I know toxic levels from meds can cause similar bipolar symptoms in people with a compromised liver. My husbands mental state was so bad a couple weeks before he died it was scarry to watch. His therapist even admitted to use after a 3rd ER visit for mania, that she "poisoned" him with the Lamotrigine she was giving him. in addition to the 5 other meds.(He had to fill 11 perscriptions in a month and a half)He couldn't even walk straight, rapid speech,hallucinations,repeating conversations and searching for items for 6-8 hours at a time,fear of being taken away. Like I said, it was scarry to watch.My fear is that my husband of 15 years was suffering from being mistreated and undiagnosed. Is this a possibility?He also had thrombocylopenia and leaukapenia sicne 2004, these were never addressed only noted in his records.He was a alcoholic. No liver test were ever ordered, only standard CBC. NO MRI, ultrasoud or biopsy were ever ordered. He had spontanious bleeding as well