is it bipolar, multiple personality D/O, alcohol, or cocaine

by Nadia Genda
(TX)

Hi,


A Dear friend has such abrupt personality changes in a 30 min period. Ex: he started texting, then alternating phone calls all in a 30 min. period that went like this: Phone call #1- hung up no message, 3 min. later text #1 told me I am a liar, a twister that I need to get help before judging others - do I understand hot shot?? 5 min later text #2: he tells me he has faults he is working on and I have many. 10 min later 3rdtext: he tells me what does it matter anyway. 5 min later text #4: he is sorry for all the hurts, deeply sorry. 5 min later 2nd phone call: he jokes calls me crazy, then says let's put it all aside, leave our character out of it and have dinner if I want to call/text him.

The whole point was to have dinner 2 weeks ago which he kept postponing...we are supposed to be friends, I got made because he asked me to send a sexy picture of myself...he had never asked such a thing before and we have known each other 2 yrs. I didn't think he would but I reversed it and said no the requester should send first...so he went ahead and did, it was shocking and I got mad because no male friend has ever done that and I felt he went off the deep end and was so focused on that instead of getting together for a nice dinner to catch up after our last interaction he told me never to contact him again, then two months later he called me and all this happened when I thought it was going to be a nice reaquaintance dinner. After talking about how it upset me for two hours, then he kept postponing dinner, then got angry, what were we going to talk about at dinner, like why need to meet?

Seems crazy to me, so erratic with mood changes, but then he always comes around to apologize and start over. I am so exhausted. He has a long term history of drinking maybe 8-12 scotch 3 times a week, says he never drinks alone at home, only out and this is when I see it. I told him to get help, but I think something else is going on here so am asking if it is bipolar, MPD, the scotch, possibly cocaine or even narcissism or a combo? thanks for your help. I told him to please get help, to forget me and that I must say and keep my boundary. So far 3 days no contact, but In the past I have always been soft, forgave, only to find getting swept up again and worse. Thanks so much for your time and help. I have tried to help him, but he either does not stick with something very long or never follows thru, then he tells me I blame him (which I don't) and that I put guilt on him and I have to learn to accept people as they are...then again he apologizes...a never ending cycle.

Ben's Response:

Your friend would not be simple to diagnose even if he were to see a professional and get evaluated, for the simple fact that he drinks excessively. You say you know he has a long history of drinking 8-10 scotch 3 times a week. That alone is a sign of a serious problem. But I have never met an alcoholic who didn't seriously minimize how much that actually drink. A fairly good rule of thumb is to double whatever the person tells you.

It is a concern that he has such sudden and bizarre personality changes, and that can be what is called "labile mood" - which can occur during the manic phase of bipolar disorder. Other drugs can definitely cause these kinds of symptoms too (especially stimulants like cocaine or methamphetamines).

You have to understand that substance abuse can worsen, or even create all the symptoms of a psychiatric illness like bipolar, so as long as he keeps drinking, effective treatment would be near impossible.

You can always add personality disorders into any pre-existing addiction or mental illness, so narcissism, borderline personality, MPD/DID, etc, will only further complicate the whole thing.

But the bottom line is, if he doesn't stop drinking, he is going to get worse - mentally and physically. And if he isn't willing to get help with his drinking, there is very little you are going to be able to do for him. Just use good boundaries, and don't let his unpredictable behavior turn abusive. You don't have to subject yourself to that.

If he wants to get help, I would recommend he see a good licensed therapist who has experience with bipolar disorder and also specializes in addictions. And he has to do it for himself. If he just gets evaluated to satisfy you, it wont change anything. He's going to need more than just a one-time evaluation.


Take Care,
Ben Schwarz, MFT


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