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Q:  Hello David

I have a 20yr old son who was diagnosed bipolar1 mania w/psychotic features. This was last jan 2006. He was hospitalized and is now psychosis free and stable on his meds. He takes 1250depakote and 2mg risperdol ( he started with 1500 and 4) I have 3 other children, two live with my ex and the oldest is away in college. I took my son at 16 due to behavioral problems. He quit high school, got a GED, attended community college ( 3 attemps ended in withdrawal) lost 9 jobs in an 8 month period. Etc etc. I just thought he was a lazy stoner. I was wrong. He dropped his old friends and girlfriend who were terrible for him and he is starting over socially. He has modeling good looks so its not going to be a problem for him. I hope. He is back going to community college, taking some fun electives, and working part time construction. He is a talanted musician and is recording a CD, his dream.

My question is this...i am responsible for EVERYTHING in his life. Making sure he takes his meds, getting him up in the morning is an endless battle,telling him to clean up after himself, do his laudry, clean his room..I have to remind him of literally everything. I am burnt out.  He is completely dependent on me, and thats ok for now, i know he has had a major brain trauma via psychosis. The meds help but they are very sedative,and he wakes up every morning with a med hangover. His Pdoc wants to keep him on this combo because its worked so well to stabilize him. His memory is bad, his cognition and attention ebb and flow with his energy level...which ebbs and flows each day being different. I make sure he gets to bed on time, takes mega vitamin dosage for memory etc. He eats only healthy organic food. But this is all due to me. If i stop, i am sure he would too. I can not keep doing this forever, i love my son deeply, but is this his baseline? Its as if hes 15 years old emotionally. He is very social, was manic and not depressed. I havent seen much depression at all yet. He has been thru a psycho-social cognitive behavioral program which has helped a lot... but not enough.  Is there light at the end of the tunnel? And i dont mean a train.

Dear B,

     I must say I appreciate your closing line and sense of humor....there's still some hope left in you.  Something isn't right here in your email and I'm going to take a giant leap in guessing at what it might be.  If you made a mistake in thinking your son was "a lazy stoner" when he actually had a diagnosable mental illness and you're still carrying around all that guilt, it's time to give yourself a break.  It's also time to realize that the crisis period that you once found yourself in, might be easing up a bit and you may be able to relax your grip on your control and hand some of that over to your son.

     At this point in time, your son is working, going to school and participating in some personal hobbies yet you say he is completely dependent on YOU.........me thinks this is NOT ok.  Someone needs to talk to his psychiatrist- it's also NOT ok that he wakes up every morning with a med hangover.  The medication that worked so well to stabilize your son may now be oversedating him.  My question too is how does he perform all his functional, day-to-day tasks with such poor cognitive skills?  By the way, psychosis comes and goes and does not generally cause any permanent brain trauma- please discuss this with your son's psychiatrist.  Don't be afraid to let your son be more accountable for his own actions and reward him for doing so if you like.  Taking on more of his own responsibility may help build his self-esteem in addition to relieving a lot of the pressure you have placed on yourself.  If you don't mind, I would suggest that you become involved with his behavioral program.  Such programs may be useful for the individuals involved in them alone but are most helpful when they are generalized to other environments such as home, work, school, etc.  Good luck and please, give yourself a break.

David Schafer, M.Ed.
Staff Psychologist

Published July, 2006

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