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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]To those who saw this in others, what were signs? The friend I am worried about is constantly angry and irritable about seemingly small things or things way way in the past, and she seems to have a lot of drama with employers, and has left several jobs. When I try to ask what happened, she evades or misleads.

I fear she is bipolar or maybe schizophrenic… she clearly needs psychiatric help but she won’t open up to discussing it [/quote]

The anger and irritability could be the mixed mania that can come with bipolar disorder. That is what it sounds like to me, and I have bipolar disorder. I have rage quit a lot of jobs, unfortunately, due to raging unstable moods. The good news is that medications are effective. The bad news is that the side effects can be bad enough that choosing not to take them is a rational decision for some. The lying you mentioned doesn't really fit with mood disorder, though -- that points me more in the direction of substance abuse. There could of course be both bipolar disorder and substance abuse; the two go hand-in-hand most of the time (which I tend to forget because I don't even drink).

And ... gently -- please don't say "I fear she is bipolar." "I fear she has bipolar disorder" is more appropriate. [/quote]

Ok, got it. Sorry about that.

What are meds that work and what are the side effects? Is it possible she’s not on any? [/quote]

There are many medications given to treat bipolar disorder, the two big categories being antipsychotics (mostly second generation ones are prescribed now, 2GAs -- some of the most commonly prescribed ones being Abilify, Latuda, Seroquel, Vraylar, and Zyprexa, but there are more) and mood stabilizers (such as lithium and valproic acid and anticonvulsants like lamictal and trileptal). Side effects vary a lot but can be quite bad -- the big ones being weight gain (I gained over 80lbs within a few years of going on medication and tried many many different meds and they all had this effect on me -- I went from a bmi of about 20 when I first started the meds to an eventual bmi of 35 which is bad obesity), sedation (I am tired all the time and have been for years) and impaired cognition (I have multiple graduate degrees, including one in English and didn't read a book for several years thanks to risperdal). For some of us, this is no way to live. If someone's joy in life is, oh, studying the existentialists or something, taking away their ability to even read novels let alone study philosophy is to take away their life. The obesity leads to serious chronic health conditions such as diabetes, sleep apnea, and heart disease that cut our lifespans short. Tardive dyskinesia is a highly problematic side effect with the 2GAs as well. I take my medication, but I very much understand those who don't.

Nothing infuriates me quite like some ableist fool rolling their eyes about someone with mental illness not wanting to take the meds because "they don't want to gain weight." Like it is a question of 10 vanity pounds or something. These medications can be very destructive on both the body and mind.

At any rate, I can't really say what meds "work." Bipolar disorder is a constellation of signs and symptoms and is likely caused by different things in different people; hence the medication that works for one person does not necessarily work for another. There is a lot of trial and error in treating bipolar disorder. I would start with lithium -- it's cheap (you don't even want to know what the new 2GAs like Caplyta cost when still on patent) and effective. Doctors don't like to prescribe it though, because you have to monitor blood levels, and psychiatrists are not fans of having to do that. So it's underprescribed. It also has ... side effects (personally, it gave me hypothyroidism, diabetes insipidus which is a fancy term for peeing constantly, and acne in such awful places that I didn't know it was acne -- so I went off it right away). I think many psychiatrists start people out on lamictal. But it really just depends on whether or not the patient presents with mania, mixed mania, or depression when initially seeking treatment. With depression they will start you on something approved for bipolar depression (don't get me started on how the drug companies started structuring their trials to show effective treatment of bipolar depression so that they could market on patent 2GAs that cost over $1000 a month for bipolar depression). And the first stuff tried rarely works. A lot of trial and error. And bipolar disorder is episodic. So sometimes one is on trial medication number three or something, and the mood gets better, and they attribute it to the medication, but it was really just the end of the episode, and here the patient is, remaining on the medication, suffering side effects. I don't know -- it is very complicated and difficult. [/quote]

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