How to help friend when in a manic phase

[SalClo]

My very good friend has had to change medication. Result has been increased manic behaviour over six months and he will not discuss this with family, and believes his increase productivity is a bonus. He doesn't see the inappropriate comments he makes to friends, the physical impact of limited sleep and increased alcohol consumption etc etc. Family approaches to his psychiatrist and GP have been unhelpful. What do we do now?

[white knight]

Hi

If you or others are inclined to correct your friend it could backfire. A better method is to ask queztions eg

"Do you think it was ok to say that...would it have been better saying..."?

I've had both extremes of behaviour, zombied on too much meds to no mefs. There is a sweet spot with most meds that is just right. He should endeavor to find that happy medium for the sakes of those around him/her

Tony WK

[romantic_thi3f]

Hi SalClo,

Welcome to the forums and thanks for your post.

It sounds like your friend is almost enjoying the episode with increased productivity, and I'm sorry to hear that it's affecting everyone including yourself.

I can see that his episode is affecting him in different ways; increased productivity, lack of sleep, increased alcohol consumption and a couple of inappropriate comments. Are there any other ways that this affects him?

I have a friend with Bipolar and sometimes the downfalls of her manic episodes are that she can end up in hospital because of alcohol poisoning, or her back account runs dry and can't pay her bills - while lack of sleep, increased productivity etc doesn't bother her, the trips to the hospital and not being able to pay her bills will. These are the things that can help motivate her to get help; so I'm wondering if you can find something similar;- something that might help see how his behaviour is more of a worry than a benefit.

You mentioned in your post that the approaches to the psychiatrist and GP have been helpful; I'm wondering if you could elaborate on that? I'm not sure what's been unhelpful but it may be worth trying to find another GP or speaking with your current GP about a different way to help manage things.

[Dr_Kim]

Hi SalClo,

This may sound a bit ruthless to you but I am going to be really upfront with my advice.
 
Poorly treated bipolar is an illness that can drag not only the patient, but their families and friends on a rollercoaster ride of chaos. The good news is that he has a GP and psychiatrist involved ( so yay for that!).

The bad news is that like many patients with mania, he may be blind to the downsides of this aspect of his mood disorder and think it if feels good for him, it must be good , right?

I am surprised that the GP or psychiatrist will not accept information from the family. I get that due to confidentiality laws, they can’t disclose information to the family without the patient's consent, but that doesn’t stop the family sending a letter to the psychiatrist and GP outlining their observations and concerns. 
 
I would also suggest that you decide to put boundaries around what you will or won’t be party to when he is unwell. For example, whilst he is manic .. if he wants to go out drinking , say no. If he says things that are inappropriate, then just say “that's not ok , I’m going to go now”. Don’t expect him to ring and apologise the next day as he won’t “get it” at this point … but you are entitled to not be treated poorly due to the bipolar. 
 
The only exception to this is safety. If he is behaving in such a way that anyone thinks that he is unsafe( at risk of injuring himself or others ) then do NOT ignore and go home. Call a CAT team or an ambulance/police or get him to an ER .