Bipolar Support Group

I have a close friend of 20 years who is exhibiting textbook manic behavior – no eating, no sleeping, mind racing, feelings of euphoria and delusions of grandeur and even the irritability. I have known him to be depressed and treated for depression but this is the first time that I have seen him manic. He is totally enjoying this state of mind and is completely unwilling to consider the idea that something might be wrong. He has cut off long time friends for even suggesting that he might need help. I haven’t approached him about this because I think I shouldn’t risk his cutting me off – in other words it seems better for me to keep the line of communication open so I can at least monitor his state of mind. Several neighbors and friends have called me because of his bizarre behavior which has been going on about 8 weeks. When I first realized what was happening I thought that it would be over in a few days or a week and I could talk to him about it when he was depressed again but it has continued and shows no signs of slowing down. I don’t think he is a danger to himself or to others but in reviewing materials on the Web I see that the longer he is left untreated the less the chance is for his recovery. He is unemployed and does not have health insurance. For all intents and purposes, I am his family. I did call the state office of mental health and was told that until I was ready to call the police because of his presenting danger to himself or others there was really nothing I could do. I am so concerned and just don’t know what to do. Maybe someone has a suggestion?

If he is truly in a manic state and you observations are correct, then you may have to wait until his moods swing into the depressive side in order for him to agree to get help. It is a classic scenario that when a person is manic, he or she will not seek help because they feel so good. In my experience, when I was left unmedicated and became manic, I only sought help when I became depressed.

I agree with Volante, unfortunately. When manic we just feel so good that it's almost impossible to get through to us that there's anything wrong. To us there isn't anything wrong. If it goes untreated he could become delusional and even start hallucinating or hearing voices. If this happens he may then become willing to get help. But most often, those things don't happen. And he'll only want to get help when he "crashes" into the depression when the manic episode is over. Also, unfortunately, a manic episode can last a long time. I once had one last for several months. I think you're right to not trying to push him into getting help unless he is truly a threat to himself or others. That way you can stay close to him and monitor what he's doing in case he does have problems. And if I were you I wouldn't hesitate to intervene if he does become a danger to himself or others. I hope it works out well for you and him both. Please feel free to ask more questions if you need to.

Thanks for your response Volante. I did think that I would just have to wait until he became depressed but it has lasted so long that I wonder if he is ever coming back. This is an extremely intelligent person and I think he has started applying his intelligence to finding ways that he can preserve his current state. Also I have read that the longer he stays manic the less his chances are for a recovery and that he could incur permanent damage. It has been 8 or 9 weeks. I don't know whether some people can just stay manic.

As I have learned in my own life, "What goes up must come down." I have never heard of permanent damage but I do know that he will not be manic forever. The brain is a very sensitive organ and being manic is very hard on it. I think that is why some of us end up in such a debilitating depression where it is extremely hard to function.

In my case, I had been severely manic for 3 months, went into psychosis thinking that I had superpowers given to me by God and ended up having cripling pain in my head leading to a major depressive episode. It is my fault that this happened because I decided I would try to fight my diagnosis without the help of medications.

My recovery takes about 6 months after severe mania and I have trouble taking on the smallest stressors. Since I am bipolar 1 with psychotic features, there is no hope for me to be without medications as I once strived to be. I learn the hard way that meds are going to be a neccessity in my life for as long as I live.

In your friends case, it would be best for him to talk with a therapist. Hopefully, since you are close friends with him, he will take your advice and make the first step. I hope he does because things can get extremely rough once he goes into a depressive episode.

Volante and RMM thanks for the responses. They were very helpful. I took a look at Volante’s thread on BP and intelligence and found it very interesting. My friend is extremely intelligent as well. He is (when normal) an incredibly good lawyer. His mania is making him feel like he is a super sentient being which he is totally enjoying. He tells me, seriously and joyfully, that he needs ten laptops because one isn’t enough to capture all the thoughts he is having. He was telling me how much energy he has and I kind of jokingly asked if he used any of it to clean up his place which is a mess. He told me that he can’t clean it up; he can’t touch a thing because it is going to be made into a museum because of the great books he is going to write.

He lives in a small town at the moment and he is making a fool out of himself. He has coffee at several places each day and says the same kinds of ludicrous things he says to me. I understand that I can’t really do anything until he comes down because he doesn’t perceive there is a problem but, on the other hand, I worry that he is never going to want face the reality that his behavior has been so bizarre these past weeks. He will be mortified. I can see him being mad at me for not stopping him. Will he remember this?

I realize it is impossible for anyone to answer but it will be easy to tell if he is a danger to others or himself after he does something but how do I know before. How do I know when he has reached that point? He has exhibited the extreme irritability that I read is also a symptom.

From everything you have written regarding his behavior, it sounds like he is bipolar but I am careful about diagnosing someone since I am not a professional. I have done some of the same things when I was manic and after I got medicated I was truly embaressed by what I had done. If he becomes psychotic, he can be a great danger to himself because it is possible for him to think he can fly or something of that nature.

Watch him closely and keep reminding him that he should see a therapist to discuss how he is feeling. The two of you have been close for a while so maybe he will listen to you eventually. But, as I had said, if all else fails, he is going to sink into a depressive episode and you will be able to talk him into it at that point.

If you are really interested in getting educated about Bipolar Disorder, there are a lot of books that can give you a clue as to what may happen with him. As I have read several times on mdjunction, a book entitled "Loving someone with Bipolar Disorder" by Julie Fast is a book to read. It has a red cover and I havent had the chance to read it yet but I plan to at some point.