I can share my anecdote about a girl I dated who had bipolar disorder. Take it with a grain of salt.

She was fine until she decided to get off her medication, and then things got chaotic. Sudden shifts from cheery to outraged about little things (not being included in a short conversation with my roommate about fishing), leaving in the middle of the night to walk home through a sketchy downtown area and convinced she would be fine. I worried for her safety and had to walk her home against her protest.

Then there were arguments about conversations that we never had. I don’t know if that had anything to do with bipolar or something else.

From what I can tell the medication made a world of difference. If I knew better at the time I would have tried to convince her to get back on it.

Stepbrother has it and ultimately his mother died from it.

He’s fine on his meds, but finding one’s that worked was apparently bad. But once they did he’s fine. Glad he managed to find them, hope he stays on them.

Type two here, with depression starting when I was 13. Was diagnosed at 21. Mostly struggled with depression and hypomania, and the rapid change between the two. Being diagnosed was maybe the best thing that happened to me. Everything fell into place. It took about 7 years to get the treatment just right, but the medication was mostly working after a year or two.

I’ve been to a lot of meetings, and I know a lot of bipolar people. The thing with bipolar is that when you get the medication right and you do the work, the disease is really manageable. But one of the most frustrating part of the disease is that many suffering from it are not taking their meds or not doing the work. And you can’t force them to either. You can lead a horse to the water, etc. I have been really focused on getting better, but I see the appeal to just don’t do it. One tends to see the disease through rose-tinted glasses. And it is work to just be “normal”. So just saying fuck it and ride the nice initial waves of hypomania/mania can be really tempting. But there is nothing good coming out of that.

I highly recommend reading An Unquiet Mind by Kay Redfield Jamison (and her other books for that matter), she is an expert in bipolar. Both as a psychologist and as a bipolar person herself. Wishful Drinking by Carrie Fisher was also good. I think it is good to try to understand why bipolar people think and do as they do. I do recommend support groups too. Where I’m at there are group meetings 1-2 times a week. Relatives are welcome too. Sometimes there are meetups for relatives only too.

I wish you all the best, and just know that it is possible to live a full and great life as bipolar. There are medication and life-style changes that does wonders, the hard part is sticking with it.

Hi, I’m currently engaged to a wonderful man who I love very much. He is diagnosed with both ADHD and bipolar disorder, and has been since he was a kid. He’s had a long time for him and his doctor to experiment with which medications work well for him and get him stable, and so, to be very honest, I don’t think I really notice much of anything that I attribute to his bipolar. If he had never told me about it and had only mentioned his ADHD, I don’t think I would have ever known.

I’ll admit that I don’t know very much about bipolar, so it’s very possible that maybe my fiance is lower on the “spectrum” (if one exists - I personally have depression and autism so this is where my first hand experience lies) than your son, but like you mentioned, your son is early in his journey compared to where my fiance is at. But I want you to know that there is definitely hope, especially with parents who love and care for him - and you must, since you’re here asking about him.

If this is your first experience with mental health care, it might be advantageous to research groups in your area for help. For instance, in my area there’s NAMI, which was a big help for my fiance’s mother when he got his diagnosis.

If you’d like to ask more questions about my experience, feel free to shoot them my way!

I was diagnosed with Bipolar type 1.

I also worked in mental health.

The early stages can be tough because the person diagnosed has not yet learned how to recognize and cope with the issues bipolar brings.

It’s not hopeless. I finished university, started a stable career, bought a home, maintained some stable social relationships for decades, have a long term romantic partner. There were challenges along the way, but you generally get better at managing them as you go through more of them.

In addition to whatever recommendations the doctor makes , there are some things that every bipolar person can do to make things easier. If my illness is flaring up, I have a simple checklist.

If you notice a manic/depressive flare up, have you … Slept well? Eaten a remotely healthy meal? Done anything physical? Done anything social? Done anything productive?

Yes, these things will help pretty much anyone if you do them regularly, but they’re especially important for bipolar. They’re also listed in order of importance.

An important question; type 1 or 2? They’re both difficult but type 1 tends to really wreck lives in a dramatic way.

Hi, Bipolar NOS (“not otherwise specified”) here, more down than up. It’s absolutely possible to do great. Like your son, early 20s onset, spent some time inpatient to get sorted out, and have been in consistent outpatient therapy and psychiatry treatment ever since. Completed a PhD program, got married, job market sucks but I’m still optimistic all things considered. I think consistency in treatment, lots of patience, and a good psychiatrist who you can trust are key.

My spiel on the medication part, and some bipolar stigma: some people want to chase the mania, or get a little hypomania and think they’re doing better and don’t need the meds, or think the medication “stifles creativity,” and they give us a bad name. Think Kanye. For every up, there is a down. Not every up is good. The down is far worse. For me, it’s important to remember how bad things can get, because I don’t want that. Whatever side effects and months/years of tinkering with medications are worth it, to me, over losing my spouse, friends, family, or even my life.

Yes, the process of trying medications sucks, but it’s entirely necessary. Also have a good plan for if things get suddenly worse, because they absolutely can — a dud batch of mood stabilizers from when your pharmacy switches manufacturers, for example.

I could literally go on forever, but the tl;dr is that you can do great, just be prepared to put some time and effort into it. And never stop taking medications because you think/feel you’re doing better.

Sounds like others covered all the bases already but, if you have further specific questions, I’m bipolar and a therapist, and happy to discuss

My mom was bipolar, but since she grew up in the 60s and 70s her experience probably isn’t going to match your son’s much. Especially since she didn’t even get a diagnosis until her mid/late 20s, after having symptoms for years.

So, the not sugar coated version of what I experienced: she was a drug addict, alcoholic, and would alternate between abuse and neglect. I’m sure part of that was no/wrong meds for a while, plus it culturally just being more okay to smack your kids back then. I saw a lot of screaming and arguing and crying that I thought was normal. She and my dad lost custody of one of my siblings for a while.

So that’s what poorly treated bipolar disorder can look like. That’s the bad place it can go if he decides he doesn’t need his meds anymore and there’s nothing wrong with him, which is made worse by the fact the meds are supposed to make you feel ‘normal,’ and some people prefer the mania to ‘normal.’

It’s absolutely manageable for many people, especially if he stays on top of his meds. It may not mean that he never has symptoms or that they don’t change, or that they never temporarily get worse or better. If he isn’t already in therapy that’s something you should really encourage, because meds are just one tool in the box, not the whole set. You mention a psychiatrist, but they manage meds rather than the emotional aspect, and it’s important to see a psychologist or therapist at least for a while on top of that.

It’s absolutely manageable with medication and good therapy.

The medication is there to get them calm enough so the therapy can do it’s work. But the medication will probably also be something they need to take their whole lives. The worst seems to happen when people go off their medications, in my experience.

There is also now genetic testing that can be done before prescribing medication so you can know exactly the best biological pathways that your body has. In essense, which drugs are most easily metabolised by your body.

This gives psychiatrists a better path to finding a good set of drugs that can help instead of going in scattershot. Knowing which drugs will be best metabolised by your body avoids wasting time on drugs that don’t metabolise well.

I strongly suggest the genetics testing for this and I stress the importance of finding a good therapist your son trusts.

Like a lot of things, the answer is “it depends”. Probably the biggest factor I’ve seen is the willingness to accept their condition and stick with the prescribed medications. The worst cases I’ve seen all involved individuals who either consistently or intermittently refused to acknowledge their condition and take the meds. It usually resulted in some near tragic circumstances that costs them friends, jobs, and the support of loved ones. In one case I know the end result was fully tragic. However, some people who are bipolar have lived mostly normal lives, so not all hope is lost. It just depends on their willingness to deal with their condition head on.

Mental health counselor here.

The outcomes of treatment for bipolar disorder are unfortunately very variable. It depends on how severe your son’s symptoms are, how well he responds to the medications cocktail he’s being given, what that medication cocktail is, and how well he adheres to it.

The important thing is that your son controls what he can control, which is largely whether or not he takes his meds and how much he engages in therapy. Therapeutic skills involve insight/mindfulness work (i.e. how well your son can recognize his symptoms as they’re happening) and resource use (i.e. does he inform his therapist and/or psychiatrist when he notices he’s be king symptomatic). Mania often feels amazing to people experiencing it, so they’re often motivated against treating it when it occurs, and this is major barrier to treatment.

A big component is whether or not symptoms of psychosis are involved in either the mania or depression. Psychotic symptoms are: 1.) hallucinations (false sensory perceptions, like hearing voices, seeing things, smelling things, etc), 2.) delusions (false beliefs that don’t conform to “normal” societal beliefs, like “I am Jesus” or “God has a mission for me”), and 3.) paranoia (i.e. feeling people around you are hostile to you or are spying on you, etc). These can be experienced in either mood state, but are most often seen in manic states.

I would suggest getting in touch with an organization called NAMI (National Alliance for the Mentally Ill) as they have tons of resources for people struggling with mental illness and family members of mentally ill people.

I’m an inpatient psych nurse. I see there are already 40 answers, so what are your specific ones for me?