Worried about a friend

[April2]

I really know next to nothing about bipolar but I'm worried about my friend and was wondering if someone could help me. My friend is married to a man who has never been officially diagnosed with bipolar but everyone thinks he is. He even took an online test once that showed he was high risk. This was years ago. However, he has been taking something for depression and PTSD.
In the past when he's tried to get off the meds, you could see a change in him. He did this once when he was on a health kick and it wasn't a nice change. He did get back on, though.
Here's the thing. When he's on the meds and doing right he's a great guy. They've had a rocky marriage for several years but she's stuck by him. Not sure if some of this could be symptoms or sIigns of bipolar but maybe if I describe some of his behavior you all can tell me.
Like I said, he's been on and off meds. He's changed jobs and moved his family too many times for me to count. He never seemed to be able to settle down until this last job that he's had the last 4 years. This is the longest he's held a job and he does enjoy it. It's a good paying job with good benefits.
In their whole marriage he's come close to hurting her with his anger twice. Once he pushed her and another time he chocked her. This was years ago, though, and he really seemed to do a turn around recently. He returned to God (supposedly) and church with her and that made her happy because he really seemed to be trying to be a good husband, treat her well, be kind and loving, etc. Here's the kicker. Just this week he quit his meds again and his behavior has been erratic. You can't tell him that, though! But I saw a change in him and tried to talk to him once and he cut me off. I finally was able to talk to him and I thought it went pretty well but he's acting like Dr. Jekyle and Mr. Hyde. He's behavior is going to extremes. One minute he's laughing, joking, being nice and then he's suddenly in a rotten mood. He's suspicious of a friendship his wife has with someone and has really blown it out of proportion. Just tonight she called me, scared and sitting in her car, because of the way he acted tonight. He was acting like her lord and master, saying she must respect him and being arrogant. She overheard him telling someone on the phone things that makes her believe he's going to cut off her cell phone and internet use to punish her. He told her that their children are innocent and so is he and how would they feel if they knew their mother was a *****? Yes, he called her a ***** twice tonight just because he's built up this friendship she has (which is innocent).
She called me from the car she was sitting in and while sitting out there he shut off the porch light and front entrance light, which she said they always keep those lights on and she was worried. I told her maybe he thought she was going to sleep in the car tonight but just to be safe, I asked her to keep me on the phone when she went back in. He had locked the doors but she was smart enough to take her keys. He didn't know that, though.

Obviously I'm worried about her but I'm not sure what to say or do to help her or him. I've been friends with them for many years and love their kids like my own. I really can't believe he'd ever hurt her but he's acting irrational again. He seems to go from one extreme to another. One minute he tells her he loves her and can't live without her and then he treats her like this.
I asked if she'd be able to talk to him calmly and she said no. He won't listen. Then I asked if she can maybe talk to one of his guy friends (she's friends with too) and see if she can get him to talk to him, to tell him that everyone's noticed his mood change lately and ask if he got off his med and try to encourage him to get back on. I don't know what else to do.
If he ruins this marriage it will be his own fault and yet he doesn't get it. He will blame her. I worry that he'll turn people away from her or even the kids. Or that he'll try anyway. I'd hope he wouldn't do that! I just don't know what to do. I swear he's acting possessed tonight. What, if anything, can I do to help my friends?
Does all this behavior sound like bipolar, especially unmedicated bipolar?  I'm really sad because he seemed to be doing so much better lately and now this. :( I'm also worried about my friend and the kids, obviously.Please help.

[ILADVOCATE]

Well it depends how extreme he is with her and her kids. If it is emotional abuse for her sake and as well as the kid's safety she should definitely leave. Someone should encourage him to go to a walk in clinic and afterwards they could set up some form of follow up to see that he takes his medication.

[April2]

If only he'd be willing to do that, though. He thinks he doesn't need the meds. He doesn't seem to see how badly he's acting. His anger is out of control and I'm worried about my friend for obvious reasons. He can be manipulative, too, and charming. I've seen it. She just deserves better than that kind of treatment. I wish there was more I could do. I hate to see him destroy their marriage but I've told her she's welcome to stay with me, her and the kids, if he kicks her out. I just worry that he'd try to take their kids, especially the way he was talking tonight. Man, I wish he'd see how he's acting and affecting her and the kids. Her kids get scared of him when he shows this kind of anger. He was slamming things around tonight and yelling. I'm just worried about all of them. :(

[ILADVOCATE]

From having made a basic full recovery from schizoaffective disorder (with the bipolar aspect, you could read through my posts) and having a family member starting treatment for cyclothymia (mild bipolar) I'd say yes. Sometimes anti-depressents alone can worsen mania in a person with bipolar but only a psychiatrist can make a conclusive diagnosis. It is hard for people to remain in treatment but it should be presented to them in a supportive way as being helpful for their recovery because it will be. If you want more information on mood disorders we have some websites linked up (go to the welcome page) such as "Depression Central" (for all mood disorders) that might help explain things better and that information could be brought to a pscychiatrist.