Thank you for the additional information and responses to my questions. Before I provide you with some strategies you may consider, I will respond to each of your questions below.
Questions: 1. Are there "degrees of bipolarizm'?
ANSWER: There are phases (peaks and plateaus) in bipolar
conditions. Degrees suggest severity and that is not the typical way we diagnose using the DSM...now version 5. Rather we use a five part axis system....
2. Can truly bipolaristic people self medicate as in 'take a pill when you feel you need one'?
ANSWER: I would never suggest that anyone at any time self medicate, whether their condition is physical or psychological. Even when a prescription is written "PRN"... there are usually specific instructions as to when, how, and under what conditions those medicines are administered. Even over the counter drugs, have specific instructions on use, and usually a time limit that if symptoms worsen or do not improve, immediately seek the advice of your physician.
3. Is this condition permanent?
ANSWER: I would not refer to the condition as permanent. Rather I believe a more appropriate term to use is "Chronic". The condition will probably never go away (unless we find a cure); HOWEVER, the condition can certainly be managed so the individual can effectively function.
4. Can any more be done than provide the strongest possible emotional support and follow the psychiatrist's instructions with regard to medication?
ANSWER: See my further comments below.
5. Is it fair to say he is very likely to get better and function at a high level, as do many other with his condition?
ANSWER: I would think with proper and appropriate intervention his situation should improve.
FURTHER COMMENTS AND NEXT STEPS:
I sincere hope you do not take my initial remarks as anything but objective and without malice. However, no matter how bright we are, or how much knowledge we possess, it is never a good idea to try to treat ourselves, especially when psycho-social issues are involved. Indeed, whenever I have had issues, either with myself, or my family, even if I had the answers (or thought I did) I would always refer to others). I strongly urge that you and your family do the same for your stepson. Toward that end, you have told me that you do not think he is actively involved with ANY mental health professional. As such, I suggest you consider the following and take appropriate action as you see fit:
1: Get your step son to a Psychiatrist ASAP for an immediately evaluation of current condition and review of medicines.
2: With consultation from the Psychiatrist, have your step son commit to seeing a competent and qualified mental health professional (there are many in the New York City area) that could see him regularly to deal with the issues that effect and impact his condition. I strongly urge a mental health counselor (Psychologist, Social Worker, Psychiatrist) but one who is a designated Mental Health Counselor (now licensed in NYS) who can competently deal with the myriad of issues your step son is facing. Without knowing the case details, I can assure you that this condition is complex that requires constant and consistent intervention by a competent therapist.
3: You and the rest of the family can best be supportive by insuring that your step son seeks and remains in a therapeutic relationship and NOT attempt to treat or offer treatment... some of his issues may involve those who are trying to help.
4. Provide, as you currently are, as much love, support and encouragement in a realistic and pragmatic fashion...that is the best intervention for family members.
I hope this has been helpful for you. Please contact me with either a new question or if you need further information if necessary. I look forward to your feedback and positive rating.