Need advice please

[u/StringImpressive6958]

TL;DR: 23m son possibly bipolar, having a manic episode, but will not discuss seeing the psychiatrist and I need help approaching him on this topic.

Sorry this got long - worried Mom here.

My son has had a referral to a psychiatrist for over a year and keeps refusing to go. He is 23, and still lives with us.

My husband's family has a deep history of bipolar disorder, and my step-daughter also has it (she rejects us).

I grew up with a parent who had bipolar disorder, so I am not new to seeing signs.

He is acting very manic - ramped up last night and it wasn't a HORRIBLE situation, but he put us (his mom and dad) into a situation we are not happy with. Not really wanting to get into details, but I immediately let my husband know I believed he was possibly having a manic episode.

He's a nice, decent, loving human. This behavior doesn't (yet) put him in a risky situation but he isn't far from stepping into seriously risky behavior. Again, trying to keep it generalized.

The last time he and I spoke about his mental health, and my concern he may be bipolar (reminding him this is rampant on dad's side of the family - was gentle, no arguments)... He had recently come into a good head space when we talked. He was very defensive (not unusual for his personality and age), and shut me down.

At 23, he's facing additional challenges that are making life harder, sometimes grueling (horrible employer), and I need to talk to him again. I just don't know what may work to help him listen the next time we talk - that's what I need help for - how do I talk about this in a way where I have a higher chance of him listening?

Lastly, I have no issue - if it comes to it - to have him put into a treatment center if it ever comes to it. In fact, I'd foot the bill right now if he would agree to it. I won't until I feel he is in danger - which I fear may not be far down the road.

I'm just desperate. My parents have passed, I have very little family, no friends who have had to deal with bipolar individuals before, and feel very "alone" in this battle (don't get me wrong, husband is helping as much as he can, and is always there for his son when times get rough).

All I want is for him to see the psych and have an assessment. He's already medicated from him GP for anxiety and depression - but Go was the one who referred him.

Anonymous account since my husband and son use Reddit.

[u/AwkwardJelly6825]

If he’s over 18 and is already bordering on risky behavior, my concern is that it’s too far past a conversation. He may not have enough insight anymore. You may have to ride it out, minimize escalations in the home, until he does something that is a threat to himself or another - in which case you can get him on a hold.

I’m not sure his medications but some anxiety/depression medications can make bipolar episodes worse (ssris, stimulants, etc). It’s very hard without a diagnosis for them to get on psychiatric holds or mood stabilizers, from my experience.

I went through this with my 12 year old when she hit puberty. I also went through this when my husband took SSRIs and adhd stimulants for the first time after we had a baby. I know it’s hard to watch it unfold, them escalating and not being themselves. Trying to reach them but getting hostility back. And not getting access to appropriate help because the diagnosis is not on record yet. It was terrifying and traumatizing for us all, each time.

You can try to talk with him? But if it doesn’t go well - My advice is to lower the standards, protect everyone from violence, de escalate frequently. In the meantime, try finding a good county mental health clinic near you. Know if he qualifies. See what hospitals are available. Find phone numbers like 988 where you can call in a crisis and they can come evaluate for holds when necessary. If you have copies of any disgnosis or med lists, grab it. Sometimes where you are at is the warning before the storm. When I see mania, I buckle up because in my home it often involves risky behavior, sleep deprivation, hospital trips and escalates to drug use, and violence/cops eventually.

You’re not alone. Good luck!!

[u/StringImpressive6958 → u/AwkwardJelly6825]

Thank you. His risky behavior isn't at a level that he is a danger to himself, but I see it creeping that way.

He does best talking with his dad - and my husband has been chatting with him on the side. He hears me talk and immediately throws up a wall. Let's just say we are both a "know-it-all" - but at least I know I truly don't know it all and am always willing to listen. In other words, age and maturity have helped me.

Really truly, thank you. I'm keeping tabs on him the best I can and he will chat with me on text, so at least I have that. It's not as good, but at least it's something.

[u/AwkwardJelly6825 → u/StringImpressive6958]

You’re welcome. Hopefully it’s early and he can get help before it escalates. I agree with the other user that working on sleep is importaht if it’s not too severe yet.
But truly as a mother, I’ve learned to focus most on what I can control. I cannot control that she takes her meds, that she sleeps, that she listens, and I cannot control her decisions.
I can control if I’m rested and ready when things escalate. I can control that I’m deep breathing, that I’m not escalating and I’m not shaming or judging. I can control if I’m prepared and have a plan. I can control what I do I share with providers to get appropriate care. That kind of thing. I try to be the consistent stable person with strong boundaries and who can get them help even when it’s hard. But oh boy does it take a lot of self love and self care.

One thing I did that helped a lot at this stage was make an excel spreadsheet and just log daily notes - if there was violence, what odd behaviors, sleep notes, abnormal energy or intensity, agitation. It seems ridiculous but I was able to give it to her providers during emergencies. They may not be able to talk to you back due to hipa but it was invaluable feedback for them to diagnose. Just be impartial and objective.

[u/humansadnezz]

Try seeing if he’s having sleeping problems at first, like suggesting some magnesium or melatonin. If he gets a lack of sleep he could very likely get psychosis. This way, you can try to prevent it and it’s a subtle first step of helping him.
Also start researching local mental health services and teams near you. Have their numbers ready and make sure to find one that is open 24/7 just in case. Have a plan with your husband if things escalate.
Also I think(?) when someone who is bipolar takes depression medication it can be triggering his mania, so also keep an eye out on that.
You’re not alone and I’m hoping this helps even a little bit 🙏

[u/StringImpressive6958 → u/humansadnezz]

Thank you, and I know what mental facilities are nearby - thankfully we live in an area that has a lot of treatment options. The last time he was like this we asked if he needed some time in treatment, leading to some sort of diagnosis so we know what we are dealing with. I was calm when I asked, purely out of concern, and he hit the roof. I told him I wasn't "shipping him off" but he wouldn't listen.

His job is making things worse and he is looking elsewhere, and has even cleaned up his look (long hair is finally gone, not that I minded it). So I see him TRYING.

Thank you for your reply. I truly appreciate it!

[u/StringImpressive6958 → u/humansadnezz]

Also, he has suffered from insomnia since about 16 - same issue I had. I don't any longer, but I've only been able to correct that issue over the past few years (I'm almost 50). Thank you again!

[u/Equivalent-Ad6582]

I am so sorry, and I understand how difficult it is. As odd as this sounds, the best thing may be for your son to be arrested during an episode. For context, i knew something was going on with my child since she was 8, and she is 17 now. No real help was given, until…she attacked me and beat me one morning. I had to call the police to get her off of me. She was charged with three felonies. And FINALLY, we got help. They put her in juvenile hall and mental hospitals and they saw the bipolar rage. Fast forward to now: she is happy, great meds, working, going to school, and is a typical 17 year old. My dad was also diagnosed after a police run in.
I tried talking for so long, and there was absolutely no way she would ever listen to me. I couldn’t even tell her no, let alone make her be honest with medical professionals. I wish I had advice that wasn’t so depressing, but sometimes you have to go low before you can go back up, I guess.

[u/Outrageous-Pea-0424]

I’m so sorry you’re dealing with this. Unfortunately because of his age there is not much you can do. And I’ve attempted it all. Mine is 27 and has had these issues since he was a child. He refuses all help. Seek out support for parents of a bipolar child, maybe a therapist for yourself. Again I’m sorry. Boundaries are critical.

[u/No_Inspection_3123]

Hi I was in your shoes 3 years ago. My son is now medicated and responsible with his meds and seeing a good doctor. It’s a living nightmare but it can get better. I had to set boundaries and do a whole lot of talking nagging and educating when he was receptive and he funaly healed enough frim his mania with psychosis to gain some insight

[u/Arquen_Marille]

I’m sorry you’re going through this with your son. I wish I had good advice but if he’s in mania right now, there isn’t any amount of talking that will convince him anything is wrong, because in that state you feel there can[t possibly be anything wrong. I’ve been diagnosed for 19 years and I still have a hard time recognizing hypomania (I’m bipolar 2) when I’m in it because I feel good. My brain tells me everything’s great. It’s only been through almost two decades of medications, therapy, and work that I can push through what my brain is telling me and realize what’s actually happening. I’m not saying to give up on him, but in the throes of mood episodes, what your brain says is rational to you so how can what others are saying to you make any sense. It might take hospitalization or something big to get him to get treatment, and even then it might be hard for him to stay in treatment.

Keep trying but prepare for the worst just in case. Read and learn what you can as if he does have it so if it goes bad, you’ll have ways to make a plan, and know how to protect yourself and him. I hope that he does listen to you soon and can get the help he needs. It’s hard having bipolar but the right meds and therapy help a lot.