Hi everyone

I never really get depressed or manic.  Sad/down sometimes if I pass the sports centre where my partner passed and haven't done so for a while, a bit manic if i have a deadline to meet so I will use someone else as an example.

Male 32, responsible job with mental health home treatment team.  Well-paid, flexible working, overtime available.  Supportive wife, 2 children, 1 due, comfortable affordable home, 2 cars.  A very capable, competent employee who's well thought of professionally.

Personally very comfortable with his own family, parents, sister etc but less so with everyone else.  He could be described as socially awkward though largely manages to hide it (would put one of his children between himself and another person at a mixed gathering meal).  Sometimes described as depressive Dave by his wife.  Apparently was a 'fat kid' and had bulimia whilst at university.  Over indulged by his parents as a child, he demanded midget gems, they went out and got them.  His mother lives her life through her 2 children and grandchildren (difficult relationship with her own mother) and is very full on though less so now due to his wife's influence.

Alcohol dependant, (would vigorously deny) carries out weekly bargaining with himself/wife - I'm going to make this bottle of wine last all week, gone in 2 days, I'm not going to drink until the weekend, doesn't last a day etc.  If out with mates doesn't know when to stop drinking, likewise on holiday, will start early if it's all-inclusive.  Often wears shorts and a hoodie with the hood up in his own home.  Covered in tattoos and is often looking forward to the next one.  Since growing a beard he sometimes lets it get long.  Despite being told by everyone it looks better trimmed he leaves it (an indication he's not feeling good about himself according to his wife.).  Goes to the gym, 5.30 am before work but then has periods when he doesn't and feels fat.  Does kick boxing 2/3 times a week with his 6 yr old son.  Unhealthy understanding about food.  loads of protein, no fat, too many energy drinks, diet coke, all food spicy, limited range, eats very fast.  Often on CM Lanzoprazole for reflux.  No stress incontinence to my knowledge but very frequent urination particularly during the night.  Doesn't like being on his own, watches TV but is often on his phone as well, can't sit and relax.

Issues with neighbours.  At the previous house a neighbour who rented was blocking their right of way with her 'stuff'.  She'd been told but had done it again.  As his dad was explaining once more, he became aware and took over in a very forceful manner.  Recently a neighbour's daughter blocked their driveway with her car for 1.5 hours whilst she visited her mother.  At work, he said had he been home, he'd have gone straight round there and told her to get it moved.

A multi conflict case I tried to get to the bottom of some years ago before I knew of Meta-health.  Fiercely private he wouldn't dream of talking to anyone about what's really going on.  Both his wife and myself suspect the root cause being some childhood trauma somewhere as he always seems to be either running, hiding or sometimes defending/fighting his corner.

The triggers for his low state appear to be a worry of some sort.  A large bill, he worries about his perceived ability to pay (even though he can).  Drinking too much, not going to the gym etc so he withdraws into himself and it's a downward spiral with 'nothing to look forward to'.  Lack of sleep when his second son was a newborn and he announced to his wife that not one bit of it was enjoyable.  Some form of life's responsibility overwhelms him and he slips down the autonomic ladder.  In so doing, in all these situations he can retreat from life and hide within himself where no one can reach him and it feels safe.

Defending his territory seems to generate manic outbursts.  Perhaps similar with finances, reminding his wife how much he earns and she doesn't when family expenditure is required and he's feeling that way out so is protective of 'his' money too.

When not balanced I was going to say he's more often in a low state than manic.  However he will suddenly clean or vac up in a quick abrupt manner.  He tends to cook in the same way, puts the oven on full temperature every time.

As an observer, it must be exhausting, I don't know how he keeps going.  He's not as bad as he was but I don't know how I can help.  His life could be so different but I'm sure we can all say that about someone we know.