Hello Everyone,

I hope that a few of you will take the time to read this and maybe be able to help me, even if in only a small way and I would be very grateful.

I have a very close friend (in her fifities) I have known for over 3 years and I am quite convinced that she has bi-polar disorder. She is on Prozac to "take the edge off" and recently her doc (medical, not psychologist) doubled the dosage. She had insomnia and was overly emotional, irritable, and at times, manic.

She has what she calls a "bio-rhythm" problem that causes her to get terribly foolish and have hysterical laughing jags. These can last for up to 15 minutes and she can absolutely NOT drive a vehicle during these "fits." If I am with her at the time she usually has these fits--about 3PM--(and yes, she has them at work also, she tells me) then I make certain that I DRIVE between 2 and 4PM.

She has not had a spell of this in a while and I thought she was better. However, combined with all of the other symptoms that she is exhibiting, I am suspecting bi-polar disorder.

Alcohol makes her act irrational and she knows that she is not supposed to drink while on Prozac but she still chooses to do so. As far as I know, she is not an alcoholic but I cannot rule that out. If she has one drink--she is mellow--two to three and she starts to get argumentative, mean, and attacks me verbally harping on any faults I have, saying I am no fun and to lighten up, I try and get her to stop drinking and she gets very defensive. I have GERD (acid reflux disease) and she starts to make fun that I cannot eat after 6PM. I also have migraines from time to time and she makes fun of that too which is hurtful.

The first serious episode was when, after she gave me a pocket knife that she was no longer using and when I could not pull open the blade, she made fun of me and started to laugh, her eyes wild and waved the knife around in my face saying, "I'll cut you (laughing) I'll cut you." I was so afraid that I told her to stop and when she kept it up, I left her house and later when we spoke she blew it off, "I was just kidding around", she told me.

The 2nd episode was just this weekend at a festival we attended together. She alternated from being very nice to very mean and drank too many beers--I was sober thank goodness--and she attacked me verbally. Then she tried to hug me and say she was sorry, laughing hysterically. When I told her I was confused by her behavior, she turned mean again and attacked me verbally--said I was selfish and me-me, that I am no fun, negative, and just a bunch of nit-picky complaints. It was all "You are wrong and I am right" with a big ego trip. As far as I knew, I had said nothing wrong because she often tells me that I am a very good and giving, kind friend. Something I said just set her off and she snapped at me rudely. She opened yet another beer and I told her that I was not going to defend myself to her and that she did not make any sense. She went off mad after I suggested that we just do the smart thing and go back to the motel room and I found myself alone at a festival where I knew no else still there--and we were there in HER vehicle and were staying at a motel a half hour away--I was stranded. I looked for her after a while and then went back to the vehicle. Luckily, she had given me a spare key. She carries a gun in the glove compartment for protection and after going back to the car, my common sense told me to lock the compartment to avoid an escalating situation. I remembered the knife incident.

I was about to get my stuff out of the vehicle and call a cab when she showed up. I was adamant that I would drive. I did and there was not a word between us all the way back. Later, she was crying and apologetic and I told her that I was very confused by her mood swings. The next morning she told me she still felt the same way but she was calmer. Soon, she acted like her old self again. We both got home safely but I am shell-shocked and upset over this. I have lost trust in my friend and I am worried about her at the same time.

I do not want to just dump my friend; I want to help her and I think she has been misdiagnosed and is on the wrong medication. Her husband never talks about it and I cannot bring it up to him. I don't know how to convince her to get help. I am not a doctor and cannot diagnose her, of course, but I suspect bi-polar disorder. I wish that it was just a drug reaction and that she could just stop drinking while on Prozac but I fear it is more serious than this.

Sincerely,

Afriend2
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replied April 2nd, 2008
Extremely eHealthy
Taking an antidepressant when the problem is bipolar disorder and not only depression can cause the person to go into manic states. Manic symptoms include impulsive behavior, irritability, talking rapidly, pressured speech (can't shut up), hyper behavior, hypersexuality, risk taking behavior, giddiness, silliness, grandiosity (I am better than anyone at... even experts don't know as much as I do....) out of control behavior (buying sprees, taking off for a road trip unplanned and without thinking of what responsibilities there may be, sexual encounters, even when married), aggression... The list goes on. Not everyone experiences all of these behaviors.

It sure sounds like your friend is suffering with bipolar disorder. I am not sure how you can approach this with her. Perhaps a note to her doctor describing the behaviors would help. The doctor will not discuss her case with you but if you volunteer information with the intent to just let him know how she is behaving then it may bring awareness to the situation. Hopefully the doctor will see her behavior himself. If you feel you can talk to your friend and not be attacked it may be worth trying but from what you describe she is pretty volatile with her moods.

I am sorry this isn't more helpful.
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replied April 2nd, 2008
bipolar personality change
As antigone said, it is very likely that your friend does have bipolar disorder.

One of the terrible things about this and other mood disorders is that it can warp a friendly or normal personality into an aggressive and obnoxious one.

Bipolars may often be diagnosed as narcissists when they are behaving in an arrogant manic mood state, and they may often fool medical staff into believing they are people with a 'nasty' personality, only to later surprise them with a more gentle baseline or normal personality if they are effectively treated with mood stabilizers.

Bipolar I patients, who experience a severe manic episode often involving psychosis and hospitalization, tend to be more likely to understand the necessity of being treated properly than Bipolar II patients who experience milder forms of the symptoms.

Also, in this case, it may be relevant to note the disorder tends to worsen with age, especially for people not properly treated.

Some doctors tend to prescribe both antidepressants and mood stabilisers simultaneously for bipolars. Antidepressants need to be handled carefully by any doctor because they have the ability to trigger mania. The proper dosage is often a trial and error process, and is often adjusted in a cyclic manner at different times of the year to accommodate the patient's bipolar cycle.

It sounds unusual to increase antidepressant medication for someone in a manic-like mood state, especially if there aren't any other mood stabilizers involved.

Remember that you are right in being concerned and assertive with your friend. Also know that the hostile person you are dealing with is different from the 'old' friend that you knew... if your friend responds to proper treatment and recognizes the problem as you do, there can be a time for forgiveness and a return to true friendship. But also don't forget that because your friend's judgement is compromised it may be extremely difficult for you or anyone else to make her acknowledge the gravity of the problem. If she stonewalls and becomes intractable, it is not your fault and you have not abandoned your friend... it is simply that you have been caught in a near impossible situation. Hopefully your friend can be persuaded to recognize the problem and can be treated effectively. I wish you the best.

take care.
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