It’s absolutely manageable with medication and good therapy.

The medication is there to get them calm enough so the therapy can do it’s work. But the medication will probably also be something they need to take their whole lives. The worst seems ro happen when people go off their medications, in my experience.

There is also now genetic testing that can be done before prescribing medication so you can know exactly the best biological pathways that your body has. In essense, which drugs are most easily metabolised by your body.

This gives psychiatrists a better path to finding a good set of drugs that can help instead of going in scattershot. Knowing which drugs will be best metabolised by your body avoids wasting time on drugs that don’t metabolise well.

I strongly suggest the genetics testing for this and I stress the importance of finding a good therapist your son trusts.

My wife of 14 years has bipolar disorder.

My experience with it as someone caring for someone with it is that, when properly managed with appropriate medications, it’s nothing we can’t handle.

Once we found meds that worked effectively, as long as she’s taking them things are fine. She understands the importance of being properly medicated, I make sure she always has the medication she needs and she takes it.

In our normal day to day I don’t think either of us think too much about it. I do know though that there are things that can trigger a manic or depressive episode. Sleep changes are a massive trigger for her, so we stick to a pretty solid routine. She can tell when it feels like she might be on the edge of a manic episode. We check in frequently when that happens, I provide support, and we get her doctors on the phone if we need to.

But in all our time together we’ve not had to go back to in patient treatment once we got our arms around it.

Good luck to you and your son. Just keep in mind that manic episodes are big and loud and people can feel a lot of shame about things they did while manic after the fact. Care, love, support and understanding are the best context to help your loved one find a path that will work for them.

A happy, full, and healthy life for your son is still more than possible.

Like most things in biology, neurological disorders are on a spectrum. So the bystander who chimed in with their outlook should be taken with a grain or salt. It comes down to the patients neurobiology, care team, meds + the associated regiment, as well as the their desire to treat the disorder. Neurbiology is a high unique aspect of every human, so anothers experience with it will be pretty biased by default. I was in a long term relationship with someone who was bipolar, but the only reason we broke up is because we were in our mid twenties and had no real idea what we were doing. If your son wants to maintain his relationship with his partner, thats fully an option, it’ll just come down to staying in front of it!

I can share my anecdote about a girl I dated who had bipolar disorder. Take it with a grain of salt.

She was fine until she decided to get off her medication, and then things got chaotic. Sudden shifts from cheery to outraged about little things (not being included in a short conversation with my roommate about fishing), leaving in the middle of the night to walk home through a sketchy downtown area and convinced she would be fine. I worried for her safety and had to walk her home against her protest.

Then there were arguments about conversations that we never had. I don’t know if that had anything to do with bipolar or something else.

From what I can tell the medication made a world of difference. If I knew better at the time I would have tried to convince her to get back on it.

My mom was bipolar, but since she grew up in the 60s and 70s her experience probably isn’t going to match your son’s much. Especially since she didn’t even get a diagnosis until her mid/late 20s, after having symptoms for years.

So, the not sugar coated version of what I experienced: she was a drug addict, alcoholic, and would alternate between abuse and neglect. I’m sure part of that was no/wrong meds for a while, plus it culturally just being more okay to smack your kids back then. I saw a lot of screaming and arguing and crying that I thought was normal. She and my dad lost custody of one of my siblings for a while.

So that’s what poorly treated bipolar disorder can look like. That’s the bad place it can go if he decides he doesn’t need his meds anymore and there’s nothing wrong with him, which is made worse by the fact the meds are supposed to make you feel ‘normal,’ and some people prefer the mania to ‘normal.’

It’s absolutely manageable for many people, especially if he stays on top of his meds. It may not mean that he never has symptoms or that they don’t change, or that they never temporarily get worse or better. If he isn’t already in therapy that’s something you should really encourage, because meds are just one tool in the box, not the whole set. You mention a psychiatrist, but they manage meds rather than the emotional aspect, and it’s important to see a psychologist or therapist at least for a while on top of that.

Hi, I’m currently engaged to a wonderful man who I love very much. He is diagnosed with both ADHD and bipolar disorder, and has been since he was a kid. He’s had a long time for him and his doctor to experiment with which medications work well for him and get him stable, and so, to be very honest, I don’t think I really notice much of anything that I attribute to his bipolar. If he had never told me about it and had only mentioned his ADHD, I don’t think I would have ever known.

I’ll admit that I don’t know very much about bipolar, so it’s very possible that maybe my fiance is lower on the “spectrum” (if one exists - I personally have depression and autism so this is where my first hand experience lies) than your son, but like you mentioned, your son is early in his journey compared to where my fiance is at. But I want you to know that there is definitely hope, especially with parents who love and care for him - and you must, since you’re here asking about him.

If this is your first experience with mental health care, it might be advantageous to research groups in your area for help. For instance, in my area there’s NAMI, which was a big help for my fiance’s mother when he got his diagnosis.

If you’d like to ask more questions about my experience, feel free to shoot them my way!

I don’t have any experience with bipolar but I just wanted to say how great it is to see all of this support and reassurance in the comments. This is the internet at its best.

Like a lot of things, the answer is “it depends”. Probably the biggest factor I’ve seen is the willingness to accept their condition and stick with the prescribed medications. The worst cases I’ve seen all involved individuals who either consistently or intermittently refused to acknowledge their condition and take the meds. It usually resulted in some near tragic circumstances that costs them friends, jobs, and the support of loved ones. In one case I know the end result was fully tragic. However, some people who are bipolar have lived mostly normal lives, so not all hope is lost. It just depends on their willingness to deal with their condition head on.

There are multiple types of bipolar disorder with various features, so take any advice from strangers with a grain of salt, as they probably don’t know the specifics. I have a couple of personal experiences with BPD in general.

First, a close friend of mine - his manic episodes would usually involve him staying awake for days at a time, and his depressive episodes were pretty bad. Before being diagnosed with BPD he had some pretty bad experiences with therapy from a “therapist” that clearly didn’t know anything about depression or BPD, since being diagnosed and settling on a medication he has been much, much more stable. I used to lie awake unable to sleep from the stress of worrying about him, I don’t anymore. He still has depressive and manic periods but they are much, much less severe.

Secondly, an aunt. She had one of the more severe types, but we didn’t know it. She always had bad depressive episodes (and there was apparently an early bad episode of mania that was written off as a one-off mental episode from stress or something) but it wasn’t until she suddenly left my uncle and their children to run off with a married man she barely knew that it became more apparent something else was wrong. I suggested - stressing that I am not an expert in the matter - that it kind of sounded a lot like some of the self-destructive manic episodes I had heard about, not from my friend but from Stephen Fry. I had heard him talk about his bipolar disorder at one of his shows in Sydney, and his past involved a lot more trouble than you’d expect. He has a couple of documentaries about it, but I can’t speak on how helpful they would be. Anyway, I turned out to be right, and so far she seems to be doing better, but it’s still early days.

The main takeaway is there is hope. One thing I took away from Stephen Fry’s talks in particular was that it is vital to keep taking the medication and not to decide, after a period of stability, that you don’t need it anymore, that’s a recipe for disaster.

As a person with a bipolar parent I won’t go near a bipolar person if I can help it. They’re often ok if you’re not too close but it’s only a matter of time until they flip on you and the nature of the disorder is inherently self reinforcing, like most personality disorders. I know some people with bipolar claim to manage with meds and what not but they’re still always off in noticeable ways and I’ve never met a bipolar person I would trust to stay on their meds with out constant supervision and enforcement, idk why so many bipolar people love going off their meds so much but in my experience it’s universal and most will lie to you that they’re still taking them even when it’s obvious they’re not.

I’m sorry you’re both dealing with this and I’m sorry my comment isn’t positive but in my nearly 40 years on this earth that’s what my experience with bipolar people has been

I don’t have bipolar disorder myself, but I have friends who have it and have dated women who have it.

So, without speaking from the POV of someone actually dealing with the issue, all I can say is that in my experience, it’s absolutely manageable.

The issue I’ve noticed seems to be with the medication. I’ve had a friend tell me he hated the side effects so he didn’t keep taking them, and would thus swing into a manic or depressive episode until he’d start back on the meds. Similarly, I’ve heard of people (but not met personally) who take the meds for some time, decide that the meds worked and they don’t have the condition anymore and then stop taking the meds. Only, of course, to swing into bipolar episode.

It’s definitely got to suck, but I think if you all listen to his doctors (even though one made a mistake by taking him off the meds, they’re human, too) and he is able to manage his medications you will all be ok.

I can’t speak to his relationship. That’s gonna be between them, but it’s probably best for all parties to read up on bipolar disorder so they can better know what to expect and what not to fear. I have a coworker whose husband is bipolar and not the best with his meds from what I understand, and while she has some interesting/funny stories and long nights sometimes, they still seem very happy together.

I guess all that is to say: It sucks, but his life definitely isn’t over lol. Listen to the doctors, maybe get him into some sort of therapy (if he’s open to it), and stick with meds that work. My bipolar friends are all kind, mostly successful, good people. For some, I wouldn’t even know had they not told me.

I’m a depressive who goes to Depression and Bipolar Support Alliance meetings. Your son might find some meetings (either online or on person) useful.

If he goes, a friend of mine always used to say that you should try every meeting twice. You try every meeting, because each has a different group ‘personality’, and you go twice because any group or person can have an ‘off’ night. If DBSA doesn’t work out, there are other groups that may help (NAMI, Recovery, etc), but those have a more general focus that may or may not work for him.

The people at my meeting go there because it provides understanding and support and helps keep them on their meds. I will say that a number of the bipolars in my group have gone on manic spending sprees at times, that they’ve later had to walk back because they didn’t have the money for the purchase(s). Like, at one meeting, one bipolar said they’d been off their meds once, walked into a car dealership and bought an expensive brand-new car. At this point, several other bipolars said they’d done the same thing, with one person adding that she’d bought a horse, and the final person confessing that she’d bought a house. They each did walk back their purchases, but it did cause some stress in their relationships. I don’t know if this is typical of bipolars in general or just the people in my group.

An important question; type 1 or 2? They’re both difficult but type 1 tends to really wreck lives in a dramatic way.

Hi, Bipolar NOS (“not otherwise specified”) here, more down than up. It’s absolutely possible to do great. Like your son, early 20s onset, spent some time inpatient to get sorted out, and have been in consistent outpatient therapy and psychiatry treatment ever since. Completed a PhD program, got married, job market sucks but I’m still optimistic all things considered. I think consistency in treatment, lots of patience, and a good psychiatrist who you can trust are key.

My spiel on the medication part, and some bipolar stigma: some people want to chase the mania, or get a little hypomania and think they’re doing better and don’t need the meds, or think the medication “stifles creativity,” and they give us a bad name. Think Kanye. For every up, there is a down. Not every up is good. The down is far worse. For me, it’s important to remember how bad things can get, because I don’t want that. Whatever side effects and months/years of tinkering with medications are worth it, to me, over losing my spouse, friends, family, or even my life.

Yes, the process of trying medications sucks, but it’s entirely necessary. Also have a good plan for if things get suddenly worse, because they absolutely can — a dud batch of mood stabilizers from when your pharmacy switches manufacturers, for example.

I could literally go on forever, but the tl;dr is that you can do great, just be prepared to put some time and effort into it. And never stop taking medications because you think/feel you’re doing better.

Sounds like others covered all the bases already but, if you have further specific questions, I’m bipolar and a therapist, and happy to discuss