The thing with meds is it usually takes about 2 weeks for a lot of them to kick in. So if he's only taking them on days that he's depressed or manic he's not getting the effect he needs.

And things like alcohol I think usually makes symptoms worse rather than better, although he may think it's helping by drowing out everything around him. I mean, alcohol can be a depressant, and alcohol also impares judgement - two major symptoms of bipolar.

Is he seeing anyone at all for his therapy? You can't be a caretaker of someone who refuses to take care of themself. I'm not in treatment although I want to be. And because of that, I try to be more aware of myself on purpose because I don't want to be a burden to my family. I am aware that I have this illness and that if I'm not well, then I have a huge effect on the people I care about. It doesn't remove my responsability from at least trying to fight it as best I can.

If he is unexcepting of his diagnosis and treatment and unwilling to try an actively healthy lifestyle (as if avoiding the alcohol,) then what can you do? You can't save anyone who isn't willing to at least try to save themselves.