Help for My Boyfriend Who is Bipolar?

Reader’s Question

Hello. My boyfriend is bipolar. He refuses any clinical help because he feels that the medications make him worse when he goes off his euphoric high from the medicines. He just had a depressed state today when he called me and was crying hysterically. He was upset about all the wrong things that he has done in his life, about what he deals with at work (he is a middle school guidance counselor) and what he sees happening in the world everytime he logs onto Yahoo! news. Like I said, he is a guidance counselor and I know what he hears on the job haunts him every night. Some physical signs that I see are withdrawal from social situations, and when he doesn’t withdraw he usually winds up telling people off for societal imperfections and superficialities displayed by the people he is talking to. He has told me that he has been snapping at his students lately. I just stayed at his home until he cried himself to sleep. How can I help him? I told him that I would drive him to a doctor and wait for him outside, but he refuses to seek treatment. I am concerned that he goes back to this job as a care giver when I’m not sure he is emotionally stable enough to help these students. I’m a teacher and I know that when my students tell me the bad stuff in their lifes, it eats me up inside too. But what kind of support can I give to him? I know he is ill. Please provide me with guidance on what I could do for him.

Thank you for your time. 🙂

Psychologist’s Reply

In Bipolar Disorder, the mood swings are more than just mood swings. In the manic cycle, the individual doesn’t just feel good — they feel like they have superpowers! Manic episodes can be highly destructive due to spending sprees, poor decisions, socially inappropriate behavior, and grandiosity. The Depressive episodes aren’t just being depressed or sad — the individual experiences profound depression. As you’ve witnessed in your boyfriend, they become overwhelmed by rapid mind speed, guilt, sleep problems and grief.

In treatment, many individuals with Bipolar Disorder dislike taking medication. Older medications for Bipolar Disorder had multiple side effects. In my clinical experience, it’s not uncommon for an individual to experience two or three profound manic or depressive episodes before they recognize the need for medication. Most folks don’t like to take medication but reality has a way of changing their mind. People with epilepsy will experience seizures without their medication. Others with diabetes, high blood pressure, heart disease, etc. have learned that the stability and protection provided by their medications outweigh the side effects. We now have new and different medications available for Bipolar Disorder that have minimal side effects.

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I’d recommend reading my article on “Chemical Imbalance” available on my website at www.drjoecarver.com. It describes the current neurotransmitter model and how medications work to stabilize the system. I would also encourage him to consult with a psychiatrist and retry medications. If he’s willing to work with the psychiatrist, medications can be identified that are a “good fit” for his body’s biology. Sadly, these extreme mood swings will not fade away and may in fact become stronger with each episode/cycle. His refusal to seek treatment may eventually jeopardize his job and career as well as his friendships.