He sounds like me.... actually he sounds exactly like me. I have SI problems and I hit myself and it comes on in these rage enduced episodes. I've not ever made a nose bleed but I've had huge bruises under my hair that take weeks to go away, (I often hit along the top of my head....) I'm not a cutter. But I get the urge to stab myself, too. I never actually have but I get it a lot. I get the urge to cut off body parts with a finger nail clipper.... It's a very scary and strong urge. It's especially scary when you think I'm scared of being poked (by needles) or cut or stabbed when I'm in my normal state.

Anyway, this flare up sounds exactly like one of my bad episodes. For me they don't happen due to depression. It's a mixed state, a bad mixed state. That's when you're depressed and manic at the same time, and can be very dangerous. I have a lot of mixed states, it comes with because I cycle so fast, but I have this also... it's really hard to deal with it. It feels like everything around you is too noisy, too irritating, attacking you, coming at you, too slow and too fast. It makes me feel like my bones are trying to claw their way out of my skin. Any little argument or frustration can send me over the edge.

I would tell you what to do but no one has ever really been helpful to me when this happens. People just basically tell me I'm a nut case and to calm down. So, I don't know what i would recommend. Usually it's like a volcano where it errupts and then after I feel sick and weak for several hours if not a whole day after. Usually after it stops it doesn't happen again right away for me, but I don't know, everyone is different. I suggest maybe calling his pdoc and letting him know this happened. Maybe when he calms down ask him if he wants to talk about how he was feeling? Does he have a T?

Sorry you're going through this. IT makes me sad to hear he is going through this because I know how it feels and I wish other people didn't have to go through it.