advice re bipolar 2 and associated symptoms

[understanding]

hi. im posting this in this bc im hoping hearing from people that have bipolar or people who have loved ones with bipolar will help make some sense of this. this is a little bit of a complicated story but I will try and make it make sense. I (F42) and my bf/partner (M44) live in different countries. opposite sides of the world. he has a 6yo child from a previous relationship. he was diagnosed with bipolar2 in his 20s. (should clarify we have been in this for about a year and a half). he refuses to take medication. refuses to see a doctor or mental health professional. he refuses to take any note of his own symptoms or triggers or take any steps to manage them. I have done a lot of research to try and understand how it works and he does not care to know - his words. he displays 'standard' bipolar symptoms and displays a lot of anger and aggression. i should note he does this to me. to others he is loud and jovial and refers to himself as the 'clown'. the anger and I guess 'meanness' is present everytime he speaks to me. he dipped into a low in august 2022 and has not come out of it since. he is addicted to alcohol which he effectively uses to self medicate. he refuses to acknowledge the truth if the addiction. he has been trying to at least cut down on his alcohol in the last couple of months. he is also incredibly competitive which I understand is related to very high dopamine levels. he participates in a weekly team competition. when he doesnt perform to his expectations it causes an anger bout and he will turn aggressive and also turn to alcohol. last Friday he did not perform as well as he wanted and his team lost. he was in a rage spiral. I spoke to him for about 5 minutes and he was very angry and told me he was going to bed. he wasn't. I could hear it. seems he ended up getting very drunk and going to his ex gf and im fairly sure he slept with her. I found out thru social media that something had happened. he lied about all of it. when I told him I knew his anger exploded even further (he said some pretty awful things), blamed me for looking at social media and he has cut me off from speaking to him. I am broken. I should add I spent a month with him (I visited him) from Xmas to the end of January and he was not like this with me in person. he was angry and aggressive before I got there (august to December) then while I was there it was what it should be then as soon as I left it took a day for it to turn again. I know that he 'blames' me for leaving. i raise that only 2 make the situation clearer. A big issue for him is that we r not in the same place - which I keep trying to speak to him about in realistic terms - to try and resolve and make realistic plans - but he gets angry everytime I raise it and won't speak. what he puts across is that I should just drop everything and go there. I raise that only to show the unrealistic approach he takes. i understand all of the obvious things that r wrong in this picture. this post is not about that. what I am really asking for here is whether this behaviour makes sense to people who genuinely have bipolar2. particularly unmedicated. and any thoughts about what he needs to do for himself here. thanku for ur time

[FloatingFeather]

Hi @understanding,

Welcome to the Forums. My name is FloatingFeather and I am one of the peer support workers at SANE. It is nice to have you with this.

I just finished reading your post and my heart goes out to you. I note that you want to focus on whether your partner's behaviour makes sense to people who genuinely have bipolar2. particularly unmedicated so I will do my best to respond accordingly. My experience is around being a support carer for a family member with bipolar1 who is medicated and seeking regular treatment (has been for more than 20 years). 

I can only offer you my own lived experience and my memory of what my family member was like before diagnosis and treatment but while symptoms were present. From memory there were extreme mood swings, ranging from extreme depression where they just slept 90% of the day to extreme highs where they couldn't sleep for days on end. There was also anger, lashing out, confusions, apologies, repeated cycles of behaviours, etc. 

What I do know in my situation is that if my family member didn't seek help I know I couldn't have continued to be their support person for so many years. In my situation it was incredibly draining and taxing not only on myself but also other people that were in my life (i.e. my children). As much as I love my family member I knew I had to prioritise myself first and foremost for my own mental health. I really believe in the saying you can't drink from an empty cup - it is not only important but it is essential that you take care of you, your own needs and your mental health in all this. 

So back to your initial question, your partner's symptoms sound very similar to what I observed around bipolar. I can only guess but without proper medical intervention alongside the continued use of alcohol to self-medicate may mean that your partner does not have the ability to change. From my experience positive change only happened through the support of professionals that knew how to help and what to do to help to treat and support my family member. I know without hesitation if my family member hadn't received help he would have continued going down the same path and I eventually would have had to stop supporting him for my own mental health wellbeing.

Warm wishes,

FloatingFeather

[ClockFace]

@understanding 

I have Bipolar 2 w/ psychotic features, I am treated and active in my own management.

I can tell you that the alcohol abuse sounds familiar for treated and untreated. Its self medication, even treated it may not be correct, it may have stopped working or in my case I just wanted to escape everything. It took my doctor deciding to report my drinking and the  prospect of me losing my license even though there was no conviction of drink driving etc. to get help. I spent some time in rehab and then I had to do a course based on ACT. That was Nov 2021 and I havent had a drop since.

The abuse, I can see that in someone not treated but I would expect that there would be times where the conversation should be more pleasant. I mean Bipolar is depressive and hypomanic episodes not singularly being rude and aggressive. So it is either he is Bipolar 2 and chosing to be cruel to you or there is something else going on. Though I would say you being there with him and him being pleasent would indicate a Bipolar trait but in my mind would not over ride the continual mean on the phone.

Bipolar does impact people differently, I dont tend to have a mean and nasty streak that lasts any real amount of time regardless of my mood. If Im depressed Im withdrawn and I could be grumpy or snappy but that doesnt last long, more a sullen not wanting to engage attitude. Hypomanic doesnt happen for me much now days but Im overly happy, I make poor decisions especially with money. I might be wrong but that seems like a much more typical Bipolar 2 life.

I want to honor your request but I will say its your life, you chose who to live it with. Chose wisely.

[understanding]

hi @FloatingFeather 

thank you for taking the time to read and respond. that accords with almost everything I have found. I guess I'm just trying to figure out how much of that behaviour links to the bipolar and how much is his choice. he needs medical intervention but refuses to even consider it. he will not even look at his own triggers and symptoms. im glad ur family member got help. I cant even speak to him about any of it as he has cut me off. I am broken and traumatised by all of it. he does need medical help. I have tried everything. I found suitable psychs in his area and offered to cover the cost of a couple of sessions to get some help and information. he refused. it never had to come to this. thank you for your time

[understanding]

hi @ClockFace

thank you for your time.i am really glad you are treated and active in that and it seems to have been good. I have tried repeatedly to have him address even the smallest of things - to know his triggers and to manage how he is feeling but he gets annoyed that I say it and he refuses. the alcohol is a problem. he certainly drinks and drives but says he is more alert with the alcohol - I assume he feels like he is since to him it is a form of medicating a bigger problem and yes I am aware of all of the issues in that. I am glad ur doctor intervened for u and I am glad u have been able to stop. I have tried to discuss that with him. he gets angry that I say he is an addict though sometimes when he is very drunk he admits it himself. he has tried to cut back but he surrounds himself with alcohol and people who will feed that with no knowledge or care of what is going on with him. our conversations can be better in the sense that we talk about normal things but since he dipped into this low in august 2022 he us always abrasive. I am not able to show real emotion as he will mock me or show contempt. he says he is just an angry individual. he puts holes thru his walls but thankfully does not hurt people. but he will smash things. he seems to believe I am out to get him everytime I ask or say anything sensitive though I never have and never would. I agree from what I read and what u tell me this seems another level beyond bipolar 2. he has trauma but again wont speak of it - only small hints. he describes himself as a wounded animal being kicked repeatedly if I ask or push anything yet I do not say anything harsh or derogatory. I only ask and raise things when they r not ok to be worked out together and addressed - but he will not do that. he perceives attack only. he has some of the depression and withdrawal you speak of. certainly depression - doesn't want to do anything and hates everything- yet will do things with people and be the clown - his words. he says he puts everyone before him and makes sure they r ok. that is all that matters. yet with me I am literally last every time. to the extent that he will announce things to the world and to strangers before me. he has never cared or consider any impact or effect on me though he will for others. similar to u I don't think he gets much hypomania anymore. I tried in person. I tried asking why hetreats me the way he does. I've asked him since and all he says is he doesn't know. but he is aware and I have told him how much damage it is causing but it is always like that. everyone matters more than me. im trying to delineate between what is referable to bipolar and mental health and what is referable to him and his choices. I am trying to work out the same for last weekend. he has cut me off and now won't speak to me at all. I am broken and traumatised. there was never any need for any of this and I have tried everything to work with him in every single way. thank you so much for your time

[tyme]

I'm sorry to hear that he is not wanting any support or help @understanding . It makes it very difficult for people to help he see a better 'normal' in life. 

Do you think he is happy with his life at the moment? @understanding 

[understanding]

hi @tyme

thank you. no I do not believe he is at all happy and he has said as much. yet he also refuses to consider or discuss what may make him happy or what he could change or do to make things better. he says he does not want 'ok' but won't do anything to even take a first step. I have tried to discuss this - all life aspects - many times. he simply refuses. he refuses help despite all of the destruction and damage to himself and around him. I dont know. I cannot follow why even basic steps are refused. I just don't know and i have kept trying and trying. thank you for your time

[ClockFace]

1. @understanding 

Id almost think that there is a possability that there is persecutory delusions at play. 

[understanding]

hi @ClockFace

thank you for that.  that is actually an interesting thought.  I had always interpreted his reactions as reactive to the way he has been treated previously but his reactions would always throw me as I never even saw why he took them as an attack.  That is an interesting thought. thank you very much for your time

[ClockFace]

@understanding 

I only realise it because I have started having them, primarily entangled with hallucinations. I had a psychiatrist consider that I might be skitzoaffective not BP2 though never formally diagnosed. With the  addition of the delusions I wonder if she was right. 

I would say your in a difficult situation and I do understand that you care for this man and want the best for him, but you cant force it on him and even encouraging  in his state would potentially be seen as you giving him commands. 

Im not saying that you should stop the relationship but you do need to make sure you are protecting yourself and if possible find third parties that would be able to help you encourage change without coming across as telling him what to do. As I said, outside the relationship trying to convince him to get help and change is not an easy situation and I think you need professional help how to achieve this