| QUESTION: | | | | bipolar is suspected, it is eventually diagnosed (i.e., if her |
| My daughter has been diagnosed with Obsessive | | | | doctor believes she may be bipolar, she probably is). Is |
| Compulsive Disorder (OCD) and Obsessive | | | | anyone else in the family bipolar (e.g., uncle, |
| Compulsive Personality Disorder (OCPD) and | | | | grandparent)? As you probably know, bipolar is highly |
| potentially Bipolar Disorder, but that last diagnosis is not | | | | genetic. |
| confirmed yet ...right now she is unable to go to school | | | | So my advice, based on my experience with others in |
| - anxiety and panic attack when the morning comes. | | | | similar situations, would be to begin focusing on the |
| We are extremely hesitant to go the home-school | | | | bipolar issue because (a) she probably is bipolar and |
| route, because of the probability of the anxiety | | | | (b) once the bipolar symptoms are stabilized, the other |
| transferring to another area --especially if she has not | | | | symptoms (anxiety, panic, OC behavior, etc.) will get |
| developed the skills to tackle it when she experiences | | | | addressed by default (at least from a medical |
| the anxiety/panic. | | | | standpoint). |
| I saw on your website the concept of getting her to | | | | Re: School -- Going on the assumption that she is |
| have 'going back to school' become her idea ...any | | | | bipolar (and again, it is just an assumption at this point): |
| magical ways of getting that to happen??? Her father | | | | Bipolar children will not function well in a regular school |
| and I are at the end of our creative strategies rope | | | | setting - so that's out, period! |
| (her father is a clinical psychologist and also has OCD) | | | | However, the bipolar kids I work with do very well in |
| ...words of wisdom? | | | | alternative school environments or GED programs |
| ANSWER: | | | | where the classes are small and they get sufficient |
| You've raised a lot of issues here. Let's first identify | | | | amounts of one-on-one attention. |
| each one: | | | | They do miss a lot of class time (e.g., "I got a |
| 1. OCD/OCPD | | | | headache" ..."I'm sick to my stomach" ...bla bla bla), but |
| 2. Possibly Bipolar Disorder | | | | most alternative schools are willing to deal with poor |
| 3. Anxiety/Panic | | | | attendance within reasonable limits. |
| 5. Unable [i.e., unwilling] to go to school | | | | In any event, your task will be to have a relaxed |
| Re: OCD/OCPD -- Is she on an antidepressant? If so, | | | | attitude about all things -- model "having a relaxed |
| does it help? A complicating factor is that when | | | | attitude" throughout the day, everyday!!! Your daughter |
| anti-depressants are given without mood stabilizers to | | | | will pick up on it at an unconscious level. Then you'll be |
| people with bipolar disorder, the antidepressants may | | | | working your magic. |
| induce mania or hypomania. So her psychiatrist will | | | | I CANNOT EMPHASIZE THIS ENOUGH: The more |
| need about a year of experimentation (the art side of | | | | you and your husband develop the "art of letting go," |
| pharmacotherapy) in order to get the right | | | | the less she will stress. The less she stresses, the |
| combinations and dosages of medication. It will be | | | | fewer symptoms she will experience. The fewer |
| important that everyone in the family be patient with | | | | symptoms she experiences, the more she can focus |
| this process. | | | | on the really important things in life (relationships, school, |
| Re: Bipolar Disorder -- Bipolar disorder is difficult to | | | | work, play, etc.). |
| recognize in young people because it does not fit | | | | It sounds like the whole family may be in "survival |
| precisely the symptom criteria established for adults, | | | | mode" (i.e., spending a lot of time and energy just trying |
| and symptoms can resemble or co-occur with those | | | | to keep the boat from sinking). One can escape from |
| of other common childhood-onset mental disorders | | | | this mode by practicing "having a relaxed attitude," a |
| and may be mistaken for normal emotions and | | | | "grateful heart" and a "sense of humor." If you think |
| behaviors of children and adolescents. | | | | you simply can't do this right now, then fake it anyway |
| As a result, Bipolar kids are often given any number of | | | | (i.e., "act as if" you are relaxed, grateful, and finding |
| psychiatric labels (e.g., ADHD, Oppositional Defiant | | | | things to laugh about). With practice, this becomes |
| Disorder, Conduct Disorder, Obsessive Compulsive | | | | habit. |
| Disorder, Separation Anxiety Disorder, etc.). | | | | In summary, the real issue here as I see it is "stress." |
| Too often they are treated with stimulants or | | | | Everybody is feeling pressure. And I can promise you |
| antidepressants -- medications which can actually | | | | that if everyone is uptight most of the waking hours -- |
| worsen the bipolar condition. | | | | you will have a long, hard road ahead. |
| Having said that, it has been my experience that when | | | | |