Q: David, I have a very bright 20 yr. old
daughter with bp disorder who is currently out of college while we try to find
the correct med dosage for her. She was diagnosed a year and a half ago and had
to quit college because of instability.
She is currently at home doing very little. She has become a recluse and has no
friends. I hate to see her at home alone this way. I wonder if I should
encourage her to get a part time job? Should I give her chores to do at home?
There are times she is so unstable that I hesitate to ask her to do anything.
Should I demand she help around the house when I see that she is feeling ok?
Her moods are still all over the place and so I have grown fearful of upsetting
her. When she is depressed, she stays in her PJ's all day and stays in her
bedroom. I have encouraged her to go to a support group but she refuses because
she feels too vulnerable and uncomfortable in that environment.
What do you recommend? When she is feeling "normal," she is a disciplined, kind
young lady. She desperately wants to go back to college and becomes depressed
about her "falling behind" her classmates. By the way, my daughter excelled in
high school (before her diagnosis).
I would appreciate any suggestions you may have. She is currently under the
care of a good psychiatrist who is working hard to stabilize her.
When your daughter is ill and unstable, her beliefs about herself and her world
will be distorted. If you try to talk to her about your about her
relationships, school, work, or life in general, chances are you'll be talking
to the bipolar disorder instead of the person you love.
Treat the bipolar disorder first. Major depressions can dramatically interfere
with functioning such as work, school and relationships. The duration of a
major depressive episode can vary substantially from person to person and often
persists for a number of weeks or months. A depressed person often slows down
to the point that nothing can get done. Getting out of bed can be a monumental
task to the depressed brain. For now encourage your daughter to remain
relentless in assisting in her own recovery by staying on her treatment, keeping
her appointments, and communicating openly about all of her behaviors and
symptoms with her psychiatrist on a regular and frequent basis.
It requires great patience and persistence to get the correct medications and
dosages and once your daughter feels improvement, encourage her to continue
taking her medication for the rest of her life. Stopping her meds because she
feels better can throw her into a relapse which can impact her ability to return
to her earlier level of functioning. Bipolar disorder is a chronic disease,
like diabetes and requires constant treatment and re- valuation.
As difficult as it may be to watch your daughter in her withdrawn state right
now, I would trust your instincts about pushing her during this time of
instability. Discuss with her psychiatrist the appropriate timing and gradual
re-integration of your daughter back into her social and school life according
to what is manageable and important to her. In my subjective opinion,
individual therapy can be just as, if not more beneficial than group support if
your daughter is willing. Again, I would not push this during times of extreme
depression or general instability. This is another topic for discussion with
These suggestions may seem insignificant but they are really quite important now
and across the lifespan for problem prevention. Encourage your daughter as
she is able to adopt a healthy lifestyle. Get sufficient rest, regular
exercise, eat a balanced diet, work at managing stress levels, and avoid alcohol
or other drugs. Research has shown that individuals with bipolar disorder who
are able to maintain a daily and regular routine are better able to avoid
relapses in their disorder.
Learn to identify symptoms that can trigger relapses. Have an action plan in
mind such as who to call, which medications to add, or which proactive behaviors
to engage in, when you notice signs of a possible relapse.
Loving Someone With Bipolar Disorder, Fast, Julie, A, 2004.
The Bipolar Disorder Survival Guide, Miklowitz, David J., 2002.
David Schafer, M.Ed.
Published May, 2006