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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.
The part about preferring mania? Super accurate. During the year or so of dialing in the meds, my wife alternated between numbness and depression, and eventually climbed her way up to “Normal”
She hated normal. I had to explain that this is how life is for everyone else. Sure there’s highs and lows, but not every day is an explosive rollercoaster of emotions, and that’s a good thing. Stay here with me a while and see if you can learn to love it. Well, she did. And life is good. But there really has to be a lightbulb moment where it clicks that life without the meds is chaotic, destructive, and unsustainable.
That's what I was saying to him in the crisis center. It sucks that you can't feel fantastic. But the merely ok feeling you have to feel is what everyone else feels.