Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.
Chiari, per se
, should not have anything to do with bipolar disorder, at least not directly.
Firstly, he has a genetic disposition to bipolar disorder from his grandparents, whom I assume are also your sister's parents. She probably inherited these tendencies, as there is a strong genetic factor.
Jake may very well have inherited these same genetic tendencies. I do not know what kind of environment he grew up in, but if there was disruptive behavior, or even the stress
of having so many siblings, and having a disorder that was probably difficult and perhaps painful, this could have added to the environmental factors that go hand in hand with encouraging bipolar tendencies to become manifest. Significant environmental stressors do play a role.
After Jake's surgery, with his difficult surgery, his sleep-wake cycle may have been interrupted over a period of time. People with bipolar disorder have a genetic predisposition to these abnormalities. The disruption of this pattern may be responsible for triggering the symptoms of depression and mania.
Loss of sleep may precipitate mania, which you described as elation, in some patients. Merely worrying about losing sleep can increase anxiety
, thus worsening the bipolar mood disorde. Once in a manic stage, the person deprived of sleep can continue or even augment his or her state of mania.
Studies have shown that disruptions in the social rhythm (sleep and other day to day schedules) can precipitate mood changes even two months after the disruption.
The best thing for Jake is to be examined by a psychiatrist for bipolar disorder and get the appropriate treatment as soon as possible. His routines at home should be regular to encourage getting enough proper sleep.
I wish the best for Jake and for all of your family, and urge you to tend to his needs as best as possible. As you stated, bipolar disorder when caught early can be controlled and the patient can lead a very normal life.
Elliott Sewell, LPCC, NCC, CCMHC