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Is She Bipolar?

QUESTION:Having said that, it has been my experience
that when bipolar is suspected, it is
My daughter has been diagnosed with Obsessiveeventually diagnosed (i.e., if her doctor
Compulsive Disorder (OCD) and Obsessivebelieves she may be bipolar, she probably
Compulsive Personality Disorder (OCPD) andis). Is anyone else in the family bipolar
potentially Bipolar Disorder, but that last(e.g., uncle, grandparent)? As you probably
diagnosis is not confirmed yet ...right nowknow,  bipolar  is  highly  genetic.
she is unable to go to school - anxiety and
panic attack when the morning comes. We areSo my advice, based on my experience with
extremely hesitant to go the home-schoolothers in similar situations, would be to
route, because of the probability of thebegin focusing on the bipolar issue because
anxiety transferring to another area(a) she probably is bipolar and (b) once the
--especially if she has not developed thebipolar symptoms are stabilized, the other
skills to tackle it when she experiences thesymptoms (anxiety, panic, OC behavior, etc.)
anxiety/panic.will get addressed by default (at least from
a  medical  standpoint).
I saw on your website the concept of getting
her to have 'going back to school' become herRe: School -- Going on the assumption that
idea ...any magical ways of getting that toshe is bipolar (and again, it is just an
happen??? Her father and I are at the end ofassumption at this point): Bipolar children
our creative strategies rope (her father is awill not function well in a regular school
clinical psychologist and also has OCD)setting  -  so  that's  out,  period!
...words  of  wisdom?
However, the bipolar kids I work with do very
ANSWER:well in alternative school environments or
GED programs where the classes are small and
You've raised a lot of issues here. Let'sthey get sufficient amounts of one-on-one
first  identify  each  one:attention.
1.  OCD/OCPDThey do miss a lot of class time (e.g., "I
got a headache" ..."I'm sick to my stomach"
2.  Possibly  Bipolar  Disorder...bla bla bla), but most alternative schools
are willing to deal with poor attendance
3.  Anxiety/Panicwithin  reasonable  limits.
5.  Unable  [i.e., unwilling] to go to schoolIn any event, your task will be to have a
relaxed attitude about all things -- model
Re: OCD/OCPD -- Is she on an antidepressant?"having a relaxed attitude" throughout the
If so, does it help? A complicating factor isday, everyday!!! Your daughter will pick up
that when anti-depressants are given withouton it at an unconscious level. Then you'll be
mood stabilizers to people with bipolarworking  your  magic.
disorder, the antidepressants may induce
mania or hypomania. So her psychiatrist willI CANNOT EMPHASIZE THIS ENOUGH: The more you
need about a year of experimentation (the artand your husband develop the "art of letting
side of pharmacotherapy) in order to get thego," the less she will stress. The less she
right combinations and dosages of medication.stresses, the fewer symptoms she will
It will be important that everyone in theexperience. The fewer symptoms she
family  be  patient  with  this  process.experiences, the more she can focus on the
really important things in life
Re: Bipolar Disorder -- Bipolar disorder is(relationships,  school,  work,  play, etc.).
difficult to recognize in young people
because it does not fit precisely the symptomIt sounds like the whole family may be in
criteria established for adults, and symptoms"survival mode" (i.e., spending a lot of time
can resemble or co-occur with those of otherand energy just trying to keep the boat from
common childhood-onset mental disorders andsinking). One can escape from this mode by
may be mistaken for normal emotions andpracticing "having a relaxed attitude," a
behaviors  of  children  and  adolescents."grateful heart" and a "sense of humor." If
you think you simply can't do this right now,
As a result, Bipolar kids are often given anythen fake it anyway (i.e., "act as if" you
number of psychiatric labels (e.g., ADHD,are relaxed, grateful, and finding things to
Oppositional Defiant Disorder, Conductlaugh about). With practice, this becomes
Disorder, Obsessive Compulsive Disorder,habit.
Separation  Anxiety  Disorder,  etc.).
In summary, the real issue here as I see it
Too often they are treated with stimulants oris "stress." Everybody is feeling pressure.
antidepressants -- medications which canAnd I can promise you that if everyone is
actually  worsen  the  bipolar  condition.uptight most of the waking hours -- you will
have a long, hard road ahead.



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