Expert: Libby Bonner - 10/7/2008

Question
Dear Libby

I am unsure if my partner has Bi-polar Disorder.He said he was diagnosed with the condition but his mediation stated 'for depression'.

If he doesn't take it, he becomes a different person. He becomes a horrible monster full of anger and aggression. He walkes past people on the street and calls them names just loud enough for them to maybe hear what he said. It's so embarrasing for me. He picks on everything I say and even looks different to me. He takes on a hard, dirty and unattractive look (sounds strange I know). We have been together for three years and initially he was very nice to me although a bit weird. He has been heavily into drugs since he was about 18 and would take anything. Christmas last year he took up with another woman who dealt drugs and told me to f... off. He had been smoking ice and this just did something so strange to him. He stopped loving me and couldn't stand even looking at me. He took up with her and got all his drugs for free as he hasn't been able to work for nearly two years now. He can't sleep properly at night and so can't wake up for work plus he is so lazy. I guess she wasn't as forgiving as I am and so she became the worst person in the world and got rid of her. I provide some of his money for smokes and food occasionally after his dole has paid rent. He seems quite happy to just keep that going. But, he has never been violent to me until the weekend. He had a big day of NRL  Grand Final drinking and we got into an argument in the car. I told him I was leaving and he threatened my family. I lost it and slapped his face and he head butted me hard I was dizzy. Then he nearly broke my arm and put his fist through my car windscreen. I'm trying to stay away but the millions of calls will soon commence and they'll get nasty.

Does he sound like he is Bi-Polar to you? He hasn't taken mediation for a couple of months as he thinks he's doing fine without it. He isn't though.  

Answer
Bipolar seems likely.  There are bipolar persons who mainly exhibit depression and not elevated mood.

However, bipolar depression and 'regular' depression are treated differently, w/ antidepressents used very very cautiously.  Mood stabilizers are the main, first meds used for bipolar - lithium or lamicatal, often, sometimes depakote...or a combo.  If the depressions lingers, anti-D would be added very carefully.

Substance abuse in an untreated or undertreated bipolar is pretty common.  They are trying to 'self-medicate' so that they won't feel so awful.

He will NOT do fine w/o meds.  But getting him back to the doc, or a new doc maybe, can be hard to do.