Is this bipolar? Please help.

[ceanothus]

I'm in CA, my 57 year old brother lives in FL with our 91-year old father. Yesterday he called 911 from home and reported that he had been kidnapped and held hostage during a burglary of some sort of pharmaceutical supply house. He told a very elaborate story of nearly being killed as these people were setting him up to be the fall guy for their burglary. The police are quite sure that none of it happened and they phoned a sister who lives a couple of hours away and told her he was hallucinating and that my father couldn't continue to stay there. She went and picked up my father and took him home with her. I phoned my brother later and he sounded so convincing that I was inclined towards believing his story and was trying to make some investigationson his behalf, but things weren't working out too well so far. This morning my sister texted me asking if I was at my father's house in FL. She said my brother had called her in the middle of the night and told her my husband and I had flown in and were there now. I actually WOULD have flown there right away, but I'm very sick from cirrhosis and from drugs I'm taking to try to rid my body of the HepC virus. I'm 7 months into a 10 month treatment, and I was in bed when I heard I was supposedly in Florida.

My brother has never had any mental dx of any kind, although he is an alcoholic. He stopped drinking about a year ago after a DUI that resulted in a short jail sentence. He truly did get off the alcohol for quite a while but we don't know if this might mean he's started again, or he's bipolar or schizophrenic, or maybe using some kind of drug we don't know about. He's never seemed to be into drugs before. Does this sound like bipolar? Does anyone have tips on how to convince him to see a psychiatrist? He reacted very badly to the police telling him he had hallucinated his experience, and we're afraid he will think we are all inspiring against him rather than trying to help him.

[Amy4891]

I would say that maybe you should go ahead and do the involuntary evaluation before it gets any worse. The sooner the treatment the better. I wish I had gotten help sooner for my bipolar disorder, but when I was younger I was in denial too. I wish I had more emotional support through it all it might have made it easier to face my problems that way. That may be something to consider while going through all this with your brother. He needs alot of support (emotional too) to help him get through all this. If he is anything like I was facing my mental health problems he may be dealing with an internal storm of confusion and conflict with in himself. I wish someone had sent me to the hospital a couple of times when I needed to go. I was so young I had no idea what was going on. I may have been mad at first, but I am sure I would have appreciated it later. I know it can be tough, but I hope you get it all worked out.

[ceanothus]

Thank you very much for your excellent reply, I really appreciated the support. I've learned a lot over the last week. A friend of my brother's was good enough to stick his neck out and tell me what I haven't been able to see from a distance. Drugs, alcohol and mentall illness are ALL playing a role in this. He seems to have come off the unknown drug and the delusions have decreased significantly. I've also been in touch with the crisis intervention office the local sheriff runs, and found an extremely caring and supportive woman running things there. One sister has flown in and will try to persuade our brother to go in voluntarily for examination and treatment, but we do now have the information on making it happen involuntarily too. I don't know if we will do that or not at this point, but we do at least have info on file at that office, so the next time he has such a break he WILL be taken in. Do you have a personal opinion as to whether we should file the papers now for an involuntary evaluation if he won't go in voluntarily? I'm thinking yes, but my father would probably disagree (he's the enabler) and my sisters are really uncertain. It's going to be hard, no matter what we do.

[ceanothus]

Thank you so much for your excellent answer. I really wasn't very clear on what is the range of possibilities for bipolar disorder, and your discussion of it was very helpful for me. I wanted to rate two answers as "best answer" so I'm just writing individual thank-you's instead.

[lindahand]

It must be hard for you because you can't really travel down there and take him yourself, and he can't get committed to a 72 hour hold unless he is a danger to himself or others. Right now his hallucinations and delusions are not immediately dangerous as you've described them.

There are a lot of potential causes. Heck even a bladder infection that is severe enough can cause psychosis, mainly seen in the elderly. That is why if you can at all encourage him to go and see a psychiatrist it would be a good thing, but how to do that is tough. You can't use reason with someone who has delusions. They see it as real.

Hopefully it is bipolar because then he will cycle out of it eventually, and that is when, looking back, he'll be able to perhaps see the need for help. It is a sad hope, but you almost hope he gets depressed because depressed people are motivated to get well and more likely to seek help. In the manic/delusional/psychosis stage of things it is unlikely they will seek help.

If he talks about killing himself or others - take him seriously and call 911. He may hate you for it, at least initially, but it may save his life or someone elses. Violence towards others is rare even with psychosis, but it does happen. There is a very mild mannered man with schizophrenia that a few years back stabbed a sleeping man on a bus multiple times because of his delusions that the man was a threat and an immediate danger. Again very unlikely, but if he talks about it, take it seriously.

[Anneinside]

Schizophrenia is a psychotic disorder in which there are hallucinations and delusions (very strong irrational beliefs) but it starts in the teens to 20's. It is VERY unlikely he has that. I, of course, don't know about all the mental disorders but I am sure there has to be one in which the primary symptom is psychosis.... but of course I'm not a mental health professional. To find out what it is he needs to see a psychiatrist and drug/alcohol abuse has to be ruled out first.

[Amy4891]

I think you would need him to get tested for drugs to rule that out first, Or maybe you could just ask him. I think when I got hospitalized when I was delusional like that during a manic episode they tested me for drugs first before they treated me. Sometimes they say that a manic episode could appear like the person is on drugs, because of the exsessive energy and delusional thinking and also hallusinations. It can appear the same.
Just so you know it is hard to get an accurate diagnosis it has taken me almost 10 years, also some symptoms can overlap different disorders.  I guess the diagnosis is only somewhat important. Just make sure you tell them ALL of his symptoms so they can treat them properly.
I think the main difference between bipolar disorder and schizophrenia is the mood aspect. I honestly don't know that much about schizophrenia, but with bipolar disorder your mood is also effected greatly. If he is manic he might be talking faster or more than usual having racing thoughts trouble sleeping.  In a manic episode it is like going 90mph super fast. Some other things that can go along with a manic episode could be grandosity or thinking very highly of oneself, increased sex drive, euphoria, excessive spending, becoming more goal oriented. Another key indicator is irittability. On the otherside this alternates with depression. Bipolar disorder is a mood disorder, it alternates between high and low mood. I think this would be the main difference between them is the mood aspect. There is also another disorder that is like bipolar disorder and schizophrenia combined which is called schizoaffective disorder.
I hope this helps and I hope you can convince him to seek help without too much of a fight.

[ceanothus]

Thank you very much for your replies. I did post the same question in the schizophrenia forum and got a reply there that indicated that this does sound psychotic, probably with paranoid delusions. It at least helps me figure out what terms to search on to get the best information for how to help him. It was hardest not even knowing quite how to look for more information about what is happening to him and how best to get him to agree to being helped.

[Amy4891]

It could be drugs, but delusional could also be a sign of mental illness. Either way he should get checked out by some kind of doctor at least. Also both drugs problems and mental illness need treatment. I think the word to describe this is psychotic, at least that is what they told me when I was having delusional thoughts. Anyways I hope you get it figured out and get your brother some help.

[Anneinside]

He doesn't sound bipolar. Lying is not a symptom of bipolar. If he isn't lying and does believe what he is saying then he is delusional which could be from drugs or alcohol.