Recognizing an Espisode; The Next Step?

Hi everyone.
I'm new to this forum & this site, but I'm desperate for help. I've been with my boyfriend for two years and he suffers from Bipolar Disorder. He's been hospitalized twice from episodes and became an alcoholic. He's tried different medications like some of the ones I read here like Seroquel, Abilify, etc., but he had all of the side effects, lies about taking them and everything else, and more. He's been doing okay for a while now, but I'm noticing the signs again that I had missed the first time. I think he's going to have an episode soon, but I'm not sure of what to do since he lies and just disputes treatment. How do I react and bring this all up? I want to know from others that understand how he feels to give me the advice on how to approach this and what to do next.

Thank you,
his_girl418

welcome to pc, his girl! i'm so glad you found us.
i am bipolar and i hope i can help in some small way. the site has many resources for you on bipolar. also many bipolars resist taking their meds in a regular fashion and of course this only brings on more episodes, in my humble opinion (IMHO).
does you bf have a therapist (T)? if so, encourage him to talk about this with his T. perhaps the T can explain this process to him and then he may be able to do as suggested. my T asked me to promise i would take my meds. if i decided to go off them he asked i call him first. that worked for me cause one, i keep a promise and i think my T knew this and two, agreeing to call him first helped me know maybe my thinking wasn't clear.
you mentioned the bf abused alcohol. does he still drink? if he does, it will muddle his bipolar mind and counteract what the meds are supposed to do.
i know this isn't all the suggestions that will help but i'm sure others will respond to you too. i've been stable with my bipolar for over 10 years. i contribute this to my meds and my therapy.

First of all let me tell you that I think it’s great that you are sticking by your bf. It’s not easy, I am sure. Bipolar is not an “easy” illness for anyone, including the family and friends. But it is not hopeless.
You are asking a tough question. There are no easy answers. Every bipolar, just like every individual, is different. But, I’ll tell you what I think would be helpful for me and hopefully other people in this forum will tell you what’s helpful for them and between us all; we can get you some help with your bf.
You have definitely come to the right place! We CARE!!!!! We will do our best to advise you & support you.
What your bf does is called “non-compliance”. Non-compliance is when you don’t take your meds, or you don’t take them as prescribed, you lie about it or sneak around about it, you don’t go to your doctor appointments, you lie or keep secrets from your doctors/family/friends about self-destructive things you are doing, about missing work… That is non-compliance.
Non-compliance is just part of bipolar. He is not doing it to me mean to you. (He may even be doing some of it, because he thinks he is protecting you!) He is actually, probably, doing the best he can. The thing is, his “best” just isn’t good enough and he needs people to step in and help him to do better.
The standard treatment for bipolar is: 1.Long-term Medication 2. Long-term Psychotherapy 3. Stress Management.
Medication is a tough one. There is no magic pill that works. There isn’t even a magic combo of pills. What meds work for one person does not work for another. Sometimes meds work great for a while and then stop working so well and you have to switch to others. Medications have side-effects, some side-effects are intolerable to a person. So, there is a lot of experimentation involved.
Plus, there are lots of reasons too that a bipolar will stop meds or not take them properly. Lots.
And it is very important to NOT drink. Drinking and drugging interfere with meds. And even all by themselves alcohol/drugs mess up the bipolar mind BAD!
Medication is not going to cure bipolar. But without medication, bipolar usually suffer a lot more thatn if they didn’t take it at all. So, meds are important. Just not easy.
In dealing with non-compliance…
For me, I tend to brush people off. I try to keep my family and doctors at a distance, emotionally. If they bring up that they are worried, I push them away somehow. I do not want them to be worried. It makes me feel guilty for causing them pain. I makes me feel scared that they are going to try and “help” me and being “helped” does not always feel “good” to me (it’s a complicated ‘bipolar’ thing that would take too long to explain) If I can keep from actually discussing how I am doing and how it is being perceived by my family and doctors, I can avoid all of that. So, that is what I do. Not too smart, but that’s the way my mind works.
One can push away in a number of ways. Just cleverly changing the subject, or getting annoyed and claiming it not a good time to talk… It is manipulative and childish, but tends to work.
Don’t let him do that to you. Find a way, to make him sit down with you in a safe place when there is plenty of time available to have a long talk.
You, “his girl418” have every right to all of your feelings of fear, anger, desperation, sadness…I am just suggesting that when you are sitting down to try and talk to him aobut all this, it might be best to keep thise feelings low key. Don’t be unemotional or monotone or unfeeling. Just remain calm.
You need to , at least appear to be, strong. It’s ok to tear up, but try not to break down and cry. Try not to lose your patients, even if you are frustrated. Crying, shouting, pleading…is very scary for me. I won’t react well. It won’t help me to be compliant. I’ll just say whatever it is I think you want to hear and then I’ll go back to my merry non-compliant way.
At the same time, don’t back down. If he is being unreasonable and he will be (if he is reasonable—be suspicious) , don’t lose patients, but don’t back down. Repeat what you say. Sometimes, I might even be persuaded to agree with something and then 5 minutes later I have forgotten, so I need to be reminded. Even after 5 minutes! So, don’t be afraid to repeat. Even if I get annoyed and say---you just said that! It still helps for me to hear things said again, because I have trouble holding on to stuff in my mind and heart.
If someone sits with me, and very calmly but very caringly talks to me and explains to me over and over what I need to do to help myself and then offers to help keep me on track, I will usually listen.
But, they have to follow through. If they offer to help me keep on track, we have to make a specific plan to do so and they need to stick to that plan just as much as I do. If they just offer vague help—it’s not helpful. We might as well have not even had the conversation and things will just go back to the way they were.
You need to make a plan with your bf. More than one plan, even. And specific plans. You may need to write things down, too. For example, a plan to take meds, which would include making an appointment with the doctor, when , specifically, to make that call, and actually make sure that he does make that call. Simple plans are good too-- A plan for where to keep the pill bottles, what time of day to take them… An important plan could be for what to do when it’s time to swallow those pills and he doesn’t want to. A good plan could be—If I don’t feel like taking them , I go get my gf and talk to her about it. OR if I don’t feel like I can talk my pills, I go to the phone and call my therapist, or I take a walk around the block, or I get out my discharge papers from the last hospital I was in and remind myself that I don’t want to go back—whatever works for him. You just need to come up with a plan!
And you, yourself must stick to the plans too. Whatever your part in the plan is, you need to stick to it. So, don’t agree to do anything that you have doubts that you are capable of. And be honest with yourself and true to yourself. If you aren’t up for it, it is OK. You need to take care of yourself FIRST.

Hi His Girl - I'm pretty new to this site too and I'm going through the same kind of situation, only I'm the one with bipolar and depression, and my bf is in your situation, trying to be supportive in such a difficult situation.

I drank A LOT for a very long time, and my Pdoc wouldn't even put me on mood stabilizers until I stopped. As a matter of fact, she wouldn't even diagnose me with bipolar because the one time she'd tried putting me on a MS, it interacted VERY badlly with the alcohol. Alcohol is one of the main triggers of depressive episodes and erratic behavior, and it's very very verrrryy hard to get that through to someone whose drinking is out of control. As horrible as it sounds, really, if they're not willing to make an effort to stop, there really isn't much that anyone can do except to let them know that you are there for them.

It could be that he's just not ready to give up his lifestyle and start facing the reality of bipolar disorder. It took me years to finally snap out of the denial and realize that I'll see my own life as crap forever if I don't accept the assistance and advice of those who know, and those who care.

My bf is just now reading a guide on bipolar that's for both those with the disorder and those around them. I think it's helping him to recognize triggers that I don't even recognize. My advice is that maybe a book will help you to find ways to live through this process along with him. There are so many, the one that I gave him that I think is the best is "The Bipolar Disorder Survival Guide" by David J. Miklowitz.

Your bf is very lucky to have your support. You are a saint for being there for him. And you have got my support

First of all, let me commend you on sticking by your bf....we are not the easiest people to love/understand/deal with...we don't mean to be...we just aren't.

It's hard for strong personalities and men to admit we are "sick" and medication is needed to help us to be functional. We think we should just be able to handle things on our own. And, we are embarassed when we have to finally admit we can't. As mention above, we are notorious for non-compliance. Maybe for this reason.

"Self medication" is another bipolar trait of some....my nephew who is also Bipolar I Rapid Cycling, as I am, self medicates with across the counter diet pills when depressed and alchol when manic.....I on the other hand fight tooth and nail with my Pdoc on any additional meds or increase in meds to control my disease.

I hope that your bf will see what a devoted and loving person you appear to be and, if not for himself but you, will do what he is suppose to do for his own mental health and in turn yours.

Peace of body and mind.