All Our Trials Seem to be Errors
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Q:  All Our Trials Seem to be Errors


My 8 y.o adopted daughter shows textbook signs of early onset bipolar. Her birth mom was dx'd bipolar, schizoaffective disorder among others. My daughter is under a psychiatrist's care. Risperdal was very effective for about 5 weeks, the severe weight gain and progressively less and less results prompted us to switch to zyprexa. She continues to eat like a horse and gain wt. and this med doesn't seem nearly as effective as the risperdal was in the beginning. I am at my wits end....extremely tired, no social life, always walking on egg shells around her and just an nth away of taking her to a residential tx facility. My other children are exasperated also.  My heart won't let me do the residential thing just yet. My sanity says "do so"! Question: any good results with antianxieties such as xanax, klonopin, etc. (not for me....for her LOL). I'm feeling like these antipsychotics may be messing up her brain chemistry even more. I know it's trial and error with this illness....however, all of our trials seem to be errors.  : (   Your professional opinion is greatly appreciated. Disrupting the adoption is absolutely NOT an option. We love our daughter tremendously. We're just tired, as i know she is.

Thank you, in advance, Doctor.


Dear Ms. Lí --

Sorry to hear you're going through this.  A couple of thoughts: make sure the psychiatrist knows how burned-out you're getting.  With young children, there is always a desire to go slowly and cautiously.  At this point, if I understand correctly, you have tried two different approaches.  Standard treatment of this illness includes many, many more options.  So my first point: even though you are already really tired of this, you are really actually at the beginning of the medication approaches. 

And the second point: overall, your daughter may benefit from a more aggressive approach, moving through medication options more quickly searching for good symptom control and fewer side effects, if you factor in the need for the rest of the family to see better outcomes quickly. In other words, if she starts losing you because you are so tired of dealing with this -- losing you in the sense of emotional distance, for example -- that is a risk for her, to be considered alongside the risk of giving a medication and inadequate trial because you're in a hurry.  Sorry, this is kind of a complex issue. A good psychiatrist should be able to factor the needs of your family into the decision-making process, although it is not easy for anyone involved.

There is a lovely book about Loving Someone with Bipolar Disorder, by Julie Fast.
It is written primarily for spouses of people with bipolar disorder, but I'll bet you can find some useful material in there. Likewise, the website of the Child and Adolescent Bipolar Foundation (
www.bpkids.org ) may provide some support for you and your family as well as great information.

Your devotion and dedication to your daughter is extremely admirable.  I hope that you get some breathing room soon.

Dr. Phelps

 

Published October, 2008
 

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