Parent carer of a Bipolar adult son

[Ralaba]

Hi there

I'm a newbie here and unsure where my post fits best so will rely on moderators to decide.

I'm a 72 year old dad with a 32 year old son who was diagnosed as Bipolar 1 in 2022. He spent two periods as an involuntary patient in a Mental Health hospital following mania episodes. He took a mood stabilizer for some months and decided they were unnecessary. He and his partner recently had a beautiful baby and they spent five weeks with us during Xmas. During this time, he often became agitated and there were two serious but short episodes of mania in which he was aggressive, threatening and abusive.They have now returned home and not conncted to any mental health support services. We are supporting his accommodation costs as he has been too unsettled to find work.

To the point: my wife and I are unsure of how best to help him and don't know whom to ask. I would like to ask him does he recall what happened during his recent mania and does he realise how frightened we were for our physical safety. If he does not know, then he will not see the need for medication. Is there a safe way to do this?

He plans to take his child and partner overseas in a few months and this terrifies us a he will not have access to quality care if he exhibits unusual behaviour and deemed dangerous. We cannot raise the issue of medication or any treatment without aggravating him. In short, we dont know who to turn to for guidance.

Any thoughts here?

[white knight]

Hi, welcome

I have bipolar 2 as do some other community champions, peer advisers with lived experience but not medical professionals. I hope I can help a little.

Both bipolar 1 and 2 come under the bipolar spectrum now but there are much difference, they are seen as severe as each other but in different ways and bipolar 1 is noted as being, well, can be more extreme with mania than depression and bipolar the reverse. 

Self awareness- it is a question asked by many here. If he is unaware of the gravity of his behaviour that isnt that unusual and insight is crucial to seeking help ongoing. People with bipolar need a flooding of tact prior to being asked about issues like if they have insight to an event they are guilty of, such is their sensitivity, therefore working with medical professionals is absolutely essential for best outcomes. This is highloghted with "We cannot raise the issue of medication or any treatment without aggravating him." Sadly but expectedly, family will face this scenario and so, I would find other avenues to tackle this. 

As loving parents in this situation realise "you cant save the world" and that downloads to leaving much of his care to his partner and taking a step back. Other important changes could be-

• not spending long periods together. A couple of days only
• more focus on encouragement/praise
• support for his partner
• minding the grandchild giving them respite

Thankyou for posting. Repost anytime

TonyWK

[Ralaba]

Thank you TonyWK.

Your comment "People with bipolar need a flooding of tact prior to being asked about issues like if they have insight to an event they are guilty of, such is their sensitivity, therefore working with medical professionals is absolutely essential for best outcomes" is the nub of the issues we face.

Getting his permission to talk about his condition seems a first step. He acknowledges his diagnosis but little else. Any tips here on how the "flooding of tact"might look prior to raising his health issues and their impact?

Also, how can we as parents access professional advice when we are not the patients?

Thank you and cheers

[white knight]

Hi Ralaba,

Thanks for replying. It isnt an easy art to get the balance right in men generally, the approach that is. So, your son's lack of approachability impedes that as well. 

This is a thread on general approach to men I wrote a long time ago, it might help

https://forums.beyondblue.org.au/t5/relationship-and-family-issues/talking-to-men-some-tips/m-p/6142...

If we put your son into the sensitive section again in general. Up to 20% of all people have HSP highly sensitive person.

https://forums.beyondblue.org.au/t5/depression/depression-and-sensitivity-a-connection/td-p/47148

There could be that invisible issue any families have like contempt due to familiarity. That's where professionals have the impact and ability to say what family members cant. For his parents you would find the move to being his friend near impossible but that's the only way the barrier can be breached, even then he might not.

https://forums.beyondblue.org.au/t5/staying-well/sensitive-break-the-cycle/td-p/361007

I'm struggling to reach the core of the issue being how to get your son to the negotiation table. and 2nd to listen and 3rd to take on board.

What do you think? What have you tried?

Parents access?

1. Carer Gateway. 1800 422 737.
2. Mental Health Carers NSW. 1300 554 660.
3. Carers NSW. (02) 9280 4744.
4. Carers Australia. 1800 242 636.
5. Lifeline. 13 11 14.
6. Men's Line. 1300 789 978.
7. Kids Helpline (children 5-25 years) 1800 551 800.
8. Suicide Call Back Service. 1300 659 476.
9. Beyond Blue 1300 224 636

TonyWK

[Ralaba]

Once again, thank you Tony, for both your reply and the links to previous material. All very useful and insightul.

I understand the contempt due to familiarity" syndrome; thats why I'm keen to search out a legit professional who can reach out to my son for ongoing therapy (and hopefully encourage a more open mind to medication).

The one thing I do  have is a very close relationship to my son. He turns to me to unload his pent up rages and I've spent many calls just listening. When the moment is right, I want to ask him something like" I've noticed that you acknowledge the bipolar diagnosis but never talk about it. Is it because you dont want to or you think we dont want to?". That may take some time to unpack but its a start before asking "do you know/recall what happens when you have a peak mania episode". If he has blanked it or is unaware, he will not ever seek help. Getting the words and the moment right are key, as wll as the patience if it takes days or weeks to inch towards answering. The only thing I can do meanwhile is improve my understanding of the bipolar world and I'm reading heaps.

[quirkywords]

Ralaba

Thank you for your honest. Your posts will help others in a similar situation.

Tony has given you helpful replies and suggestions and support. I was diagnosed with bipolar 1, nearly 50 years ago and for first 16 years I was in denial and aggressive, impulsive, did risk taking , and refused medication and any help because I thought everyone r,se had a problem. I also had 3 young children during 7 years of that  time. I coped with my children but still hated when my parents wanted to interfere even though they were so supportive. 

Your son is fortunate to have you caring for him and it is helpful you have a great relationship. 
we are here to listen and offer support. 

[white knight]

Ralaba,

You really do have much wisdom so thats a benefit. Quirky has some first hand insight into being BP1, along with recalling the early days of risk taking and impulsivity. 

I'm wondering if it is better for you to not use your son as the focus? eg rather than

" I've noticed that you acknowledge the bipolar diagnosis but never talk about it. Is it because you dont want to or you think we dont want to?".  Alternatively- "I was talking to an aquiantance the other day and he told me his nephew has bipolar 1, he told me his nephew doesnt recall any incident that involves a family dispute or outburst. Do you relate to that"?

Then following that depending on his answer to it, rather than- 

"do you know/recall what happens when you have a peak mania episode"

"based on my friends situation do you ever recollect disputes like the one WE had over xmas? not that I want us to recall it too much"

Another idea is to take a printout of a BP1 event off the internet that was an example of violence etc. Tell him you found this event and would like to ask him his  opinion on it. At the end of the discussion "you recollect events though dont you? when you get angry, do you remember them"? and so on.

I think overall you have the level of tact needed, it's just some ideas on fine tuning it to not directly implicate him as the person in error, such implication could set him off again.

It's great you have a close relationship with your son, that is a gift you fully appreciate, a rare thing really with such a serious mental health issue.

your thoughts

TonyWK

[Ralaba]

This is such good advice Tony, many thanks. So much meaning hinges on choice of words and your suggestions are invaluable. Cheers

[Ralaba]

Thanks for the encouragement Quirkywords. I already feel better just putting my thoughts here and having the benefit of the lived experience of others. We are talking to a clinical psych today for advice on moving forward and I will be researching the list of carer support forums that were flagged by Tony above. My wife and I will be chatting with another mum with a bipolar son so maybe its the start of a support group. Reaching out here and elsewhere is a life saver. Cheers

[Elephant86]

I totally understand I am Bipolar 1 and I go through the manic episodes but mine are well under control with medication. I realise the fear and intrepidation your family would be under not sure what to do or where to go. There is always a path and a way to find help. It is hard for the family when there are barriers to receiving care but you mustn't lose hope that a solution will be found. I think getting in touch with some mental health professionals and asking for a plan or steps on what to do next.

I totally understand because my parents went through a similar thing to find a treatment plan for me. The difference is that I decided to take steps to look after myself and my health. I do admit it is hard when I go through my episodes but for me it is a journey of acceptance and great love and care from my parents that was my guiding light in the darkness. You need to be strong and try to stand united and make correct health conditions for your son to bring him back to health.

It is a hard challenging path bipolar but for me I realise that I never walk alone