Not sure what to think...

[Pamela]

"I've had a sleep disorder since I was a teenager"
"TV helps me dream, the silence keeps me up"
"I self-medicate with beer"
"Sometimes, I feel crazy..."
"No, I don't remember what I said/did..."
"I didn't get abusive (i.e. say very hurtful things)"
"Brother died when I was 12 and 'they' say I tried to kill myself afterwards with pills.  I locked myself in my room and learned how to play the guitar, trying to remember everything my brother had taught me about chords"  (incredibly talented musician who claims his brother's death was a 'trigger' for his 'problem' AND musical talent)
"And you call yourself a psychiatrist" (No, I never called myself a psychiatrist, yet HE says this to challenge me everytime he is upset and almost out of control.  I took it as a challenge because it finally dawned on me, once I could get beyond my own anger/reaction to him, that it was his way of asking me for help).
"sssshhhh..."  (His answer everytime I bring up the idea that he needs to get checked for a possible bipolar disorder - not the type that requires hospitalization.  He fits every description of cyclothymia in terms of the symptoms, but I'm not an expert).

Sometimes angry and paranoid.
75% of the time, loving and sweet
25% of the time, mean and nasty (usually after drinking - but he drinks to control his moods - self-explanation.  I tend not to think of is illness as directly responsible for behavior, but it is definitely part of his behavior.

Both parents were medicated all their lives for unknown reason.  Mother is deceased, but father shows signs of depression (apparently life-long).  Mother was very protective of son and seemed to understand that he had a problem.  She was hospitalized for an 'anxiety attack' after friend was born (one of several required hospitalizations in her lifetime).  

Has first cousin with autism/bipolar and a nephew with autism.  Several other family members have drug problems or suffer from depression (self described).  All family members incredibly talented, gifted in music - along mother's family genetic history.

Is this sound like it could possibly be a tertiary bipolar disorder (cyclothymia, according to what I've read)?  Any suggestions?  I need help in getting him into a psychiatrist.  He claims he has seen several and was listed as 'noncooperative.'  At the moment, I'm trying to get him past the stigma of mental illness and to let him know that I don't think any less of him.

Any comments or suggestions?

[HFHS.MD-AJ]

It is impossible to give a diagnosis without evaluation in person. Alcohol abuse and personality disorders must be considered, among several other possibilities. You may want to continue encouraging him to seek psychiatric help, or involve the police/courts if he becomes a danger to himself or others.

[Barbara]

Drinking can cause all sorts of serious mood problems. Self medicating with alcohol is a major mistake! I learned the hard way, as I am still fighting to get off the booze.

The withdrawal seizures and DT's really suck!!!! I have been trying to stop since last October and have only managed 27 days sober. Now I am seeing an addiction psychiatrist and she put me on Klonopin and Celexa to control the withdrawal, depression and anxiety disorder. She demanded I go to in-patient detox but I cannot afford the expense for the hospital stay as my insurance doesn't cover it and I don't want to take time off from work to go into the mental ward with all the mental patients for free detox.

[Pamela]

He entered a drug/alcohol rehab facility several years ago after a wreck (he later admitted a suicide attempt).  He never experienced withdrawal symptoms and was told by the counselors that his problem didn't seem to be alcohol.  He didn't 'fit' the norm of alcoholics.  That's why I decided to view the drinking as a symptom and not the problem.  I've heard him say, "I'm beered out," and quit drinking (without being intoxicated) many, many times.  He knows his limitations, apparently.

He can put the bottle down and in fact, has quit drinking as much as he did when me met, two years ago (after a divorce and the death of 2 family members).  He's come a long way since then, yet he still has symptoms of something much 'bigger' than alcoholism.  It wasn't until I checked out his family history and talked to some family members that I decided it may be a bipolar disorder, specifically cyclothymia.  He certainly has the genetic background.  His condition is somewhat alarming at times, but he is able to work and get along most of the time.  He has angry outbursts (cold sober) that are difficult to endure.  At times, he can be incredibly mean and not even remember what he said the next day.  That's the most frustrating part.  I've decided to record him the next time he 'loses it.'  Maybe then, he'll understand what I describe to him the next day.