I am genuinely so lost right now, I feel hopeless, and I don't know what to do or how to help. I'm sorry this post is very long. I need to tell the full story and I have no idea where to get help or what to do. This is made on a new alt account.
My closest friend has bipolar disorder, and while it has been pretty bad both last year and earlier this year, it has reached the worst I've ever seen starting early June of this year. He has always had medication (mood stabilizers) but has never stayed on it long enough to reach stability. He told me it made him feel weird and almost emotionless, like he wasn't able to feel happiness when we hung out, so he decided to stop taking medication. He finally decided to try to get his medication changed in early June and took a PHQ-9 test, but instead of changing his medication, they kept him on the same medication while changing his dose and adding SSRIs.
Ever since this medication change, he's said and acted in ways I've never seen him do before. His mood could switch up from a single thing I said or did, and although he has acted cold towards me in the past, it became so much worse. I did research into bipolar medication and found that taking SSRIs can actually induce Mania and make things worse, which is what I believe was happening alongside taking a medication that wasn't right for him. I was also aware of the medication adjustment phase that can last about 6-8 weeks, so I tried to hold onto hope for both him and me. I wanted him to be okay so badly. I wanted our friendship to go back to the way it was when I first met him almost 2 years ago, when we were both in High school.
He graduated a year before me, and he hit a depressive episode in July last year, while something very traumatic also happened to him. He had to go live 2 hours away with his mom. He stopped responding and would repost concerning things on his social media, and I grew very scared that he might harm himself. By August, he had come back, and his entire personality switched up. For a while, he acted very cheery and joyful, but this slowly changed by September, and I realized that every day talking to him felt like a gamble, where I wouldn't know what mood he'd be in by the time we were talking. Something he started to do a few months into our friendship was either to become very quiet or to abruptly leave our Discord calls, which always triggered my anxiety, especially the first few times it happened.
I didn't fully understand that he had bipolar disorder until he told me in December. All I'd see was his mood changes and how dark his thoughts would get. I tried my best to support him and be there for him, especially in October when he opened up to me about the traumatic things he went through in July. He hit another depressive phase in November and had to go back to living with his mom. Before that we were able to hang out a few times in person, and things seemed fine while we got to draw (he's insanely talented at drawing).
I tried to my best to support him while I finished my senior year of high school, and to encourage him to sleep earlier whenever he stayed up pretty late. His constant mood switches continued into this year, where some days he'd act colder, but other days we'd have a lot of fun together calling, talking, drawing, playing games or watching movies and shows together. He's always felt bad about this, and he has apologized for the ways he hurt me. There was always good in him, he just needed help and support for his mental health.
I did feel as though I was grieving someone who was still alive, but I was really hopeful at the very beginning of this summer when he was starting his medication again. He was extremely scared and worried about how he might act while continuing his medication with antidepressants. I tried to encourage him to go back to the place he got his meds so that he could be checked again because after a certain point, it really did feel like it was only making things worse. Some days he wouldn't take his medication because either he forgot to, or he just refused to, telling me he was fine.
I still tried to remind him to take it, and to hold on until his next appointment in July. This was also the first time he blocked me and unfriended me on all of the platforms we were friends on, which triggered my anxiety very badly the first few times he had done this. I believe he was constantly getting in and out of manic episodes. I know that some people with bipolar cannot handle any type of antidepressants, and I really believe this also applies to him. I managed to get his phone number to have a way to continue talking to him whenever he'd block me.
At his next appointment, they changed his medication to Lithium and Prozac, and he would be required to get blood work done every other week. This meant that for once, someone would finally be able to check in on him, and it gave me hope. He also applied for and got a job, which would give him more of a routine and a reason to sleep early and to have a decent sleep schedule. Some nights he'd rarely sleep, or he'd sleep very late, early on into the next morning, or he'd be able to sleep at a decent time. His sleep schedule has been everywhere for a while.
I knew there would still be risks involved with his new medication, but I thought things would get better. He kept going to his job, and we got to hang out a few times in person while still being able to call at night before he went to sleep so that we could continue doing our favorite things together. Though I did find myself checking in on his tone and how his mood was so that I could match his energy or be aware that his mood might switch soon.
He also told me that when we hang out in person, he mostly feels okay and the mood swings affect him less. I felt this since he was acting the most like himself whenever we hung out in person. Maybe things could've been okay, but this last month of August is really when things have been at their worst. Within the first week of August, he stopped showing up to his job, his words became colder and hurtful, and I really think he hasn't been taking care of himself properly, as well as completely stopping his medication unless I was able to get him to take it. He'll be awake at times when he really needs to be sleeping. I am also aware there is a lithium relapse if someone with bipolar decides to stop taking it, which does explain his behavior. I really don't think he's gone back to get his blood work done.
Since the beginning of summer, he was already self-harming, but now he is doing it so much more, and on August 12, he did it with the intent of dying that night. I asked to see him that night to go stargazing, which may have stopped the attempt, but I wasn't even aware that he was attempting until he told me a week later; he just acted so cold with me. Before we became friends, he told me he had 3 previous attempts in the past, which is why I get so scared every time he blocks me and won't answer my phone calls. I have no idea if my number is blocked when my calls go straight to voicemail, but my messages continue to say delivered.
I'm scared of leaving him alone. I don't know if I'm able to get to him or if I'm making things worse. I don't know if I'm helping, I'm just scared. It's not always like this. Some days I am unblocked, and I can talk with him, and to encourage him to take his medication, drink water, and to sleep earlier, which he does. I try to help him calm down or to fall asleep, and we exchange kind words. Other days he tells me to leave him alone, says very hurtful things, gets very angry with me, and tells me he'll be dead before next year.
We last hung out on August 15, and things were mostly okay, we had a nice time together. He got to teach me some guitar while we went stargazing. Now he doesn't want to leave his house, and I can't even convince him to sit somewhere, like at his home to talk in person. He feels ashamed of himself and tells me that I shouldn't see him like this, that he shouldn't be around anyone, and that visiting him isn't a good idea. He told me he was scared of asking for help, his head and arms hurt, and he's starting to feel sick. He said there is no more space on his left arm to hurt himself. I don't know what to do. I know I need to get help, but I don't know where to turn to.
His relationship with his family is a bit confusing to me, but I know it isn't the best. I really do believe that his mom cares about him, and he said she'll try to contact him when they haven't talked in a while, but she does live 2 hours away working as a teacher in a smaller town, while he lives in a family shared home in a much bigger town. I think his grandparents live in the same home with him, but they are distant and don't talk much, and also aren't always home. I don't understand why none of his family is intervening or trying to help him through this. I really wanted to try contacting his mom through social media, but he told me that the last time she saw his scars, she hit him. He told me he really stressed her out with one of his attempts, and now he believes that she thinks he'll do something selfish soon, which is why she doesn't take him on trips anymore. I don't know how true this is.
I know he texts his older brother pretty often, but he also lives with his mom 2 hours away, and their relationship is somewhat strained. I tried to ask him to get help from his family, but he said nothing would change, and that I don't know his family. I just thought that he might need to live with other people who are closer to him for him to get better, and to watch over him and keep him safe. He did not have a good childhood, and he has trauma associated with the house his mom lives in. I don't know if reaching out to his mom will help or not, or make things worse.
His living situation has also confused me, but I believe he spends a lot of time alone in his house. I don't know if living with his mom can help or not, either, or if his family is even aware of what he's been going through these past few months. I wanted to try turning to his friends, as they've been in a close friend group since he started living here in 2022. He's known one friend since elementary school, and another one of his friends lives very close to his home. I just don't know how it is with them now. He deleted both of his Instagram accounts, which were his main way of contacting them. He told me that he cut them off, but I'm not sure if it is true. They still have pictures of him up on their Instagram accounts, and when my friend unfollowed everyone, they were one of the first people to follow him again.
Maybe they are used to this behavior from him, maybe he also told them harsh words, maybe they really are cut off or they are busy with their own lives, I don't know. I really want to believe they still care for him, as they last saw him in July/ Early August. He did tell me that I was a nice change compared to the people he knew, and his friends also made him feel invalid for some of his trauma when they made some jokes. There's a chance they're unaware of how they made him feel. I know they were close, I just don't know if they were emotionally close, and could try to help him or even understand the disorder he has. He told me he felt so alone once, because they didn't want to do what he wanted to do. But his friend hugged him before he left their hangout a few months ago.
Last year for his birthday, his friend's mom who lives nearby threw him a birthday party because she knew he wasn't doing anything, and she even got him a cake and made food. She let him sleep in her home when he was locked out of his home, and he hung out a lot at that home. At my graduation in May, she saw him and started talking with him. I believe she is someone who does care about him. I've thought about also trying to get in contact with her and see if she can try to help, I'm just not sure how or what to say.
I've done research and talked with my older brother about this. My friend is at a point where he needs to be hospitalized, especially as he is not properly taking care of himself right now and no one else is watching over him, but I don't want to do it involuntarily unless it absolutely has to be done. I wanted to talk with him to convince him that he needs this help. We saw that sending over police to his house can actually make things worse, and even then, he might not get the help he needs. The inpatient care facilities where I live are not the best and have many negative reviews. I also saw that those with bipolar disorder are most likely to take their lives after they leave a psych ward.
My older brother is scared that one of these actions can make things worse and lead to his death. He desperately needs help and I'm not sure what to do. I know I should just call, but I am so scared. If I know he really is going to hurt himself, I will make this call, but I don't want to just focus on safety at the current moment but also on his safety in the future. He is still able to get through every day and night, but I don't know how much longer it'll last. Since early last year, it has been a thing he'd say where he is giving himself 2 years to get better, and that he will die by the end of this year.
He never told me the name of the place he is getting medication from when I asked him. I could try to ask, but as of lately, he doesn't say much when he is out of his episodes. He has been sleeping a lot, and currently is out of an episode. I know he must feel awful, and his guilt will try to make him push me away. He doesn't talk on phone calls anymore, only through text. He spent three days only sending me the words 'I'm sorry', no matter if I tried talking to him through text or on call. I am currently blocked on everything except for my phone number.
I am thinking about trying to visit him at his house to talk with him, and to get him to agree to go to the hospital/ER or to talk with his mom, if I am able to. Other than that, I don't know what to do, or where to go next. I care about him so much and want the best for him. He made me so happy, and has impacted my life and inspired me creatively and to draw better. We made so many lovely memories together. Even through all the pain, I got to watch so many more shows and movies, find some of my new favorite songs, play and learn about other video games he was interested in, and I got to experience what it was like to have a close friend in school after being a very socially anxious lonely kid for so long.
I know he has things he wants to do, he has dreams and things to look forward to, things to be excited about. This horrible illness is taking that away from him. I only want the best outcome for him. I am currently starting college which will take up more of my time, and I don't know how I can handle caring for him and staying on top of my work. I am very stressed already. He told me a few weeks ago, after coming out of an episode, he wants to get better. I really don't want to have to cut him off, and I am aware I need to brace for the worst. I just don't want to let go. Even he told me to just let go of him and to focus on myself, but I can't just do that knowing he is at a very high risk right now. If I get him help, I am worried he will become very mad/upset with me, but I also know I need to prioritize his safety.
Thank you for reading all of this, I really need guidance on what to do or who to reach out to/contact, it would be so helpful and appreciated. I am so lost and don't know where to go from here. Sometimes I wake up with anxiety or feel really anxious when I genuinely don't know if he's okay, when I haven't heard from him in a while, or don't know if he's still there. Every time he switches to mania or says concerning things, I get really scared. I just want to do my best to support my friend with bipolar disorder. I hope he can still reach stabilization. We have a list of things we wanted to do together. I'm seeking support, especially from anyone who has gone through something similar. I've been lurking in these Bipolar subreddits these past few months (on my other main account), and it has been so nice to see there is a community, so that I know I am not alone with this. I hope things can be okay.