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Q:  Hi David,

  I am writing in concern for my 23 yr old son.  When he was around 7, he was diagnosed with ADD,learning disability, and he placed on Ritalin. It didnt work. We have been to several doctors,counselors,tutors,psych, and not once has he been tested for bipolar. He does have several of the symptoms, such as mood swings, lack of concentration, depression, etc.Currently he is taking 1mg xanax for depression/anxiety attacks. When he takes it, he becomes more depressed, isolated from everyone. He doesnt sleep much,eating disorders,constant headaches, Its a freaking emotional rollercoaster ride now a days. I forgot to mention that he was also diagnosed with having dyslexia at 16. Always struggled in school, quit at 17. His marriage is a wreck(she needs help too)but,his wishy washy attitude is driving us all insane. His moods change like the wind! We have always been there for him and always will, but we dont know what to do, we are concerned because he has said that he wishes he was dead on several occasions, but then an hour later, he might be on top of the world. One minute he wants us to help, and later he is grown and tells us he can take care of himself.( I offered to go with him to the psychiatrists office since he asked me to go with him to his MD)Is this possibly bipolar? And if so, why cant they see it, and get him the proper medicine. Its like he is full of anger and his way is the only way.Jumps to conclusions, assumes the worst, and never happy anymore. He thinks he wants something, then when he gets it, he still isn't satisfied. Is there a certain med that I could suggest to his doctor to let him try? I will do anything to help him get better. I have read articles on bipolar, but still dont understand. Is he ADD or bipolar? or NEITHER!!!!! I am seriously afraid he will hurt himself or someone else soon. What do you suggest? I will keep researching, but I am afraid I am on a short timeline  before disaster stikes. 

Thank you,

Dear R,
     If you have strong doubts about the diagnosis you have been given, getting a second opinion is a good idea.  Select a psychiatrist who is knowledgeable about bipolar disorder and persistent in getting as much accurate information from you as possible.  Ask to accompany your son to back up or supplement any information he provides to the doctor.  Bipolar disorder is frequently misdiagnosed as ADD in younger children.  Understand that there are many reasons why bipolar disorder can be hard to distinguish from other disorders..

     If you do seek a second opinion, be prepared to be asked some of the same questions about symptoms that were asked the first time.  Tell the new psychiatrist why you think your son has bipolar disorder and why you don't think the diagnostic criteria for ADD don't fit.  Bring along a close family member, significant other, or trusted friend.  This person can offer a different perspective on your son's symptoms and life experiences, which may be quite useful to the person making the diagnosis. Most of all, it's important to work collaboratively with your doctor.  Say what you can about your history and report events and symptoms as accurately as possible even if what you are reporting is sometimes embarrassing or painful..  Try to see things from the doctor's perspective.  If the doctor thinks you are bipolar, what is the rationale behind that opinion?  What diagnostic criteria does the doctor think apply to you?  Is he or she considering other diagnoses, and if not, why not?  Good luck.

David Schafer, M.Ed.
Staff Psychologist

Published June, 2006

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