Lithium is considered the Gold Standard for bipolar treatment .

Although not always best for depression.

I think you should follow the Dr's advise.

If your son still smokes Pot and drinks, treatment for BP is just going to be that much harder.

Good luck

From my understanding Lithium works well for both mania and depression. I don't what your son's DX is but he sounds more on the depressed scale than manic. If he was greatly manic anti depressants would be totally out of the question. I think a person needs a good structure , regular sleep schedule, and some basic coping skills in place if they are dealing with bipolar or substance abuse. Then wean off.. maybe he isn't all that serious of a case and the doc thinks he will be okay.

my son doesnt smoke pot or drink anymore - 16 years ago he ws heavily and appeared "manic" Since he suffered from depression they diagnosed him wiht bi polar II and put him on zoloft and lithium. For about 7-10 years he ws fine but then the zoloft stopped working. His depression is very severe. I just thought that lithium was for the manic side but I guess its not. He is only weaned down a little for the last two days and already is very agitated and argumentive. Next week he will be on 10 mg and will see the dr again and then we go to Cape Cood - I am worried that he is doing this right before vacation and there will be no support, except family, for him out there.

PS - my son thinks he is not bi-polar -he thinks that when he was smoking and drinking it just looked like a manic episode- and that is possible - it could be depression only but, he is so depressed it scares me. He has a twin brother - identical - and he doesnt take meds - he has never been diagnosed but there is a definite mood thing going on in both of them

Bipolars don't want to take meds - when they work, we think we don't need them - when they don't, it absolutely feels Worse...

There is a group on here for Family and Friends, you'll get better advice - from the family side.

Dr. Drew said something I like - if you think he is suicidal - I would rather piss him off, and admit him. then him to think and pull it off. So, if he's not homicidal and suicidal - life sucking, depression can last a LONG TIME... I was bed ridden in melancholy a 18 months almost - ok, not all bed - but didn't want to do Anything, with anyone..... its harder to watch then to be in.... so my heart goes out to you...

Damned if you do, and damned if you don't. Now If you son is a grown man, I learned detachment with Alanon - my job, was not to create a crisis or Stop one... he has his own lessons in life... a man can learn a lesson carrying a cat by the tail, that you just can't tell him : )

Family and Friends of Bipolar

http://www.dailystrength.org/c/Family-and-Friends-of-Bipolar/forum

Gina you said it best. Its hard to be bipolar and go off meds. I tried that a bunch in my 20s and I always got manic, I tend to get manic more than depressed anyway. Good luck and keep a close eye on your son.

thanks guys - he is not doing good - fighting with wife - or trying to - she is trying so hard to just be there for him and love him and not argue - he doesnt think its because he has gone to a lower dose - but it is.

It's hard to even diagnose a mental health disorder if someone is abusing substances....
It's great that he's working with his doctor... Hopefully he'll keep an open mind... It can take quite some time to get onto the right med regime and the meds unfortunately have side effects
Most people with bipolar disorder need them though...sigh....x