Maggie asks…

My 21-year-old was diagnosed with Bipolar I after an extreme manic episode (he was hospitalized). It was a long and difficult few months (awful treatment, bouncing around to different doctors, etc.) during which his mania tapered down, and then turned into a deep black depression, which he is out of now.

No one can persuade him to take medication. Now that he’s feeling normal again, he seems to think that he doesn’t need medication. So no meds, no therapy, no treatment of any kind. And I am quite sure he’s self-medicating with “other” substances. (He lives with us – me/mom, younger brother, step-father.)

Advice?

Dr. Fink answers…

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Cathi asks…

My friend’s 9 year old has had severe behavioral problems and several alternating diagnoses. The Dr. has prescribed Focalin, Trileptal, Lamictal, and Seroquel. She has no concentration, violent outbursts, hallucinations, etc. She has been diagnosed, at present, with ADHD, Bipolar, ODD, and PDD. She will not do work at school; instead, she sits and picks at her skin. She has been violent and tried to choke other individuals. Mam says she can’t even leave the house with her.

My friend has no money. The state has removed an older child due to DMH reasons. She is afraid of the state agencies, but has nowhere to turn. Court appointed attorney said to call if she won the lottery. What happens to these children? These medications seem excessive and risky considering her age, the possibility of adverse interaction, and off label usage. Any advice or help. We are desperate. Thank you.

Dr. Fink answers…

This is an all too common situation in children with multiple levels of developmental, emotional , and behavioral symptoms, especially when the family’s resources are limited. The first place to start is with the current doctor to get a clearer picture of the reasons for the current medications and to express clearly the ongoing symptoms that are not being addressed.

The National Alliance on Mental Illness (NAMI) has a Stages of Emotional Responses chart that traces the emotional path people generally travel in coming to terms with their loved one’s mental illness. I’m pretty much at the final stage, Stage III: Moving into Advocacy, but I’m still sort of stuck at Stage II: Learning to Cope, which is characterized by Anger/Guilt/Resentment, Recognition and Grief.

Yes, we’ve been living with bipolar disorder for about 12 years now, and I’m still angry and resentful. Now, though, I’m not angry at my wife who has bipolar disorder. I blame bipolar disorder. It accosted my wife, tried to ruin our marriage, emotionally traumatized our children, ruined my wife’s career, and stole tens of thousands of dollars.

In an article in The New York Times entitled “Mental Health Needs Seen Growing at Colleges,” Trip Gabriel explores the increasing demand for mental health services on college campuses across the country.

The college years have always been vulnerable to mental health issues – partially due to the stresses of academic demands and the transition to living more independently and partially because late adolescence/early adulthood is the most common time to see full blown first breaks of major mental illnesses, including depression, bipolar disorder, and schizophrenia.

But in recent years it has become clear that more and more students are coming to campus with previously diagnosed psychiatric conditions and taking medications. While this may be a sign of over-diagnosed and over-medicated youth, I see it in a more positive light for three possible reasons:

Rebecca Riley was four years old when she died three years ago. She had been diagnosed as having bipolar disorder and ADHD and was being treated with clonidine (a blood pressure medicine sometimes used as a sedative for ADHD) and Depakote (for bipolar). (See the Department of Social Services (DSS) case file recounting the timeline of DSS involvement with the family of 4-year-old Rebecca Riley.)

The Rebecca Riley case underscores the need for professionals to obtain as full a picture as possible to reduce the risk of operating on false or misleading information – from any source.

Purple Tablets Asks…

I’m a female of child-bearing age… who has been diagnosed as Bipolar II. The message that the different doctors have given me so far has been “don’t get pregnant.” (In fact, one offended me so much with how she delivered this message that I cancelled my follow-up appointment and got a new psychiatrist!)

Shelli Asks…

My ex refuses to believe that our son is bipolar. He insists that our boy tried to choke his half-sister to death and that our son speaks of his “evil-other side” but he fights with me about giving the boy medication. Could he be so stupid as to think our boy is just mean? Since he is medicated he is a calm and kind teenager. Have you ever heard of one of those? The ex even commented one time that our son was “like a different child” when he was visiting after he started his Seroquel but still refuses to believe the diagnosis. What can I have him read or look at to help with his disbelief?

Syndicated from the Bipolar Blog

I grew up in a household with mental illness in a parent. The illness was never fully identified or named, yet it decimated our family life. I was enormously relieved to realize, over time, what was going on in my family when I was growing up. It helped me understand my parent more and to tell my family story in a way that is less judgmental and critical and more compassionate – toward my parent with mental illness and toward me and my siblings and my other parent. As a professional and as someone who lived with this, I feel strongly about the need for honest, open communication in families when a parent is struggling with mental illness.