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Bipolar, Infidelity, and Basically Trying to Understand

Hello. My boyfriend has been diagnosed with bipolar. He is compliant on his medicine (lithium) but when he has been without medicines (switching therapists because he had to move back home with his parents because he lost  his job, etc) or seems to be too low a dose of medicine, he falls back into a pattern where he calls everyone a racist (he is biracial), acts very self-centered, starts texting/sexting other women (once slept with another woman, once left town to be with another woman), masturbates more, and we have sex more frequently. He also talks about another woman who he was with for 2 months, saying how much he loves her and that she was his only true love.

When all of this is over, he regrets flirting with/sexting other woman and said he deeply regrets sleeping with the other woman with whom he slept. He sometimes denies the flirting/sexting or is dismissive of the events (he said he was going to another state to be with another woman; he had sex with her and came home, saying she was deeply damaged). In the case of him sleeping with another woman, the first one happened 1-1/2 year ago yet stays with me, because (as you might imagine) my trust in him has never been fully restored.

I have insecurities because I am 20 years his senior (he's 31, I'm 51) but I am fit and fun. When we talk about the age differences when he is healthy, he says it is a non-issue.

Recently his psychiatrist took him off Prozac (my boyfriend told the psychiatrist he was feeling suicidal) and put him on a very low dose of lithium. When the Prozac started wearing off he re-started the pattern of calling people racists, sexting woman, remarking on young female friends' sexy pictures, speaking aggressively, arguing with nearly everyone, and acting very aggressive (dumping out liquor bottles, heaving them across our yard/alley, throwing a bag of dog poop across the yard).

Every time this happens, I kick him out to preserve my sanity and to ensure I am safe (he is nearly 7'; I am 5'3"). He goes to stay with his mother in Tennessee or father in New York. And THAT is a big mess because he is successful in Chicago and has nowhere to live except with me.

My questions are these:
1. How do I gauge how much is too much before calling it quits for good? He is kind and gentle when he is not in this state.
2. Am I correct in seeing these acts (hyper-sexuality, grandiosity, verb aggression, race rants) as mania?
3. Is it important for him to admit he has bipolar (he swears he does not have it yet is compliant on his meds)? His father believes he denies bipolar because his grandmother is deeply psychotic and he greatly fears being her. His mother and I believe he should acknowledge it so he can be in charge of his health.

Thank you for trying to help me understand.
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Avatar universal
Can you tell me more about the mental health awareness course?
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Avatar universal
Thank you for sharing your story with me. I'm so sorry to hear of your struggles.

I don't believe he was tonguing or cheeking pills but I can't be sure. The problems re-started when his psychiatrist took him off Prozac. Apparently he told the psychiatrist that it was making him feel suicidal.

I noticed a gradual change start to happen. The same behaviors slowly returned.

My internal turmoil is so great. I love him very much when he is well.
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8751072 tn?1440886796
hi sweetie i to have bipolar it has taken me a long time to admit just like with my seizures i still find it hard to accept i have had one.  unfortunately  only you can decide how much you are willing to stand by your man noone else can anser that for you just as my pertner was told the same when he asked the same question. my partner has luckily for me chose to stand by me no matter what and when i was in my stable episode asked me to marry him. during my manic episode which for each individual is comletely different i many ways including the intensity of sex drives etc, i to have the shame of that i went else where but i was in such a bad manic phase i didnt care i had no self awareness at all i even jumed out a window to find someone for sex because it was all i could think of. my depressive episodes though well we wont go there it's a very long thing. my advice is to think what you want for your life. try and get him to admit his illness without that it will probably try and keep taking over him. does he ctually take his meds or is there a chance he coud be tonguing them as i used to do ? i hope things work because since i have admitted to my illness my live hs improved so dramatically and now i have qualified and passed both my mental health awareness courses all because i made an admission to myself about my condition and started to take my medication properly.
i am glad he now has a therapist sweetie and yes she should have arranged a backup therapist as we need continuity and to feel safe to open up it may be that he needs his medications re looked at . i hope you find this of help, best wishes
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Avatar universal
Thank you. He is seeing a therapist. She left on vacation for 2 weeks without providing him with a backup therapist. This was several days after he had admitted himself to the ER. I feel that was negligent on her part. He's been so unwell.
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Avatar universal
Answering out of order as I feel question #1 can be better answered after reading the other two answers.  I am answering as a person living with bipolar type I with psychotic features.  However, my therapist has commended me on many occasions because I have been really good at tracking things myself and seeking help from the beginning.  Many patients living with bipolar disorder do not.

2. Yes, it is a manifestation of his mania.  HOWEVER, that is NO excuse for him to go out and cheat (emotionally or physically).  He should be seeking you out when he's feeling hypersexual.  I've been hypersexual before while manic and while depressed (typically as a result of a mixed episode).  Before my boyfriend, I wanted but never did jump anyone's bones.  I took care of it myself because I didn't want to lower my self-esteem further than where it was then.  I have been hypersexual and near an attractive male since, but have I allowed myself to remain in that situation?  No.  Out of respect for my boyfriend.  Just because you're manic does not make you unaware of what you're doing.  It may lower your filter, may make you not care so much, but it is not something that forces you to do something.  

If he really feels bad for what decisions he made in the past while manic, he needs to address these things so he sets up barriers to work against it.  (i.e., safety plans with you, ways you can suggest he sees his therapist without offending him, etc.)

It's something that he needs to take care of and monitor.  If he knows he's going to switch psychiatrists, he needs to refill before switching.  If he knows meds are being switched, he needs to remind (or inform, if new) the psychiatrist how he reacts to being cut off of one med and put on another.  Typically, titration should be used in both directions, and unless they're known to interact, I don't see why this can't happen around the same time.  He should be in constant contact during the process of medication switching.

I also believe he should start seeing a therapist in addition to the psychiatrist.  A therapist (usually LSCW, can be other degrees) typically cannot prescribe medication.  That's a psychiatrist--a doctor.  Yes, you can talk to them as you would a therapist, but therapists do tend to specialize in types of therapy and can help focus on that more than what needs to be doing with med  I found DBT (dialectical behavior therapy) very helpful.  He needs to learn his triggers (seems medication changes and missing doses at the very least, but there may be more.) so he can react immediately to seek a medication adjustment/therapy at first sign and try to avoid an episode.

3. He does need to learn to accept he has bipolar disorder.  That will lead to many of the points made in response to your second question falling into place.  It sounds like he's convincing himself he'll be fine when he's feeling well or starting to fall into mania.  So, he doesn't seek that extra medication refill before switching or immediate help when starting to exhibit his behaviors that are typical of his episodes.  He needs encouragement that seeking help is the only way to avoid being like his grandmother.  It will get worse without a proper treatment plan.

1. It's up to you where you draw the line, but it's going to be hard to build trust if he doesn't own up to seeking proper treatment and care for his own health and your sake.  Without trust, there is no real relationship in the long run.
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