It’s good that you reached out for help.
You say your ex-partner is bipolar 2 (no full blown mania) and has post-traumatic stress syndrome.
And, “She will not take lithium because it turns her into a zombie. She has an anti stress medicine but I am not sure if she takes it.”
You note, “In 2008 she had a serious accident and suffered burns to 26% of her body. For 5-6 years she was on meds to reduce her stress levels and there were no eposoides”
So, when she takes medicine, she has no episodes.
It looks like she needs to see a psychiatrist, and get on some medicine.
As a biopolar I person, one who has full blown mania, while your ex-partner is bipolar II, which means hypo mania only, not full blown.
I take Lithium for my mania, and Mirtazapine anti depressant for my depression. The first time I took Lithum, I felt like a balloon which had the air let out of it. I didn’t realize I was that tense, but I was.
I think if your ex-partner would take a mood stabilizer, like Lithium, which she can’t take but there are several others, she would see a world of difference.
Her attitude seems to be getting in the way. If she would be positive maybe she would allow herself to try another mood stabilizer or 2, would be able to see herself as getting better.
The time to see this psy. is when she is doing OK. Or, during an episode when she ends up in the hospital, and just stay on the medicine they give her.
What does she do after she gets out of the hospital, and they have her stabilized, she quits taking her medicine?
I used to be very neg. also, and it was tripping me up, but she could be like me, her own worst enemy.
You say, “I can not say for sure she is manic but the pattern is identical to her previous eposoides.
“how can I be certain she is manic? When do I call policer, her family.
“What is a reasonable time between checKS.”
Below is some data from mayoclinic.org which talk about some of this:
There are several types of bipolar and related disorders. They may include mania or hypomania and depression. Symptoms can cause unpredictable changes in mood and behavior, resulting in significant distress and difficulty in life.
Mania and hypomania
Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization.
Both a manic and a hypomanic episode include three or more of these symptoms:
• Abnormally upbeat, jumpy or wired
• Increased activity, energy or agitation
• Exaggerated sense of well-being and self-confidence (euphoria)
• Decreased need for sleep
• Unusual talkativeness
• Racing thoughts
• Poor decision-making — for example, going on buying sprees, taking sexual risks or making foolish investments
Major depressive episode
A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships. An episode includes five or more of these symptoms:
• Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood can appear as irritability)
• Marked loss of interest or feeling no pleasure in all — or almost all — activities
• Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected can be a sign of depression)
• Either insomnia or sleeping too much
• Either restlessness or slowed behavior
• Fatigue or loss of energy
• Feelings of worthlessness or excessive or inappropriate guilt
• Decreased ability to think or concentrate, or indecisiveness
• Thinking about, planning or attempting suicide
If you have any symptoms of depression or mania, see your doctor or mental health professional. Bipolar disorder doesn't get better on its own. Getting treatment from a mental health professional with experience in bipolar disorder can help you get your symptoms under control.
When to get emergency help
Suicidal thoughts and behavior are common among people with bipolar disorder. If you have thoughts of hurting yourself, call 911 or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend. Or call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).
If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.
Left untreated, bipolar disorder can result in serious problems that affect every area of your life, such as:
• Problems related to drug and alcohol use
• Suicide or suicide attempts
• Legal or financial problems
• Damaged relationships
• Poor work or school performance
• Mood stabilizers. You'll typically need mood-stabilizing medication to control manic or hypomanic episodes. Examples of mood stabilizers include lithium (Lithobid), valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro, others) and lamotrigine (Lamictal).
• Antipsychotics. If symptoms of depression or mania persist in spite of treatment with other medications, adding an antipsychotic drug such as olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon), lurasidone (Latuda) or asenapine (Saphris) may help. Your doctor may prescribe some of these medications alone or along with a mood stabilizer.
• Antidepressants. Your doctor may add an antidepressant to help manage depression. Because an antidepressant can sometimes trigger a manic episode, it's usually prescribed along with a mood stabilizer or antipsychotic.
• Antidepressant-antipsychotic. The medication Symbyax combines the antidepressant fluoxetine and the antipsychotic olanzapine. It works as a depression treatment and a mood stabilizer.
• Anti-anxiety medications. Benzodiazepines may help with anxiety and improve sleep, but are usually used on a short-term basis.
Finding the right medication
Finding the right medication or medications for you will likely take some trial and error. If one doesn't work well for you, there are several others to try.