I don't know how to help him or myself
December 2, 2012 6:21 AM   Subscribe

My boyfriend of 8 years just had what looks very much like a manic episode. It involved him doing incredibly stupid, dangerous stuff with alcohol that got him arrested. He's out of jail now, he's in touch with a lawyer... So, the legal stuff is as settled as it can be right now. But now we're dealing with much larger psychological issues, and I am desperate for advice.

I'm a 30 y/o woman, and he is a 30 y/o man. We live in Washington, but I don't wanna give more info than that.

He has a history of bipolar disorder in his family. His brother and his mom have both had manic episodes that were seriously dangerous in the past. He's always been scared of being bipolar, but he's never had an episode of mania before. Instead, he's only ever sought treatment for depression. He's on a medication for depression that can exacerbate symptoms of bipolar disorder. He is acting depressed now. He is in no way a threat to me, and he is not currently a threat to himself but he has a history of self-harm.

He has no health insurance. There's an assistance program that got him three free sessions with a therapist in the area. He has seen the therapist (NOT psychiatrist) once and is scheduled to see him again next week. But the therapist is out of town right now and cannot be reached.

I do not want to describe the behavior he exhibited, but I want to stress just how incredibly out of character it was. The behavior he describes, like the things he did and everything, just do not match the man I've known for so many years. And his actions were insane. I mean that literally. They were insane behaviors. I am terribly frightened, and he is terribly frightened. The only thing I really know right now is that he needs help, and there's very little of it I am able to give. I'm not a mental health expert, I'm just his girlfriend. I love him terribly.

I would be so grateful for any advice you may be able to give. First, do you know any resources in the state of Washington that may be able to help him? Would AA maybe be helpful? He's not an alcoholic, but his behavior did involve alcohol.

Second, do you have any advice for me? I feel lost and helpless, and angry and shamed, and worried and sympathetic, and.... and I don't know. I do not feel like I know how to handle this, and I am flailing. I could use help making sense of what is going on with him, and with figuring out what I can / should do to help. I also am desperate for advice about what I can do to take care of myself, while all of this is going on around me.

Thank you for any advice you can give.
posted by anonymous to Health & Fitness (8 answers total) 1 user marked this as a favorite
Is he willing to check himself into a hospital? Even w/o insurance, they will have to ensure that he's stabilized.

Does the therapist have anybody who is covering while he is away?
posted by angrycat at 6:34 AM on December 2, 2012

I'm so sorry that this happened. I hope that you and he are able to get support you need. I know that many manic folks end up needing hospitalization to find the combination and dosing of drugs they need, and to keep them safe in the meantime. Find out if there is a "mental health crisis center" in your community--they are sort of a one stop shop for assessment, hospitalization if appropriate, and referrals to other services. And they will know how to handle this without insurance.

I strongly recommend NAMI for help for both him and you. They have support groups that could be helpful to both of you and which would be more relvant than AA.
posted by hydropsyche at 6:39 AM on December 2, 2012

Don't panic. He may very well have had a manic episode, and you cannot be diagnosed with the primary forms of bipolar disorder until you have one. However, only a qualified professional can make such a diagnosis.

You say he is on medication that can exacerbate bipolar disorder but he has no health insurance. He needs to contact the provider prescribing this medication and report the incident and find out if he needs to cease taking this medication.

I have bipolar disorder and started treatment before I had health insurance. The minimum expenditure involved seeing a psychiatrist ($200 or so), getting diagnosed, and getting a scrip for a mood stabilizer and a couple of anti-depressants. Then regular payments for medication management visits.

There are currently two main treatment approaches for bipolar disorder--one involves the use of medications originally given to people with epilepsy but have been found to be of use as bipolar mood stabilizers. You still need to regularly see a psychiatrist or psychiatric nurse practitioner to be monitored if you take these medications. I'm being treated this way. All of the medications I currently take for bipolar/depression are $4 meds at Target.

The other generally accepted option is Lithium. Lithium is much, much trickier to manage because the patient must be absolutely complaint with his meds and he must have regular blood tests to verify that his dose is appropriate.

AA won't be of much use unless he is an alcoholic. I would try contacting NAMI to see if they can offer any advice. They have support programs for families/partners of people with various mental illnesses, and may be able to point you in the right direction. My parents have attended a few of their support groups and found them to be helpful.
posted by xyzzy at 6:41 AM on December 2, 2012 [2 favorites]

Nthing NAMI. They can point y'all in the right direction. That is their purpose. I've had good experiences with NAMI in Washington (state, right?).

Also, if you are in Washington state, here is the website for the state mental health services. I'd look there for help as well (NAMI will usually recommend them as your first line of defense). They are -- in my experience -- helpful for just such emergencies.

Having no insurance should not be a barrier to seeking help. I also have bipolar, and I wouldn't be as stable as I am without taking advantage of the services offered by the various states I've lived in. I haven't had health insurance in decades for various reasons, but I've been stable for many, many years because of these services. They will help your boyfriend, mostly because they don't want crazy people walking the streets. ^_^

If you're in Washington DC, this is the link for their mental health services.

I wish you both the best.
posted by patheral at 7:26 AM on December 2, 2012 [3 favorites]

Do you have health insurance? If so, book some couple's counselling for some guidance (and individual for you as well). You mentioned feeling shame and I am sorry the stigmas of mental illness has made you feel that way. Reach out to your larger support network though - this is what true family and friends are for, to help you through crisis.
posted by saucysault at 7:56 AM on December 2, 2012

In terms of taking care of yourself, reach out to your friends / family. It would probably feel good to tell everything to someone, but it would also feel good to just spend time with people who care about you and love you, even if you don't tell them the specifics of what is going on (or anything at all about what is going on).

I have a couple friends with bipolar who are stable and doing well. Many of them had a rough time (with depression and/or mania) prior to diagnosis - untreated bipolar can be really hard on a person and the people around them, but today's medications are really good. Try to take things one day at a time, recognizing that it may be rough for a while, but the difficulty will pass, and things will be easier again in not-so-long.
posted by insectosaurus at 7:56 AM on December 2, 2012

NAMI, NAMI, NAMI. For both of you - see if there's a support group in your area. You don't have to go in with a definite diagnosis, and one or both of you can go, in most groups. NAMI also runs some sort of six-week course ("family to family" or something like that?) that I've heard is immensely helpful, but the scheduling has never worked out for me.

My partner's first manic episode was terrifying - and heartbreaking and angering and all those things you're feeling. Please, please do take care of yourself. That may be going to support group, or finding your own therapist, or finding one good friend you can confide in, or treating yourself to good food or a day off or time to exercise or read a book or whatever. But it's so easy to lose yourself in the bipolar whirl that you can forget that you are just as important. Which you are.

You may want to look at the BPSO mailing list, a private email list for significant others of people with bipolar disorder. Again, you do not have to know for sure what the dx is when you join. I'll put a pretty significant caveat on this, though. Personally - I cannot read that list day to day. I come away feeling like most of the people on the list don't like their partners at all anymore, much less love them. And my partner and his struggles aggravate and anger and scare and worry and upset me - but I always love him, and so the tone on that list doesn't quite work for me. And to be honest, maybe it scares me a little - maybe that's what bipolar looks like after twenty years of it, and I'm just not there yet. But it is an invaluable resource, so I send it straight into a folder that I don't usually read, but if I want to know about other people's experience with a certain medication or type of therapy, I can search that folder and usually find something helpful.

Good luck to both of you. Feel free to contact me via MeMail anytime.
posted by Stacey at 8:19 AM on December 2, 2012

Is he still acting manic, with unsafe behaviors? If so, he should consider hospitalization. You should go to a public, not for profit hospital that accepts state Medicaid (or whatever the state funded insurance is in Washington) so that he has a chance of his stay being covered. You can also call the local community mental health center and ask if they have any way of providing coverage, as well as setting up an appointment for him to see a psychiatrist there. (In Arkansas, community mental health centers can cover hospital stays for those in crisis without insurance as long as they are screened by the CMHC first and approved before being hospitalized).

If he's not in a manic episode at this point and isn't dangerous, still call and find an appointment with a psychiatrist. Your local NAMI office can help you identify places that will provide treatment low cost. The community mental health center is probably the best place to start.

Also, keep in mind that this is a chemical imbalance in the brain, and is about an illness, not his character. I know that sounds impersonal, but that's what you need to do right now to focus on getting him help. Later on when he's stabilized, you and he can talk about IN THERAPY the things he did, what drove them, and the consequences of his actions. But right now there's no need to overanalyze those actions...focus on the basics of getting him stabilized on meds.

Good luck. It's scary, but it can be managed. One step at a time.
posted by MultiFaceted at 10:59 AM on December 2, 2012

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