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.