Ask Lemmy

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.

Now that my brother has found the right medication, his life is actually going really well.

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!

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.

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.

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.

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.

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!

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.

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.

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.

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.

An important question; type 1 or 2? They're both difficult but type 1 tends to really wreck lives in a dramatic way.

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.

I'm an inpatient psych nurse. I see there are already 40 answers, so what are your specific ones for me?

It depends on the person.

The first bipolar person I (knowingly) met was someone who transferred into my school when I was 12. This girl began to mercilessly bully me. It started with the “usual” things, like insults and shoving in the halls. But it ramped up. She destroyed my class projects. She beat the shit out of me to the point I lost a tooth. I had to get changed for gym in the gym teacher’s office, and she snuck a phone beneath the door to photograph me undressed.

Eventually, I couldn’t attend school anymore, and had to spend the final few years being homeschooled instead.

But, leaving school didn’t make her stop. It’s been sixteen years since I first met her, and it’s still continuing. She still harasses and stalks me, my partner and my family, both on and offline. This ranges from insults and threats sent via online platforms, to physical assaults or vandalized property/vehicles IRL, to one instance of SWATing.

She has spent time in jail for some of the things she’s done to us, but that hasn’t deterred her. Some of us are planning to leave the country soon (not because of her, it’s for other reasons) and one of the things we’re looking forward to is her no longer being able to get to us offline.

I’m aware that she is bipolar. Back when we were in school together, during the many meetings that involved her parents, that was something they always brought up. But (and I’m obviously not in a position to diagnose her) I have doubts that bipolar is the only thing that this person has.

Her parents also excused all of her abusive behaviors during those meetings at school, and continue to do so to this day, which I feel plays a far more significant role in her actions than the disorder itself does. They also said they were not medicating her with anything during those meetings, and were just using talk-therapy as the only form of treatment. I don’t know if she’s taking medication now or not.

So, it’s bipolar, mixed with some other disorder, mixed with absolutely terrible parenting where she never faced any consequences until she was already neck-deep in this cycle. I blame her parents for how she turned out long before I’d blame the disorder.

But, since you want all possible realities, I still wanted to mention her. I think she’s what can happen if something serious is left unaddressed, untreated, and the focus is on excuses instead of healing. To be honest, I feel bad for her in spite of all she’s done, because she needed help at an early age, didn’t get it, and so she’s continually gotten worse. No way is she a happy person like this, and she could have been with a proper intervention.

I also know that how she behaves isn’t how most people with bipolar behave. I’ve met several other people who’ve told me they have bipolar, and they’re very different. Both from her and from each other.

My closest friend with bipolar, from what I’ve experienced with them, mainly struggles from the depressive episodes, will zigzag between feeling worthless and feeling happy. This friend was hospitalized once for a suicide attempt before I met them.

This friend is taking medication and going to therapy, which both seem to help a lot. They said it took time to find the right medication and dosage though, and that certain things made them feel worse and behave in ways they didn’t want to. So, it’s something that needs to be handled carefully and monitored.

My friend only made the one suicide attempt, and has never tried to harm another person. They also have friends and family that would get them help if they expressed suicidal ideation again or displayed any other dangerous behaviors during an episode.

I think one of the biggest factors is just having a proper support system.

My mom was bipolar, but since she grew up in the 60s and 70s her experience probably isn’t going to match your son’s much. Especially since she didn’t even get a diagnosis until her mid/late 20s, after having symptoms for years.

So, the not sugar coated version of what I experienced: she was a drug addict, alcoholic, and would alternate between abuse and neglect. I’m sure part of that was no/wrong meds for a while, plus it culturally just being more okay to smack your kids back then. I saw a lot of screaming and arguing and crying that I thought was normal. She and my dad lost custody of one of my siblings for a while.

So that’s what poorly treated bipolar disorder can look like. That’s the bad place it can go if he decides he doesn’t need his meds anymore and there’s nothing wrong with him, which is made worse by the fact the meds are supposed to make you feel ‘normal,’ and some people prefer the mania to ‘normal.’

It’s absolutely manageable for many people, especially if he stays on top of his meds. It may not mean that he never has symptoms or that they don’t change, or that they never temporarily get worse or better. If he isn’t already in therapy that’s something you should really encourage, because meds are just one tool in the box, not the whole set. You mention a psychiatrist, but they manage meds rather than the emotional aspect, and it’s important to see a psychologist or therapist at least for a while on top of that.

I'm a depressive who goes to Depression and Bipolar Support Alliance meetings. Your son might find some meetings (either online or on person) useful.

If he goes, a friend of mine always used to say that you should try every meeting twice. You try every meeting, because each has a different group 'personality', and you go twice because any group or person can have an 'off' night. If DBSA doesn't work out, there are other groups that may help (NAMI, Recovery, etc), but those have a more general focus that may or may not work for him.

The people at my meeting go there because it provides understanding and support and helps keep them on their meds. I will say that a number of the bipolars in my group have gone on manic spending sprees at times, that they've later had to walk back because they didn't have the money for the purchase(s). Like, at one meeting, one bipolar said they'd been off their meds once, walked into a car dealership and bought an expensive brand-new car. At this point, several other bipolars said they'd done the same thing, with one person adding that she'd bought a horse, and the final person confessing that she'd bought a house. They each did walk back their purchases, but it did cause some stress in their relationships. I don't know if this is typical of bipolars in general or just the people in my group.

I've had a classmate who was bipolar. Super lovely girl, she would sometimes feel more sensible if the medication changed but I've never thought of her as needing to be treated with any special considerations when interacting socially. She got married and had kids and is still going well.

A close friend of my mother was married to a bipolar woman. She tried to kill him with a kitchen knife on one occasion, and in another, she effectively set the house on fire- they lost everything.

So, I don't really know what to say to you. My understanding is that your mileage may vary and by a lot. Personally I believe it's manageable in most cases with proper healthcare, and you probably already deal with several bipolar people day to day - you just don't notice it. But, I'm not an expert so take this with a pinch of salt.

It's absolutely manageable with medication and good therapy.

The medication is there to get them calm enough so the therapy can do it's work. But the medication will probably also be something they need to take their whole lives. The worst seems to happen when people go off their medications, in my experience.

There is also now genetic testing that can be done before prescribing medication so you can know exactly the best biological pathways that your body has. In essense, which drugs are most easily metabolised by your body.

This gives psychiatrists a better path to finding a good set of drugs that can help instead of going in scattershot. Knowing which drugs will be best metabolised by your body avoids wasting time on drugs that don't metabolise well.

I strongly suggest the genetics testing for this and I stress the importance of finding a good therapist your son trusts.

I don't have bipolar disorder myself, but I have friends who have it and have dated women who have it.

So, without speaking from the POV of someone actually dealing with the issue, all I can say is that in my experience, it's absolutely manageable.

The issue I've noticed seems to be with the medication. I've had a friend tell me he hated the side effects so he didn't keep taking them, and would thus swing into a manic or depressive episode until he'd start back on the meds. Similarly, I've heard of people (but not met personally) who take the meds for some time, decide that the meds worked and they don't have the condition anymore and then stop taking the meds. Only, of course, to swing into bipolar episode.

It's definitely got to suck, but I think if you all listen to his doctors (even though one made a mistake by taking him off the meds, they're human, too) and he is able to manage his medications you will all be ok.

I can't speak to his relationship. That's gonna be between them, but it's probably best for all parties to read up on bipolar disorder so they can better know what to expect and what not to fear. I have a coworker whose husband is bipolar and not the best with his meds from what I understand, and while she has some interesting/funny stories and long nights sometimes, they still seem very happy together.

I guess all that is to say: It sucks, but his life definitely isn't over lol. Listen to the doctors, maybe get him into some sort of therapy (if he's open to it), and stick with meds that work. My bipolar friends are all kind, mostly successful, good people. For some, I wouldn't even know had they not told me.

I don't have any experience with bipolar but I just wanted to say how great it is to see all of this support and reassurance in the comments. This is the internet at its best.

Like a lot of things, the answer is "it depends". Probably the biggest factor I've seen is the willingness to accept their condition and stick with the prescribed medications. The worst cases I've seen all involved individuals who either consistently or intermittently refused to acknowledge their condition and take the meds. It usually resulted in some near tragic circumstances that costs them friends, jobs, and the support of loved ones. In one case I know the end result was fully tragic. However, some people who are bipolar have lived mostly normal lives, so not all hope is lost. It just depends on their willingness to deal with their condition head on.

I've got type II bipolar.

The depression side sucks, so I'm lucky the hypomania just manifests as boundless energy, racing thoughts, and an inability to sleep.

Going for a walk in the middle of the night actually feels quite nice.

The depression is much more manageable these days, CBT, some time with a therapist, and self exploration with psychedelics helped a lot I think. I still get the big downer episodes, in one at the moment and I hope it'll clear up in a few days.

What sucks is when a wave of paranoia or anxiety hits. As both those make coping much more exhausting.

But I'm alive, in my late 30s now, holding down a job, have a family, and often have people tell me that they think I'm a great parent.

So it's not the end for your son. Everyone's journey and path is different, and there'll be hard moments - but people are strong and we can find ways to push through and adapt.