Exactly, which is why he should go to a regular doctor, as well – who can probably reccomend tests and such. While a tumor isn’t likely, behavior like his friend is having should still be checked out. Bozuit isn’t qualified to diagnose his friend, nor be able to tell if he’s a danger or not.
The whole, “they’ll lock him up and throw away the key!” hysteria shouldn’t prevent those who need it from getting treatment. His friend may genuinely need help.
I am happy for you.
As far as I know, standard operating procedure for someone going through a manic phase with delusions is a few days under observation. And considering the pharmaceutical inputs (an SSRI and cannabis), while a tumor is possible, I don’t expect they’ll even try to do an MRI. “When you hear hoofbeats, think horse, not zebra,” and all that.
There’s a whole range of possible prognoses here, but from my experience of mental health care in the USA, I would expect him to be pushed into a short-term (2-4 days) stay in a psych ward, which the hospital will then claim was voluntary on his part so they can bill him $2000 a day. This will be followed by “outpatient care” which will barely actually happen due to lack of trained personnel, and may involve going back on citalopram, or more wacky drugs.
Ahem. Yes, I’m still bitter about it.
Seriously, though, coming off an SSRI is like a religious experience. It opens up parts of the range of human emotion that the patient hasn’t been able to access, because the SSRI suppresses them. Throw in cannabis, which can induce hallucinations, and you can have a lot of NEW and EXCITING ideas and perceptions that feel an awful lot like TRUTH and ENLIGHTENMENT. The memory of that may stay with him and affect him the rest of his life.
Also, since SSRI’s often suppress sexual function, coming off means things like orgasming more quickly, or being able to orgasm at all, depending on how much the citalopram messed with that. It could also affect erection, even urination. Does this sound like your friend’s sexual oversharing?
Well in that case shouldn’t everyone on earth go for evaluation to make sure they aren’t dangers? 
Shit everytime anyone tells me anything I’m going to call mental health services since I’m not qualified to know whether they made threats against others or their own life, let me put it on speed dial.
Serveral people here have gone so far you’d think everytime they feel deja vu they go check into a mental hospital for observation, because you never know what could happen years down the line, hey they could become dangerous at some future point!
I’m categorically not touching any of the religious discussion anything in this thread. No way no how.
I would be worried for your friend. One, you describe a very very large swing in a very very short time. Suicidal to euphoric is a huge range. People don’t usually do that pretty much overnight. He sounds like he’s so preoccupied with the new feeling that he can’t recall what it was like to feel the other way, which is a bit of a bad sign – if nothing else, those who cannot remember history are generally doomed to repeat it.
Two, his ability to explain what he’s thinking and his expectations that you will understand are badly mismatched. You say he expected you to get what he got after a brief surface explanation, when what he’s trying to get across is clearly something he feels goes very deep. It suggests he doesn’t really know how he sounds outside of his own head, or can’t distinguish in short-term memory between things he’s said aloud and things he’s cueing up to say that don’t manage to escape.
Three, he seems to be persisting in behaviors that make you uncomfortable. If he’s talking to you about his new feelings, you’re probably someone he should know well enough to know what level of penis-chat you will and will not be comfortable with. This suggests that either he isn’t able to self-monitor, or he isn’t able to keep long-term knowledge about you in the forefront of his mind.
And four, citalopram shouldn’t be discontinued suddenly. It has a rather short half-life, and brain transmitters do not re-normalize themselves fast enough to compensate. If nothing else, he may be at risk for something like seizures, particularly if he’s adding other drugs to the mix. You may wish to put in a call to whoever gave him the citalopram, if you can find the information. It might be on the pill bottle. The doctor can’t tell you diddly about your friend, but there’s no law that says you can’t leave a message for the doctor describing what’s going on.
Most people, whether they’re having a revelation or a manic episode, are not actually out to harm others. People who aren’t thinking clearly, however, may perceive threats where none exist, or fail to recognize the risk in what they’re doing. A much more likely danger is that you’re going to get stuck doing all the housework and possibly repairing things for the forseeable future, as he’s going to be much too involved in whatever he’s got going on to take care of things on Planet Earth. If this is mania, you may also get awakened at three in the morning when he needs someone to talk to. Good luck.
This could well be it. He’s got a new prescription for citalopram now - a lower dose than before - but annoyingly he didn’t even pick up the actual pills on the day he got the prescription! I hope he’ll do that today.
He knocked on my bedroom door in the middle of the night last night. I wasn’t asleep but wanted to be left alone to go to bed by that point. He sat down and told me he wouldn’t be surprised if he dies soon, and maybe that’s what has to happen to make what he says more credible. He said I shouldn’t be sad etc. if that happens and it’s OK as long as I don’t die too, since I’m the only one to have read his ideas (he wrote something down but it’s really not coherent). He did stress that he is not going to hurt himself, which I believe for now. I was very tired and starting to get irritated with his egotistical behaviour (yes I know he probably can’t help it) so although I didn’t say anything to that effect, I really couldn’t hide in my expression how unwelcome this was. I don’t know if he saw that but thought his message was important enough that he should ignore it, or if he really couldn’t tell that I wanted to be left alone.
He does seem to want to talk a lot. My hints that I would prefer to do something alone are normally ignored. The other day he managed to keep a conversation I wanted to get out of going for around 4 hours or more. Part of the problem is that he talks for minutes at a time then starts talking again before I’ve said more than a few words. I think this is mostly unrelated and that it’s because his short-term memory is awful (especially when he’s high) and he feels he has to say absolutely everything in his head before I’m allowed to reply, otherwise some point might be forgotten.
He appears to be at his worst when he’s the most high, which I take as a good sign. It hasn’t been long enough for me to be sure about this though - there are other explanations (including coincidence) for why he might decide to bring this subject up again at the same times he’s very high. He’s going to his parents’ house for a week or hopefully a bit more to keep off weed since his dad is worried about him too. I think that will be good for him because he does respect his parents and will listen to them more than a peer (me) and they’ll make him spend some time in the real world as opposed to hiding from it as he largely does here (and I enable it).
Once again, thanks for all your replies so far. I’m going to be unable to post for the next 2 days or so, but I hope any of you with useful insight will check back in a few days - I don’t want the thread to die because I went away.
Sounds like he had a drug related (or sudden lack of drug) “peak experience”. It’s a common enough thing when the brain gets excited enough due to drugs or meditation or intense prayer or physical activity.
He just needs to ground himself. Tell him to meditate, do yoga, volunteer, or drink a lot of fluids and eat some healthy food. Or take a nice nap. That might bring him back to earth.
Whether he’s a prophet or not, it doesn’t make you his disciple. If he gets annoying tell him to go write it all down or make some visionary art.
This sounds simular to something I did go through in my ‘dark days’ Expecting to die but not thinking of initiating it - actually something worse the death but it would be too much of a digression to got there. Though I had someone who cared about me and went through something simular and she would call me and speak for sometimes hours to make sure that I was OK - actually there were a few such people but she was the first that came to me that showed me true caring. This was also a learning point on my journey to find that there are some people I can open up to but not to others who would not understand.
The major difference is that she desired to do so, you don’t desire that ‘role’ in his life, nor does it seem like you are qualified as you lack such life experience. Also for me it was nicer as it was a m/f relationship so there was a less inhibited closeness then you typically get with a m/m one.
To this day we keep in touch and it is still comforting to hear her voice, actually seeing her later today on a hike.
So as I see it you are not really qualified to do much, nor can you, except if you see that he is hurting himself or others from monitoring the results of his actions and decisions, and in that you admit that his life appears better then it was, though the high use of weed is a bit troublesome. You also have to take care of yourself and if you can’t handel him you may need to let him go/cut him off for your own good - so watch on his effect on your life.
Also would you care to share a few of his ‘not coherent ideas’.
I agree with the first part and strongly disagree with the second. I think the average person can differentiate between ‘my friend is acting weird’ and ‘my friend may be a danger to themselves or others’.
I object strongly to the word “hysteria”. My opinions on whether he’ll be held on a psych ward are based on past experience. Nor, also based on past experience, do I think I’m over reacting.
I missed this before. I could not agree more that suddenly going off an SSRI is a very, very bad idea. The withdrawal is horrible. Antidepressant discontinuation syndrome - Wikipedia SSRI withdrawal may explain some of your friend’s problems. It makes it very difficult to function.
I think your friend needs help. Professional help. ASAP
Smoking up may not necessarily change what he’s thinking of so much as it makes him more willing to talk about it and impervious to any indications that his audience might want to go to bed already. Being intoxicated tends to silence the little voice in the back of your head that says ‘hey! my roommate might not want to hear this!’ It’s the same general idea as in vino, veritas.
Just FYI, you’re not responsible for your roommate’s mental health. You’re not required to keep trying to talk him down, especially if it isn’t working. You sound like a nice guy, so you might want to step back a bit an assess what you think you have an obligation to do for any random human being (“inform people closer to him, call someone if he seems like he might hurt himself or others” is a pretty good start) and at what point you can simply refuse to listen to any of this and leave it alone.
Based on what you’ve posted the chances are close to 100% he’s dealing with some major mental dysfunction issues, and on the swing down after this phase is over and the tide goes out on this brain chemicals he is going to fall into a yawning chasm and he may attempt suicide.
People with these sorts of issues are OK until they are not, and at that point are utterly unreliable and potentially dangerous. I would not be a roommate with a person undergoing these kind of mania swings. You’ve had plenty of warning and at this point you are rolling the dice.
The posters cautioning on intervention have a point re it being his life, and to some extent none of your business. You cannot cure someone with these sorts of problems all you can really do is use various drugs and hope for the best. Sometimes the results are miraculous, but mostly not. Talking to them hoping to have them see the light is utterly and completely useless. You cannot fight his brain chemistry malfunctions with conversation.
If you think he’s going suicidal refer him to the authorities, otherwise you need to find another place to live. You are very vulnerable if he snaps and gets violent. Having a person in psychotic phase tell me they want to “help me reincarnate” is all the heads up I would need to get packing, but you’re trying to parse it into something benign.
You indicate these swings are getting wider and more intense. You need to get out of the way.
An important distinction needs to be made between “tell your friend about available mental health services” and “tell mental health services about your friend”.
Again, if he just came off Celexa/citalopram, what we’re looking at is probably a result of withdrawal rather than a manifestation of chronic bipolar disorder. Get him through his crash if there is one, and maybe he’ll be OK.
Not saying he isn’t depressive or bipolar naturally, just that he may not be naturally prone to this degree of mania
I don’t think anyone said anything about reporting said friend to a mental hospital. It’s mostly urging him to get help, however.
Now, if he starts trying to stab people, or blow up buildings, THEN maybe he could consider it.
I, for one, welcome our new stand-up comedian overlords
There is a difference between a stone age religion and a man in modern times sprouting this stuff.
Sorry but I don’t feel comfortable doing that. I know he wouldn’t want me even saying this much, but for now it’s fairly unspecific and just to help me. If I actually share his ideas I think he’d take that much worse and see it as me actively trying to undermine or make fun of him.
The thing is that I probably am the one who should be doing this. There’s his parents and there’s me. He has other friends but there’s no one else who spends anywhere near the same amount of time with him. Unfortunately this kind of behaviour really freaks me out, possibly because I have actually dealt with some similar stuff before and it got pretty scary. I want to be able to help him better but being alone with him makes me uncomfortable, especially since I don’t know the limits of this behaviour yet. I’m aware this quite possibly makes me a coward and a pretty bad friend. He’s coming back tomorrow (I should have known he wouldn’t do a whole week) and I suppose I’ll see how he is then.