Son, 20, first signs of bipolar

[Anonymous]

My freshman son is back from a full year of college in Oregon. (He came home for Christmas and spring break but he stayed there over the first part of the summer.) Last week he started saying things to me that sound like depression (I have depression so I know) and I talked with him a bit to try to establish a foundation of facts and trust. I nudged him to see a therapist but he said no. Yesterday he started saying things that sound more like bipolar and now I'm freaking out because that's completely out of my depth. He had *very* stable mental health the first 20 years of his life, didn't party in high school, and I suspect these symptoms have been triggered by substance use. One side of the family has depression genes and the other has addiction genes. I have read enough New York Times articles to know how terribly wrong this can go but I am a bit paralyzed at the moment. If you have expertise or first-hand experience with this, please tell me what should I do? I don't want to rush things or give any hint that I'm freaking out, and also I don't want jump to a false diagnosis. Either way I need to have a plan in place before he goes back to school at the end of September.

[Anonymous]

First, book an appointment with the doctor. There is increasing evidence that bipolar disease is a physical disease caused by an autoimmune response, possibly to the Epstein-Barr Virus, Lupus or some other autoimmune diseases.

See here: https://health.ucdavis.edu/news/headlines/autoimmune-disease-or-psychotic-disorder/2025/04
https://onlinelibrary.wiley.com/doi/full/10.1002/cti2.1116v
https://www.managedhealthcareexecutive.com/view/autoimmune-diseases-almost-double-mental-health-disorder-risk

Take your son in for a comprehensive checkup, noting your concerns about autoimmune diseases and/or inflammation. Do you have autoimmune diseases in your family? Do you see other signs of autoimmune disease? Does he have vivid dreams or nightmares?

[Anonymous]

First - sorry you're going through this.

I assume he knows you struggle with depression? Share your experience and that you would have benefitted from earlier help so it didn't get to the point it got to. College is a huge transition and if he's open to it, yuo'd love for him to speak with someone for the next few months. Start there. Also focus on exercise and nutrition. Lead by example and ask him to join you on a hike, etc. Good luck!

[Anonymous]

My sister is bipolar and while there were signs before, she really started exhibiting symptoms in ccollege.

The reality is he is an adult and unless you have a concern that he is a danger to himself or others, you can't make him do anything. Getting my sister to see a doctor and stay on her meds has been a long struggle and back and forth. You can encourage but you can't make them do it. Unfortunately manic phases can lead someone to get paranoid and upset and it's very hard to get someone to listen during those phases.

You can try and encourage but you are going to have to be really patient. I'm sorry, it sucks.

[Anonymous]

Anonymous wrote:My sister is bipolar and while there were signs before, she really started exhibiting symptoms in ccollege.

The reality is he is an adult and unless you have a concern that he is a danger to himself or others, you can't make him do anything. Getting my sister to see a doctor and stay on her meds has been a long struggle and back and forth. You can encourage but you can't make them do it. Unfortunately manic phases can lead someone to get paranoid and upset and it's very hard to get someone to listen during those phases.

You can try and encourage but you are going to have to be really patient. I'm sorry, it sucks.

Is your sister living a functional life? Is she mostly happy or not?

[Anonymous]

Anonymous wrote:First, book an appointment with the doctor. There is increasing evidence that bipolar disease is a physical disease caused by an autoimmune response, possibly to the Epstein-Barr Virus, Lupus or some other autoimmune diseases.

See here: https://health.ucdavis.edu/news/headlines/autoimmune-disease-or-psychotic-disorder/2025/04
https://onlinelibrary.wiley.com/doi/full/10.1002/cti2.1116v
https://www.managedhealthcareexecutive.com/view/autoimmune-diseases-almost-double-mental-health-disorder-risk

Take your son in for a comprehensive checkup, noting your concerns about autoimmune diseases and/or inflammation. Do you have autoimmune diseases in your family? Do you see other signs of autoimmune disease? Does he have vivid dreams or nightmares?

Wow this is amazingly helpful. Yes he does have autoimmune issues (as do I) and we actually already have a bunch of appointments set up to look into that. Do you know any physicians in the area who might know about this intersection between autoimmune and mental health?

[Anonymous]

Anonymous wrote:First, book an appointment with the doctor. There is increasing evidence that bipolar disease is a physical disease caused by an autoimmune response, possibly to the Epstein-Barr Virus, Lupus or some other autoimmune diseases.

See here: https://health.ucdavis.edu/news/headlines/autoimmune-disease-or-psychotic-disorder/2025/04
https://onlinelibrary.wiley.com/doi/full/10.1002/cti2.1116v
https://www.managedhealthcareexecutive.com/view/autoimmune-diseases-almost-double-mental-health-disorder-risk

Take your son in for a comprehensive checkup, noting your concerns about autoimmune diseases and/or inflammation. Do you have autoimmune diseases in your family? Do you see other signs of autoimmune disease? Does he have vivid dreams or nightmares?

Those do not say that bipolar disorder is caused by autoimmune diseases. The links say that many people with autoimmune diseases experience neuropsychiatric symptoms, and for some even symptoms of psychosis. The last one also says that people with autoimmune disease have increased risk of a psychiatric comorbidity.

[Anonymous]

I don't know anyone specifically but I'd start by contacting https://www.nimh.nih.gov/research/research-conducted-at-nimh/scientific-director/office-of-clinical-director/nimh-office-of-the-clinical-director-consultation-services/autoimmune-brain-disorders-program

I suggest first going to your primary care doctor and getting tested for various autoimmune diseases and inflammation markers and asking the doctor for ideas.

[Anonymous]

Anonymous wrote:

Anonymous wrote:First, book an appointment with the doctor. There is increasing evidence that bipolar disease is a physical disease caused by an autoimmune response, possibly to the Epstein-Barr Virus, Lupus or some other autoimmune diseases.

See here: https://health.ucdavis.edu/news/headlines/autoimmune-disease-or-psychotic-disorder/2025/04
https://onlinelibrary.wiley.com/doi/full/10.1002/cti2.1116v
https://www.managedhealthcareexecutive.com/view/autoimmune-diseases-almost-double-mental-health-disorder-risk

Take your son in for a comprehensive checkup, noting your concerns about autoimmune diseases and/or inflammation. Do you have autoimmune diseases in your family? Do you see other signs of autoimmune disease? Does he have vivid dreams or nightmares?

Those do not say that bipolar disorder is caused by autoimmune diseases. The links say that many people with autoimmune diseases experience neuropsychiatric symptoms, and for some even symptoms of psychosis. The last one also says that people with autoimmune disease have increased risk of a psychiatric comorbidity.

One important clue to the likelihood of BD being an autoimmune disease comes from the observations that, like multiple sclerosis (MS), which is a chronic autoimmune disease of the central nervous system (CNS), BD tends to present clinically in adolescence and early adulthood and that it initially has a relapsing–remitting course, which later becomes progressive and unremitting.14 Intrathecal IgG synthesis, a hallmark of MS, occurs in 30% of patients with BD compared with 4% of controls,15 as well as in healthy siblings of MS patients.16 It has been hypothesised that intrathecal IgG synthesis with oligoclonal bands is caused by clonal expansion of EBV-infected autoreactive B cells in the CNS.4 Increased serum/plasma interleukin-6 levels in BD7, 17, 18 provide further evidence for a role of the immune system in the pathogenesis of BD.

[Anonymous]

Anonymous wrote:

Anonymous wrote:First, book an appointment with the doctor. There is increasing evidence that bipolar disease is a physical disease caused by an autoimmune response, possibly to the Epstein-Barr Virus, Lupus or some other autoimmune diseases.

See here: https://health.ucdavis.edu/news/headlines/autoimmune-disease-or-psychotic-disorder/2025/04
https://onlinelibrary.wiley.com/doi/full/10.1002/cti2.1116v
https://www.managedhealthcareexecutive.com/view/autoimmune-diseases-almost-double-mental-health-disorder-risk

Take your son in for a comprehensive checkup, noting your concerns about autoimmune diseases and/or inflammation. Do you have autoimmune diseases in your family? Do you see other signs of autoimmune disease? Does he have vivid dreams or nightmares?

Those do not say that bipolar disorder is caused by autoimmune diseases. The links say that many people with autoimmune diseases experience neuropsychiatric symptoms, and for some even symptoms of psychosis. The last one also says that people with autoimmune disease have increased risk of a psychiatric comorbidity.

+1 This. Op. Is your child being seen by an actual psychiatrist or a therapist? You need an actual diagnosis by a qualfied professional, not diagnosis by Internet randos. It's hard to schedule appointments, particularly in August, so get moving asap on this if you haven't already.

[Anonymous]

Anonymous wrote:

Anonymous wrote:First, book an appointment with the doctor. There is increasing evidence that bipolar disease is a physical disease caused by an autoimmune response, possibly to the Epstein-Barr Virus, Lupus or some other autoimmune diseases.

See here: https://health.ucdavis.edu/news/headlines/autoimmune-disease-or-psychotic-disorder/2025/04
https://onlinelibrary.wiley.com/doi/full/10.1002/cti2.1116v
https://www.managedhealthcareexecutive.com/view/autoimmune-diseases-almost-double-mental-health-disorder-risk

Take your son in for a comprehensive checkup, noting your concerns about autoimmune diseases and/or inflammation. Do you have autoimmune diseases in your family? Do you see other signs of autoimmune disease? Does he have vivid dreams or nightmares?

Those do not say that bipolar disorder is caused by autoimmune diseases. The links say that many people with autoimmune diseases experience neuropsychiatric symptoms, and for some even symptoms of psychosis. The last one also says that people with autoimmune disease have increased risk of a psychiatric comorbidity.

I would go out on a limb here and say that all mental illness is caused by something organic. They used to recognize that schizophrenia was somehow connected to month of birth. Now they know it's connected to the mother having the flu during pregnancy, which is why month of birth made a difference. OCD is caused by strep. And on and on. We just don't know all the causes yet.

[Anonymous]

Seconding to see if he can talk to his doctor and eventually to a psychiatrist. Especially if you think there's mania, I'd make sure he knows to talk to the doctor about that because some anti-depressants make the mania worse.

I don't have experience with a kid, but I've been with my wife since we were both 18 and this about when her bipolar surfaced. She'd been diagnosed depression before, but the mania was first noticed at 22 after it got worse as a result of Zoloft.

There's ups and downs, but with treatment she's doing well. Don't despair.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My sister is bipolar and while there were signs before, she really started exhibiting symptoms in ccollege.

The reality is he is an adult and unless you have a concern that he is a danger to himself or others, you can't make him do anything. Getting my sister to see a doctor and stay on her meds has been a long struggle and back and forth. You can encourage but you can't make them do it. Unfortunately manic phases can lead someone to get paranoid and upset and it's very hard to get someone to listen during those phases.

You can try and encourage but you are going to have to be really patient. I'm sorry, it sucks.

Is your sister living a functional life? Is she mostly happy or not?

Yes my sister is mostly fine but she has also been hospitalized maybe half a dozen times (I honestly don't know all of them). Things got a LOT better after she met her partner. He's very patient and keeps her going to see her doctors.

In my family, bipolar disorder is genetic. My grandma had it, my aunt has it, my cousin has it, my mom has anxiety disorder and so on. Most of them live or lived full lives. The person I can speak to at this age is my sibling.

[Anonymous]

Can you say more what made you think it might be bipolar?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My sister is bipolar and while there were signs before, she really started exhibiting symptoms in ccollege.

The reality is he is an adult and unless you have a concern that he is a danger to himself or others, you can't make him do anything. Getting my sister to see a doctor and stay on her meds has been a long struggle and back and forth. You can encourage but you can't make them do it. Unfortunately manic phases can lead someone to get paranoid and upset and it's very hard to get someone to listen during those phases.

You can try and encourage but you are going to have to be really patient. I'm sorry, it sucks.

Is your sister living a functional life? Is she mostly happy or not?

Yes my sister is mostly fine but she has also been hospitalized maybe half a dozen times (I honestly don't know all of them). Things got a LOT better after she met her partner. He's very patient and keeps her going to see her doctors.

In my family, bipolar disorder is genetic. My grandma had it, my aunt has it, my cousin has it, my mom has anxiety disorder and so on. Most of them live or lived full lives. The person I can speak to at this age is my sibling.

Oddly, so are autoimmune diseases.