I'm hoping someone can offer some good advice on encouraging my brother, I'll call him Jan, to seek more conventional medical treatment for his bp. He was diagnosed about two years ago after he was hospitalized for severe depression in the fall. He was placed on anti-depressants at that time. He's very seasonally affected and in the summer he cycles into mania. He's been on lithium twice and it worked very well at controlling the overabundance of energy and aggression he experiences during a manic episode. But two months ago he weaned himself off the lithium because he wanted to pursue alternative therapies (herbal remedies for the most part). I'm not sure if his md knows he's off the lithium. He doesn't have a p-doc - he saw one for a while but didn't like the "let's-dig-through-your-childhood" approach - he wanted something more focussed on strategies for dealing with the present. At first it seemed that he was doing okay off the lithium but my mother and I are becoming very worried about him. As the summer arrives he is becoming more and more manic - tons of energy, a million projects on the go but none of them completed. But the biggest indicator (this has happened twice before) is his mood. He is very aggressive, very sensitive, and easily aroused to irritation or anger which he expresses very forcefully - to the point of shouting. He always apologizes afterwards but it's difficult to live with both for us and, I think, for him. He must be exercising iron control but he just can't fight his own brain chemistry. I am really hoping that someone could steer me in the right direction in terms of bringing up the topic of his current condition and encouraging him to seek treatment. I am worried about him and I am also worried about my parents, who are his main support system and are bearing the brunt of this episode. Both of them suffer from unipolar depression (as do my sister and me - call us the Zoloft poster family - Jan was actually initially misdiagnosed as unipolar because it's so common in our family that no one even thought of bp) and this makes it doubly hard on them - not just because he can be very hurtful and, to be frank, mean, but also because they care so much about him and it's devastating to watch him go through this again and to worry about what will happen in the fall Does anyone have any advice on how to bring up the topic of treatment in a way that might make him more receptive? Even if it's just what not to say, it would help a lot. And also how do you tell someone that their behaviour is inappropriate (shouting, etc) without escalating the situation? Any advice would be appreciated.
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