new diagnosis... i'm desperate

hello everyone, i'll try to keep this short but i'll give a TLDR: i'm wondering what my boyfriends manic episodes will look like now that he is getting treatment. i experienced his first ever manic episode, and it was very confusing, stressful, and unsettling, and i'm worried that all his manic episodes will be a repeat of what we've already been through. any insight?

for more context, i've been seeking some guidance regarding my partner's new diagnosis with bipolar 1. he had his first ever manic episode this past june, and it was a huge shock to us all. when his mood began to shift, i didn't understand what was going on at all and felt confused and lost. the person i loved was turning into a stranger in front of me.

as things progressively got worse, i convinced him to see a doctor where they told me his diagnosis. however, his mania was very severe, coupled with full blown psychosis which made him unwilling to accept what was happening or that anything was wrong. he lashed out at me, saying hurtful things or blaming me for thinking that he needed help, and even got aggressive at times--characteristics that are completely opposite to his usual kind and sensitive personality. finally, after 3 painful months (including multiple forced hospitalizations, and several times on and off his medication) he began to get better. now 6 months after his diagnosis he has found a good therapist and medication which works for him, and he seems much more stable.

im happy that hes gotten better because it was such a relief to see the man i loved come back to me again, but now im thinking about the future. with this new factor in our relationship, i'm worried how it will affect us long term. i was hoping to get some insight from people who have lived with this disorder or have loved ones that experience it.

what should i expect during his future manic episodes now that hes on medication and getting treatment? will it always be as severe as this first one (i.e. should i expect him to be involuntarily hospitalized and refuse treatment every time his mania resurfaces? will he be as withdrawn and angry towards me, or is it possible that he will be more controlled?). i know that everyone deals with this differently, but any personal experience or advice you may be able to offer would be incredibly appreciated.

I have only.ever witnessed one manic episode in a lady that I think is one of the nicest people I know. It was confusing at the time, she jumped around rearranging furniture (in a public place) and accusing everyone in the room of failing to visit her when she was depressed. It's not the same as living with someone who has the diorder, but I still really like her and she was nice when I met her the next time.

From experience of living with someone who refuses to get help for a different disorder, I feel that the hard part is trying to figure out if their behavior is who they are or if their mental illness is a separate thing that you can't use as an indication of their character. It is a good sign that your boyfriend accepts the diagnosis and is willing to have treatment, but those bad times will almost certainly come again.

It is hard not to take things personally even when you know someone's insults or aggression comes from mentsl illness. I hope you are more resilient than I am. My family member can get so nasty sometimes that I panic and don't know what to do. Then they will suddenly act nice and it makes me think I might have overreacted or I that I am losing my mind.

The best thing you can do is try to have a good support system and take time for yourself when you need it. Maybe decide in advance an activity that will help you destress and relax that you can turn to whenever you feel overwhelmed.

I am sorry you both have been dealing with such a difficult situation. Glad things may be turned around a bit for mow.

There is no possible way in one or even ten posts here to give you all the information you now need. I will just say that irritability is one of the hallmarks of mania in my opinion. The affected person often may become angry because you are doubting that she is really Jesus, or communicates directly with Milla Jovovich through the TV, etc, etc. Those hurtful things, unfortunately, are sometimes hard to deal with and some people just can't do it and they write the patient off forever. That has certainly happened to this bp 1 person. I have lost a ton of people due to my illness.

I would recommend you do some more reading. One good book is "An Unquiet Mind,' by Kay Redfield Jamison. It is actually my all-time favorite bipolar 1 book. It's short and can be read quickly. Tremendous descriptions of what it was like for this medical professional trying to make sense of what was happening in her brain. Really good. Just my take.

There is no real way at this stage to predict what your partner's course will be. Some bp1 people become what are sometimes termed 'high-functioning.' They take their meds and work full- or part-time and everything is pretty stable. Others may be in the hospital seldom, but occasionally. And others may really struggle for stability. There are 8 zillion different things that go into all that and it's just too much for this little post.

I am curious what meds he is on--do you know? Does he mind taking them? Does he agree that he has bipolar 1? Does he want to get better, or does ha absolutely looooove being manic? What does he thin of his psychiatrist?

Sending you positive vibes. I would lastly urge you not to make any rash decisions right now. What you need is information and I think starting with the Redfield Jamison book is a good start. Hang in there.

I am in complete agreement with bpcyclist's post. I'll add that his med compliance (or not) would be the deal-breaker for me. If he's treatment compliant - great. If not, well...that's a huge problem.

@MrsA thank you for your insight and kind words. it's hard living with the hurtful things he's said or done, but i know that he's not himself during his mania and i don't want to hold those actions against him. i'm sorry to hear that you've dealt with untreated mental health in your family, it can be so difficult to watch someone you care about refuse to get better. wishing both you and them the best.

@bpcyclist thank you so much for your response, i really appreciate hearing from people who have lived with bipolar 1 themselves. i will definitely be looking into your book recommendations as well.

to answer your questions: he recently (2months ago) started taking 3mg of vraylar and he's really happy with it--no side effects at all. he had previously tried lithium and risperidone, though i don't remember the dosages, but both of them didn't work well for him. he's told me that after finding vraylar, he's okay with taking medication for life if he needs to (which it seems like he understands that he does need to). i'm still worried about this though, because during his mania he was incredibly resistant to medication or treatment, and i'm worried that will persist in future manic episodes. but i wanted to ask--in your experience, if someone is willing to accept treatment while they are stable and at baseline, can that change when their mood shifts? or do you think that he will maintain his perspective of trying to get better?


i do think that he wants to get better and values his stability over mania, but i can't help being nervous that he might change his mind.

thank you again for your response, i value it more than you could know. as this is all new to me, i have many questions and it's very helpful hearing from you. you've already been a big help but if you'd be willing to answer some other questions i'd be so happy--though please don't feel obligated to respond, i dont want to ask too much of you.

if he stays on medication and continues treatment, is it still inevitable that he will have another episode? and if he does have an episode, is it possible that he be more controlled with his medication, or should i expect full blown mania whenever it arises? how much does your perspective shift when you have a mood change? (i.e. should i expect him to change his mind about continuing treatment when he begins feeling more "up" again?)

thanks again, wishing you the best

No one, regardless of education, experience, or both could give you definite answers to the questions you've asked. He might never have another mania - or mania might be recurring for him. Hopefully, medication will ameliorate episodes. Generally, meds make the time between episodes less frequent and less intense. So, the idea of meds is to increase stability.

My son-in-law had a psychotic manic break 15 years ago and was dx'ed with BD1. He was in hospital for six weeks. When he came out he stopped taking meds. Thus far, he has not had a full-blown episode again. But he's very reactivate to every little thing and he has occasional rage episodes. He self-medicates with ZZZQuil every single night so he'll sleep. He has a good job. According to him he's "cured." Pfffft. What I see is that he's 1/4 inch from having a serious episode, sooner or later.
Bipolar Disorder cannot be cured, but it can be managed, which is what medication is for.

Too often, bipolars feel better, think, "I'm okay now", stop meds. Big mistake, and one that many of us with BD make.

So, yeah...meds and therapy are key.