Son, 20, first signs of bipolar

[Anonymous]

Anonymous wrote:

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.

+2 Get your child seen by a psychiatrist, or at least a psychiatric nurse if you can't find someone to put them on the schedule right away.

[Anonymous]

You need an integrative psychiatrist and integrative physician. Get genetic testing and full blood work up. Google the terms to find one near you. I'm in the Philadelphia area, not DC, so no recs, but using integrative medicine changed our lives (long line of bipolar/depression/alcoholics in my family)

[Anonymous]

Anonymous wrote:You need an integrative psychiatrist and integrative physician. Get genetic testing and full blood work up. Google the terms to find one near you. I'm in the Philadelphia area, not DC, so no recs, but using integrative medicine changed our lives (long line of bipolar/depression/alcoholics in my family)

Thank you. Our family sees an integrative physician but we have not brought this up with him yet. What did they do for you?

[Anonymous]

Anonymous wrote:You need an integrative psychiatrist and integrative physician. Get genetic testing and full blood work up. Google the terms to find one near you. I'm in the Philadelphia area, not DC, so no recs, but using integrative medicine changed our lives (long line of bipolar/depression/alcoholics in my family)

What kind of genetic testing?

[Anonymous]

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

Yes, please share with us OP!
I am wondering.

[Anonymous]

I think it's odd that OP feels qualified to say she is seeing signs of bipolar when she is not a therapist or other doctor.

[Anonymous]

Anonymous wrote:

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

Yes, please share with us OP!
I am wondering.

Yes, OP, you need to share more about symptoms. For instance, with bipolar, symptoms don’t change day to day - no one is “manic” one day and depressed the next day. Straight up Depression can cause delusions or a lack of sleep. When we were working with our DD’s psychiatrist he said “you’ll know mania when you see it.”

[Anonymous]

Anonymous wrote:

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.

Who is “they”?
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]

Anonymous wrote:

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

Yes, please share with us OP!
I am wondering.

I don’t want to say too much, but he said he only feels extremes of either deep negativity or extreme happiness and that in the middle there is complete lack of feeling. He says he is most often in the negative space and to get through that he has to remind himself of the extreme happiness that will eventually come. He has never said anything like this before and he has always been a very subdued/cerebral person but also very rigid and black/white. He has said this a few times now and it has me worried.

[Anonymous]

My now 23 year old has Bipolar Disorder and has been for quite awhile. Honestly I have not seen therapy as helpful and often seemed to make things worse. Management has been through medication and it was tough to get it right for a number of reasons, primarily because medication is trial and error anyway and you would be extremely lucky to get it right on the first try and also because he has comorbid ADHD and cannot function without stimulant medication which is contraindicated for those with bipolar. It was no minor feat to find a provider who would treat both conditions.

The two biggest hurdles to success are getting agreement to see a doctor - and remember, they are not going to talk to you, only your son. My son's don't talk to me even though he has given permission - not even to schedule appointments. You might get in faster with a psychiatric nurse practitioner and, while some will diss this route, our needle in a haystack provider who agreed to treat both the bipolar and the ADHD is a PNP and she is the only person to have been able to stabilize him over many years of treatment.

The second hurdle is getting medication compliance. Not only do you have the issue of intolerable side effects, but you also battle the mindset of when you feel better you don't believe you need it.

Your situation is complicated by the fact that he is likely leaving for Oregon in a couple of weeks and it is highly unlikely that you will be able to even get him in to a psychiatrist before he goes, even if he agrees. And, due to licensing and insurance requirements, you can't do teletherapy with a provider across country (or even across state lines in most cases). So you may need to figure out a support network in Oregon.

I hope you are wrong about your suspicions because it is a tough disease. But in the chance you are not, I will leave you with one last thing. I'd be trying to check in often with him once he leaves to return to college. I'd also be sure I had contact information for those with whom he spends his time. When my son spiraled it was fast and dangerous.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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

Yes, please share with us OP!
I am wondering.

Yes, OP, you need to share more about symptoms. For instance, with bipolar, symptoms don’t change day to day - no one is “manic” one day and depressed the next day. Straight up Depression can cause delusions or a lack of sleep. When we were working with our DD’s psychiatrist he said “you’ll know mania when you see it.”

Actually that can happen and it's called ultra rapid cycling.

[Anonymous]

Anonymous wrote:My now 23 year old has Bipolar Disorder and has been for quite awhile. Honestly I have not seen therapy as helpful and often seemed to make things worse. Management has been through medication and it was tough to get it right for a number of reasons, primarily because medication is trial and error anyway and you would be extremely lucky to get it right on the first try and also because he has comorbid ADHD and cannot function without stimulant medication which is contraindicated for those with bipolar. It was no minor feat to find a provider who would treat both conditions.

The two biggest hurdles to success are getting agreement to see a doctor - and remember, they are not going to talk to you, only your son. My son's don't talk to me even though he has given permission - not even to schedule appointments. You might get in faster with a psychiatric nurse practitioner and, while some will diss this route, our needle in a haystack provider who agreed to treat both the bipolar and the ADHD is a PNP and she is the only person to have been able to stabilize him over many years of treatment.

The second hurdle is getting medication compliance. Not only do you have the issue of intolerable side effects, but you also battle the mindset of when you feel better you don't believe you need it.

Your situation is complicated by the fact that he is likely leaving for Oregon in a couple of weeks and it is highly unlikely that you will be able to even get him in to a psychiatrist before he goes, even if he agrees. And, due to licensing and insurance requirements, you can't do teletherapy with a provider across country (or even across state lines in most cases). So you may need to figure out a support network in Oregon.

I hope you are wrong about your suspicions because it is a tough disease. But in the chance you are not, I will leave you with one last thing. I'd be trying to check in often with him once he leaves to return to college. I'd also be sure I had contact information for those with whom he spends his time. When my son spiraled it was fast and dangerous.

Thank you very much, PP. I am sorry about your situation. Can you recommend your nurse practitioner? We talk to him on the phone weekly, and he always sounds fine then but I always wonder what’s going on when we are not calling. Are you saying we should visit often as well?

[Anonymous]

Anonymous wrote: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.

I have a similar story with my husband. Though I met him in our late 20s. We are now very watchful of our older teens.

I agree with everything this poster said. I’d also, for good measure, make sure the kid has a full physical. I would not get into all the other causes for bipolar at this point, but that’s me.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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

Yes, please share with us OP!
I am wondering.

I don’t want to say too much, but he said he only feels extremes of either deep negativity or extreme happiness and that in the middle there is complete lack of feeling. He says he is most often in the negative space and to get through that he has to remind himself of the extreme happiness that will eventually come. He has never said anything like this before and he has always been a very subdued/cerebral person but also very rigid and black/white. He has said this a few times now and it has me worried.

Is he talking very very quickly, thoughts/speech flitting between topics so it’s hard to follow, not sleeping yet not feeling tired, grandiose, engaging in risky atypical behavior and/or spending money in a wildly uncharacteristic way? Obviously you need to see a doctor but if this answer to these is no bipolar is not likely based just on what you have said.

[Anonymous]

Anonymous wrote:I think it's odd that OP feels qualified to say she is seeing signs of bipolar when she is not a therapist or other doctor.

I’m not a therapist or a doctor. I can when my spouse is manic or depressed. Be glad you don’t have the personal experience!