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<sup>Dear "Mr. Smith,"

I am sorry to hear about your son's refusal to accept his manic-depressive diagnosis. I understand your concern, especially since manic depression, without proper medication and treatment, gets to be more severe. The mood swings tend to come more frequently and the moods themselves, more severe in nature.

It is very nice to see a father who cares this much about his son. To seek out and write for help is a sure sign of a love that your son has from you that are not very common. For the mere fact that you love him, doing nothing else, is a positive factor and will help, I believe, in the end. People carry the love they get from their parents, or others, inside of them... and that inner support is priceless.

Yes. I have manic depression. I found out in my late 20s... I am 38 now. I went through some very severe and tough manic episodes, hospital stays, depressions and much all the horrible things that you may have heard of when learning about manic depression. Since then, I have been educated, consistently medicated and have an okay time of it.

It is not uncommon for manic-depressive to be in an inner or outer denial of their disorder. Especially men. I think men have a greater struggle with this than do women because of certain stigmas we live with. While depression sees more female victims than male, manic depression is very different. There are equal numbers of both the male and the female manic-depressive. It is considered a weakness to have a mental or mood disorder, especially one viewed as possibly a more 'female' one like depression. Therefore, when men hear 'depression' in a diagnosis, they hear 'Weakness' ...and sadly, weakness; in addition, mental illness, is not what most men want to hear or believe about themselves. The first gentle option would be to give him information, like the fact that this is a men's illness equally or that as in diabetes, this is a chemical imbalance... it just has symptoms of mental illness, and so it is.

Another reason why there are many manic-depressive, is due to the illness itself. Because this mood disorder, of course, changes moods... they recognize how impaired they are and they may even blame their problems on some other cause rather than mental illness. Even still, I often do not realize symptoms that are very clear to others. For example, my racing thoughts and my rapid speech while I am in some form of mania do not seem or feel like a problem to me. It is not until someone lets me know that I am jumping from topic to topic, or that they cannot understand what I am saying, do I even realize that my symptoms 'are showing.' My thoughts are going so rapidly, that I often finish an entire idea or two and move on with other things before the other person has digested the first thought. So, your son may just really feel like he is fine and perhaps he was not diagnosed-properly.

Manic-depressive needs strong encouragement from family and friends to seek treatment. So, this may just take more people's opinions than just your own. Family physician can play an important role for such referrals. Many manic depressants that are not facing their illness WILL go to see a regular family doctor to speak about physical things. If you can somehow speak with his doctor in advance, let him know what is going on and your son's history and then convince your son to get a physical check up, (which we all should do anyway once a year, or two), perhaps this intervention and the referral from a doctor could work in your situation.

If this does not work, loved ones must take him for a proper mental health evaluation and treatment. Manic depression is often taken too lightly, and it is not a light illness, it is severe.

If your so is in the middle of a severe episode, he may need to be committed to a hospital for his own protection and for much needed treatment. I do not really know what the factors are in your son's illness, or how severe it is or has become.

Of course if he has considered suicide, he needs immediate attention, preferably from a mental health professional or from a physician; school counselors and members of the clergy can also assist in detecting suicidal tendencies and/or making a referral for more definitive assessment or treatment. With appropriate help and treatment, it is possible to overcome suicidal tendencies.

Education is important for the manic-depressive. The more he knows the more he will be able to see in himself and recognize as manic depression, (or considers it as a possibility and seeks medical advice). It is important for patients to understand that bipolar disorder will not go away and that continued compliance with treatment is needed to keep the disease under control. Call or write the National Depressive and Manic-Depressive Association, (NDMDA), 730 North Franklin Street, Suite 510, Chicago, IL 60610. Their toll free number is; 1-800-826-3632. They will mail out pamphlets regarding manic depression that your son may agree to read. Let them know your situation so that they can chose the pamphlets that would help you and your son the best.
The publications are free.</sup>

^{___________________________________________}

...for family, friends and loved ones of a manic depressive...

^{Coping With Someone Who
Does Not Want Help...}

Remember to take care of yourself. Often more than not, the family and loved ones of the manic-depressive have a very hard go of it too. They watch their loved ones going through the strains of the illness, struggle to help and be caught up in the sometimes-heated blows of the manic symptoms. You can better help yourself and your son by requesting, (from the NDMDA), information regarding family and loved ones. Those publications are also free. They can also advise you on the nearest location of support groups for families and friends. They mostly meet one time per month. Your son's wife may wish to attend one too, and hopefully if all goes well, your son can join a manic depressive support group too.

I hope that some of this information can be of assistance. Let me know if there is anything else that, I can do. I have been in a place where your son is now, and will help anyone the best that I can to get out.

Finding ways to be supportive when your help is rejected is difficult but it is possible.

Admit that your offers of support are being turned away by a person you care about. Until you do so, you may only acknowledge that you and your loved one are not getting along. You may not identity the root of the problem. Only by admitting to the rejection can you begin to cope.

Think about how you feel when your help is turned away. Try to put your reaction into words so you can clarity your feelings and come up with actions you may take in the future. For example, when your support is rejected, tell the person with the manic depression how you feel. Talk in a calm and no accusatory way. Ask what kind of support would be best. Maybe your loved one prefers if you just listen, ranter than trying to solve problems with specific suggestions. By just listening and saying that you hear and understand, the depressed person will fell more supported than if you make unwanted suggestions.

^{Realize that the person with manic depression may or may not want help or support. Understand that rejection is often part of the illness. Do not take it personally... this is very important.}

If you feel "stuck" in a communication pattern and unable to change it, talking to a professional counselor may help. Check with your doctor, your county's metal health department or even the NDMDA, and get the help and support that you need.

^{be good to yourself,}

^Lisa