How can I support a bipolar friend who may be decompensating?

@janbb Not bipolar that I know of. I’d let them know you’re there for them and ask if they want to talk. Give them an opening and hope they come to you. If I’m offbase I sure hope someone will tell me.

Did your friend discuss their decompensation with you, @janbb? I’m not bipolar, but I know a few people who say they are being treated for bipolar disorder. I would think that you should discuss what you can do to help them when they are discussing their problems with you. Let them open the door.

Meanwhile – I’ve heard from him and he sounds fine but it is good for me to learn about for the future anyway.

It really depends on how self aware they are. If they recognize or are willing to hear that it is the disease and not reality you might be able to help.
Unless they want help you might just have to back off and let it run it’s course.

I am just getting close with him but he seems very self-aware.

If his behavior ever seems extreme, depressed or hyper, ask him if he’s taking his medicine and point out what you notice, @janbb. I’d have to assume that as you get to know each other better, the appropriate time will come up to discuss how he was diagnosed, his history with the illness and your concerns with how to help him if he ever needs help.

@janbb Tell him what you observe in him, as you observe it. If you think it seems unhealthy or unreasonable, tell him that. If he values your insight, it may help him. If he wants to exert control, and he can, that is.

I don’t think you’re in a position to tell him, “you should…” or “you are having…” And don’t consider arguing about it.

Ways you can help as a layman without a prescription pad are pretty limited. Just remember this isn’t the bad time for him. It’s just one of them. Heroic measures are not appropriate.

In my experience, decompensating is what happens when a person diagnosed with a chronic illness stops taking their medication for whatever reason. The illness can be physical or mental. It means deterioration.

It happened to me once, and it was horrific. I won’t go into the details of why the medication was stopped. I will only say that what worked in the end to get me back in shape was hospitalization. There, I was able to recuperate and my medication was stabilized.

I would only suggest that you speak positively to your friend about medication and its value and also about the positive aspects of hospitalization. You’re a wise penguin. Don’t use “you” in your conversations. Use “I see…” and “I feel…”

Best of luck.

@Hawaii_Jake You’re a good man Jake. You care so much about people.

Would he tell you if he stopped his meds. or started to fiddle with them? Does he see his doc regularly?

Decompensating means stop taking your meds? Never heard of that before. What a weird way to say it. Anyone know how that became the term of art? I fucking hate psycho-lingo.

Anyway, the main reason people stop taking meds is because of the side effects. Do you know what he is on? How long has he been on them? Do his hands shake? Is he gaining weight? Does he seem logy at times? Is he sleeping too much? Too little? Does he work? Is he drinking? Smoking a lot of pot? Does he spend money he doesn’t have?

God I hate the rules of this place. I feel like I’m supposed to give you an answer because this is in General, but I don’t have an answer for you because I don’t know anything. I’m just an idiot. I don’t understand your question and they will moderate it because of that. What a fucking waste! If you had put this in social, I might be able to give you an answer, but because I have to be serious, I can’t give you shit. Sorry. Go ahead and flag it.

@wundayatta How about sending janbb a PM with your thoughts?

@wundayatta No – that is not the way I understand the term or the way he explained it to me. I don’t want to violate his privacy by going into too much detail. He is extremely disciplined about his meds and extremely aware and has told me a lot: from what I undestand, major life stressors, like one that is happening now, can send him into a down cycle while still on his meds. (The down cycle is what I understand as “decompensating.”)

I don’t think anything you’d post about this would be modded @wundayatta. I put this in General because I didn’t want fluff answers, but anything helpful would help however it’s worded.

I was worried last night but he seems fine. It really feels too private to post more but I am still interested in hearing suggestions – especially from wundy and Jake.

The best way to explain decompensation is that the drugs stop working as well as they once did. In other words, the drugs compensated for a problem. Now they aren’t. They are decompensating.

I see. I don’t like the term. We don’t know if it’s the drugs that have stopped working or something else.

One of the hardest things to cope with is wondering, “am I getting depressed, or is this situational?” Also the other way around. Am I getting manic, or is it situational. I find that I can easily get high or depressed just be being around other bipolar folk who are one or the other. By high, I mean manic. Mania is a high for me—a mild one compared to most people, since I’m hypomanic, but still a desirable state. What makes me feel manic is something most people would think of as quite normal. I like being around people and joking and telling stories. When people respond to me, it gives me a buzz. For the most part, there is nothing harmful about it. And I take care never to let it go too far, but I can tell there is a too far.

I get very hopped up and I see things—not hallucinations; but I get very strong visions about who another person is and what will happen to them, and then I tell them what it is, and it has a powerful effect. I don’t know if my visions would be accurate. But I’m not sure it would matter. I would make people believe because I believe.

This is why it can be so confusing to know if you are getting sick again. Sometimes you keep things under control. Sometimes you don’t but they don’t go out of control. Sometimes, you fear going down into one of those depressions with no end, and a week later you are fine. You got all worried over nothing. And so you second guess yourself all the time.

Is this bad enough to call my shrink? Or is this a false alarm like before? If I call, and he gives me new meds, and then it turns out I could have handled it without the meds, then I will be stuck taking meds I don’t need.

That happened to me. The first time I started feeling depressed after I got well, I freaked out instantly and ran back to my shrink and got back on a med I had stopped. Soon after that, I realized it was situational, and I understood that I could have handled it on my own. And the next time I got depressed I held off going to the shrink and I did just fine.

But it is so hard not knowing if you are making the right decision. It can be hard to trust yourself. And yet if you don’t trust yourself, you damage yourself that way and you feel more dependent and less capable. But if you don’t ask for help, and you make a mistake, it could send you back to the hospital…. or worse.

And then there are the people we care about, who worry about us. Should we tell them? Is it worth worrying them? What if they start bugging us to go see the shrink or get our meds checked up? That’s a pressure we may not want. I know I don’t want my wife pushing me to see the shrink. That’s my decision, and if she pushes me, I will be more likely to go when I don’t need to, just to please her and keep her from worrying.

So it gets very tempting not to tell her. To see if I can take care of things on my own, and over the years, I’ve gotten really good at this. I’ve taken care of myself without worrying her. Maybe she sees. Maybe she knows. Sometimes she casts a worried look my way, but I’m not sure. I do know that I’ve taken care of myself and I haven’t needed help and I am pretty sure if I told her, she would have worried and maybe pressured me into seeing the shrink when I didn’t need to.

I think what I want from people who love me is a faithful mirror. I don’t want you to tell me to see the shrink or to take meds. You don’t know what that is like. But it is ok if you tell me I look worried or anxious or I’ve been doing such and such a lot, recently. Please do it without judgment if you can.

Please understand that I don’t want to hurt you. I don’t want to get depressed. I don’t want to die. But I also need to work on managing my own life, and that may involve things getting a little bit out of control. I’m sorry. It’s an inevitable part of the process. With your support, and especially with your nonjudgmental love, I’ll get better sooner, most likely.

And if it’s too much for you… then go. I don’t want to keep you. It’s hard living with me, I know. I will probably place some big demands on you, and there is a chance I will hurt you badly—although I don’t know if that is different from any other relationship. But we can be more volatile and more intense. We seem to need more intensity out of everything. So if that is too much, then I understand you need to protect yourself and guard your own life.

I hope I’m worth it, though. I hope you’ll still through this with me. I know it can be very painful to see me depressed and unable to to anything. I know it can be very frustrating. I know it can seen impossible to understand and you wonder what planet I live on. I’m sorry. This is what I can be like, sometimes. I work very hard not to be there, but shit happens.

Understand this. If I ask you to stay, it means I really love you and want your help. If I push you away and attack you, and I know this sounds ridiculous, but it also means I really love you and I want your help, but I don’t expect you give it to me. I have my pride. If I am too much for you, I don’t want you. Even if I do love you.

We can give messages that are the opposite of what we really want, and I think the reason we do that is because we can’t stand the idea that we’re hurting you. We can’t stand the idea that we are not in control of ourselves, and therefore we hurt you. When it’s like this, we can push away out of a kind of pride that we don’t want anyone to give us too much. It is better to be homeless than to have someone resent us that we ask too much.

Of course that hurts immensely that we are too much and fills our sense of worthlessness, and makes us act out in all kinds of perverse and weird ways, as we try to find any kind of good feeling we can, yet we know we don’t deserve anything good. So booze and drugs and sex.

I know this is rambling and probably doesn’t make much sense. I doubt it if will help. It’s just a peek into my mind as I understand it, and the kind of thinking that goes on there when I’m sick. It is very confusing. It is shameful, too. I hope there’s enough sense there for you to get a little bit better perspective. And I really feel this is not a suitable answer for general. There is no answer in my answer and it probably isn’t on topic. General is the wrong place for a question like this, and it gives me a great deal of anxiety to write the way I do here.

@wundayatta You might have a mistaken – or different notion from me – of what general is.

Your answer was very useful to me. This person is a friend – not a lover – but he is very dear to me and I don’t want to hurt him, nor do I want to lose my sense of my own self.

General is where you give useful answers. The mods get to decide what is useful whether they know anything about the topic or not. I don’t like answering here because I have had several good answer taken down because the mods didn’t think they were useful.

This means I can’t say what I think. I have to couch my answers in ways that I think the mods will believe they are useful. In other words—I have to appeal to their prejudices. Which is hard, since I don’t know who they are.

It is much freer to tell the truth in social because they can’t take down your answer just because it doesn’t fit with what they think they know. It’s a form of censorship that is difficult to see, but makes this place increasingly unfriendly, and as you know, I am being personally attacked on another question of yours.

If you asked this is in social, you would have had a free answer from me, not one that is double and triple thought. It might even have made sense. Probably would have been shorter. Anyway, go ahead and flag this as off topic, or whatever. I just hope you get a chance to read it before some busybody mod comes through to impose their view of the world on us.

@wundayatta Oh my! Well, anyway, I appreciated your answer here. It gave me some insight into the possible mindset of my friend although of course, each individual is unique.

^^Why not exchange emails and keep the information both private and a propos?

@gailcalled That’s a thought but as I said above, I don’t want to reveal anything in detail because I am uncomfortable in violating my friend’s privacy, even in pms.

^^Good point.

Without knowing any more, I can only begin by saying it’s sad your friend is hurting, yet it’s good he has someone close like you that cares. There’s really very little that you can do for him other than:

1. Remind him that self-help is phenomenal but it can only go so far.

2. His medication may need to be temporarily adjusted to deal with the present stress.

3. Effective talk therapy is a great help.

4. The Internet is ripe with anonymous ways to reach out to other people with bipolar. All it takes is a bit of searching. Here’s a great place to create a completely anonymous account and share anything that’s on one’s mind about experiencing bipolar.

I think I would leave it at that. Expressing those things will do a world of good to let your friend know you care.