication made a world of difference. If I knew better at the time I would have tried to convince her to get back on it.
Mental health counselor here.
The outcomes of treatment for bipolar disorder are unfortunately very variable. It depends on how severe your son’s symptoms are, how well he responds to the medications cocktail he’s being given, what that medication cocktail is, and how well he adheres to it.
The important thing is that your son controls what he can control, which is largely whether or not he takes his meds and how much he engages in therapy. Therapeutic skills involve insight/mindfulness work (i.e. how well your son can recognize his symptoms as they’re happening) and resource use (i.e. does he inform his therapist and/or psychiatrist when he notices he’s be king symptomatic). Mania often feels amazing to people experiencing it, so they’re often motivated against treating it when it occurs, and this is major barrier to treatment.
A big component is whether or not symptoms of psychosis are involved in either the mania or depression. Psychotic symptoms are: 1.) hallucinations (false sensory perceptions, like hearing voices, seeing things, smelling things, etc), 2.) delusions (false beliefs that don’t conform to “normal” societal beliefs, like “I am Jesus” or “God has a mission for me”), and 3.) paranoia (i.e. feeling people around you are hostile to you or are spying on you, etc). These can be experienced in either mood state, but are most often seen in manic states.
I would suggest getting in touch with an organization called NAMI (National Alliance for the Mentally Ill) as they have tons of resources for people struggling with mental illness and family members of mentally ill people.
There were hallucinations in the first episode, and definitely some grandiose ideas in both the first and second episodes.
I have some concerns, because some aspects of his care after the first episode were neglected because he was felt he was experiencing too much anxiety to deal with it. That left him without any therapy, and because the psychiatrist had weaned him off the meds, he was unmedicated.
I don’t believe he would have stopped the meds without the psychiatrist saying he should. However, we do need to make sure he has ongoing care, therapy, and group meetings.
An important question; type 1 or 2? They’re both difficult but type 1 tends to really wreck lives in a dramatic way.
We’ll have to ask that. I don’t think it’s been said, although it’s possible that it went past me without me understanding.
This is a really good podcast by an actual psychiatrist about it. Don’t listen to Andrew Huberman and his garbage science.
The important thing is getting the meds right, and taking them faithfully. They really do work remarkably well but figuring out what to take is hard. But plenty of people do really well on them, I have type 2 myself, and I work normally and have lots of friends, and you’d really never know because I’ve been on them for years and am really even Steven and responsible and calm and managing fine.
I think type 1 is harder in many ways because the manic episodes are so disabling, but type 2 is really hard to diagnose and makes you WILDLY irritable. A work friend recently got diagnosed, she’s a very educated physician, and yet she ended up manic, and I do believe she maxed out her credit cards, and was driving recklessly and wrecked her tire, and she ended up hospitalized after telling ALL of her friends and colleagues on WhatsApp, which she has no memory of, as well as being really out of it trying to do clinics. It has devastated her and I’m honestly not sure she’ll ever be able to work again.
https://www.psychiatrypodcast.com/psychiatry-psychotherapy-podcast/dealing-with-bipolar-illness
There are multiple types of bipolar disorder with various features, so take any advice from strangers with a grain of salt, as they probably don’t know the specifics. I have a couple of personal experiences with bipolar disorder in general.
First, a close friend of mine - his manic episodes would usually involve him staying awake for days at a time, and his depressive episodes were pretty bad. Before being diagnosed with bipolar disorder he had some pretty bad experiences with therapy from a “therapist” that clearly didn’t know anything about depression or bipolar disorder, since being diagnosed and settling on a medication he has been much, much more stable. I used to lie awake unable to sleep from the stress of worrying about him, I don’t anymore. He still has depressive and manic periods but they are much, much less severe.
Secondly, an aunt. She had one of the more severe types, but we didn’t know it. She always had bad depressive episodes (and there was apparently an early bad episode of mania that was written off as a one-off mental episode from stress or something) but it wasn’t until she suddenly left my uncle and their children to run off with a married man she barely knew that it became more apparent something else was wrong. I suggested - stressing that I am not an expert in the matter - that it kind of sounded a lot like some of the self-destructive manic episodes I had heard about, not from my friend but from Stephen Fry. I had heard him talk about his bipolar disorder at one of his shows in Sydney, and his past involved a lot more trouble than you’d expect. He has a couple of documentaries about it, but I can’t speak on how helpful they would be. Anyway, I turned out to be right, and so far she seems to be doing better, but it’s still early days.
The main takeaway is there is hope. One thing I took away from Stephen Fry’s talks in particular was that it is vital to keep taking the medication and not to decide, after a period of stability, that you don’t need it anymore, that’s a recipe for disaster.
jsyk, BPD stands for Borderline Personality Disorder, not bipolar disorder. I get them mixed up as well because BPD could reasonably stand for both.
The disorders can seem similar, which leads to more confusion, but they are pretty different in some aspects.
Whoops, I knew that, but I typed this just after waking up. I’ll edit that.
Both times, at the height of the episode, he recognized that it wasn’t right and asked for help.
While sitting in the crisis center with him and waiting for an out-patient placement this time, there was a moment when I was saying he just needed meds to get centered. He objected and said he was centered. I pointed out that if he was centered, we’d all be sleeping in our beds, and he was able to accept the logic of that.
The only reason he went off the meds the first time was because he was experiencing some bad side-effects and the doctor wasn’t certain of the diagnosis. I’m pretty confident that he’ll stay on the meds.
It’s worth exploring different medications to see if there are less side effects, it took my friend a few tries to find one that was effective without intolerable side effects.
Yeah, I spoke to him about that in the crisis center. I told him that it’s going to take time and it’s important to keep trying and to be aware of the possible side-effects so he can watch out for them.
When he told us that he started meds again, he told us what it was and let us know that he asked the doctor about side-effects, so I felt good about that.