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Q:  David,
Recently, my daughter has been diagnosed with bipolar. Last fall she had a manic episode, very out of control, car accident, problems with the law, etc. Since this was our first experience with this, we did not recognize it or know what to do, but seeked counseling for advise. The last 3 months up until about two weeks ago were the down side and she was very depressed. During this time we were able to get her into counseling being overseen by a Psychiatrist. She was prescribed an anti-depressant and almost overnight after about 3 weeks of taking the medication has flipped pretty fast to what we can now know is the manic side again.

She now wants to work as much as possible, has signed up for summer classes, and on the go constantly. She is now taking Lamictal for five days and the anti-depressant has been discontinued. Well, at least, she is supposed to be taking it as we found one pill on the floor in her room this afternoon. She has been drinking excessively and smoking at l  east two packs per day, doesn't sleep much and when she does sleep, it is erratic.  I'm frustrated, losing my own way and it seems like the support I need is hampered my the slowness of the system. My Husband and I, after much contemplation and discussion have decided to commit her.

1) Can you give me some advice about how committing her will work from here and what the risks are? We felt we had no choice at this point as she is getting unmanageable (by the way, she is 20)?

2) How can I change the situation; make it better?

3) Are there any successful clinics or sanitariums and if so, where and how do we go about getting her into one? 

Thank you so much,

Dear L,
      I completely understand your frustration.  Hopefully, you have discussed your plans with your daughter's psychiatrist.  Resources and commitment laws vary by state and even county and he/she should be familiar with what types of services are available specifically in your area.  There are a number of levels of care available and generally speaking the least restrictive alternative which is appropriate yet effective is the one to choose.  This should be worked out between you and your daughter's mental health workers, in particular, her psychiatrist to find the treatment setting most appropriate for her.  Some of  those sources of information for referrals to such places include the following:

# Employee Assistance Program through your employer
# Local medical society, local psychiatric society
# Local mental health association
# County mental health department
# Local hospitals or medical centers with psychiatric services
# Department of Psychiatry in nearby medical school

     You can begin to change the situation to make it better by attempting to help your daughter treat her bipolar disorder medically first (get stable on meds), in other words do what you can to communicate openly about all of her behaviors and symptoms to a psychiatrist/therapist who is persistent in getting as much accurate information from her as possible and is knowledgeable about bipolar disorder.

     Encourage her to get and stay on her treatment.  Your daughter may be drinking excessively in order to self medicate her bipolar disorder.  It takes patience and persistence to get the correct medications and dosages and once she feels improvement, she will need to continue taking her medication for the rest of her life.

     Depending on where you live, there are university-affiliated hospitals with both inpatient and outpatient mental health units that are successful in treating a variety of mental illnesses.  Again, discuss this with your daughter's psychiatrist especially if involuntary commitment is necessary.  You will also need to inquire about your health insurance coverage as well.

Recommended Reading:  Loving Someone With Bipolar Disorder, Fast, Julie A., 2004

     Don't get discouraged.  Bipolar disorder is a chronic disease, like diabetes, and requires constant treatment and re-evaluation.  It can become somewhat predictable and treatable.  Over time, 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.

     For you and your daughter- adopt a healthy lifestyle.  Get sufficient rest, regular exercise, eat a balanced diet, work at managing your own stress level, 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.

     Good luck and hang in there....you are not alone.

David Schafer, M.Ed.
Staff Psychologist

Published May, 2006

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