How do I talk to my friend about suspected manic episode?

[Norberta]

In short I believe my friend (friend for 10+ years) is having a manic episode.

She has been absent from group chats and plans for weeks and has suddenly resurfaced sending long nonsensical completely bizarre and self absorbed messages on our group chat (I’m talking 100s of words and things that don’t really connect and insanely happy and up beat)

For context she does have CBT occasionally but otherwise has no diagnosed mental health conditions.

When we were at uni she did also have a breakdown of sorts where she took amphetamines consistently days (weeks) on end for a period of time and we had to intervene and threaten to call her parents. She did sort herself out and pass her degree but it was intense. She also has a difficult relationship with alcohol and since uni has had to embark on long periods (up to a year) of sobriety after some catastrophic drinking episodes. As far as I know she is currently not completely sober but seemed (until today) to be holding it together.
I think I need to speak to her candidly but with kindness about how she is feeling and what’s going on but I don’t want to make it worse or force her away from us.

please help me to help her!

If she’s manic it’s unlikely you’ll be able to get through to her at this point but after a manic phase a depression usually follows so maybe you’ll be able to step in more then? Often people only seek help when they feel low then get offered the wrong treatment, so maybe offer to go with her to the doctor or encourage her to tell them about the manic phase too in order to get the proper diagnosis and treatment? How is your friend now?

Thanks for your reply!

my friend and I went to see her a short while after the episode and talked things through. On reflection I wonder whether she might have been having some kind of drug induced bender at the time all this was kicking off rather than it being a period of mania. She denied that and said she was experiencing strange side effects from new anti depressants but…. I don’t know I’ve never seen anyone act like that from prescription drugs. We have since seen her again and it was clear she had been drinking before and was not quite on the same page as everyone else at the dinner. She also keeps telling strange lies about small things that don’t really matter but are clearly not true, I won’t go into it as there’s a litany but it’s just odd behaviour. She also asked to borrow money from another friend of ours which I thought was unusual.

Sigh, I think she is very troubled, in denial about her issues with substance abuse and probably quite lonely. So I guess all we can do is be there for her and keep asking whether she’s ok when these situations arise.

Anti depressants can induce mania in people who have bipolar/bpd so it could be a reaction to the meds however if she is using drugs/drinking then that will also be having an impact, unfortunately it's very hard to reason with someone when they're manic