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Dealing With Bipolar Dsorder

Question:

Dr., My son was diagnosed with Bipolar Disorder a little over a year ago. He is 21 years old. He was placed in an institution for 14 days after an attempted suicide and was put on Depakote. His diagnosis was Bipolar Disorder with anger outbursts. Since the time of his diagnosis he has had intermittent employment, relationship issues, and loss of self esteem. He is depressed almost constantly. Due to his financial circumstances and lack of insurance he receives care from a state funded facility. However, shortly after beginning one on one therapy they moved him into group therapy. The results have not been good. This week he lost his relationship with his girlfriend of three years. The Depakote seems to be controlling the suicidal thoughts but he is out of control. He can not make a decision, he is obsessed with trying to bring her back into the relationship (she has placed a restraining order against him) and of course he is depressed and feels no self worth because he blames himself for the failure of the relationship. I realize that he needs intervention. I cannot get him to go to the local facility. My question is this.. How do I go about intervening and getting him the help that he needs? The last time I tried to get him help I had to wait until he harmed himself before they would intervene. What do I do?

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Answer:

If I understand correctly, your son is already under care. I assume that he has a psychiatrist who is prescribing his Depakote and he has a therapist and is in group, but not individual, therapy.

Mom, you are asking about one of the most frustrating situations that face parents of adult children who have a mental illness. Unfortunately, there is nothing you can do unless your son is threatening either suicide or to harm you, the family or another person.

Hi doctors will not answer any of your questions unless he gives them written permission to speak to you and only for one time. Without that permission, signed by your son, none of them will speak to you because he is now an adult and they have to protect his right to privacy.

I fear that the best you can do is to gently try to persuade your son to speak to his psychiatrist in order to report how bad he feels.

You must remember that breaking up is difficult for anyone, whether they have a mental illness or not. He has every right to feel upset, although, he has no right to harass his ex girl friend.

You know Mom, there is a good chance that you, like most parents, would feel worried about your son breaking up with a girl friend because of the emotions it stirs. No parent likes to see their adult child suffer but, there things do happen. I understand that it is that much more difficult because of his Bipolar disorder. Yet, even people with Bipolar must learn to cope.

I know you stated that the results of his starting group therapy have not been good. However, you do not know that for sure. Of course, I am not there and cannot know but, I can point out that group therapy can be very beneficial but, sometimes a person may get worse before they get better. I do not know your son’s situation but, it is possible that the group is starting to have a good effect on him (or not).

Again, encourage him to talk to his group therapist, to the group and to his psychiatrist. Psychiatrists leave room for extra sessions when a patient is having problems between meetings and the time between can be a month or more.

However, if you son refuses, there is nothing you can do.

Lastly, you need to set up house rules. That means that your son cannot be allowed to be exploding at you or anyone else at home, regardless of diagnosis. If he cannot control his temper at home, tell him he will have to move: but you have to mean it.

Best of Luck

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