Reply to Son, 20, first signs of bipolar

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[quote=Anonymous][quote=Anonymous][quote=Anonymous]My now 23 year old has Bipolar Disorder and has been for quite awhile.  Honestly I have not seen therapy as helpful and often seemed to make things worse.  Management has been through medication and it was tough to get it right for a number of reasons, primarily because medication is trial and error anyway and you would be extremely lucky to get it right on the first try and also because he has comorbid ADHD and cannot function without stimulant medication which is contraindicated for those with bipolar.  It was no minor feat to find a provider who would treat both conditions.

The two biggest hurdles to success are getting agreement to see a doctor - and remember, they are not going to talk to you, only your son.  My son's don't talk to me even though he has given permission - not even to schedule appointments.  You might get in faster with a psychiatric nurse practitioner and, while some will diss this route, our needle in a haystack provider who agreed to treat both the bipolar and the ADHD is a PNP and she is the only person to have been able to stabilize him over many years of treatment.

The second hurdle is getting medication compliance.  Not only do you have the issue of intolerable side effects, but you also battle the mindset of when you feel better you don't believe you need it.

Your situation is complicated by the fact that he is likely leaving for Oregon in a couple of weeks and it is highly unlikely that you will be able to even get him in to a psychiatrist before he goes, even if he agrees.  And, due to licensing and insurance requirements, you can't do teletherapy with a provider across country (or even across state lines in most cases).  So you may need to figure out a support network in Oregon.

I hope you are wrong about your suspicions because it is a tough disease.  But in the chance you are not, I will leave you with one last thing.  I'd be trying to check in often with him once he leaves to return to college.  I'd also be sure I had contact information for those with whom he spends his time.  When my son spiraled it was fast and dangerous.

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Thank you very much, PP. I am sorry about your situation. Can you recommend your nurse practitioner? We talk to him on the phone weekly, and he always sounds fine then but I always wonder what’s going on when we are not calling. Are you saying we should visit often as well? [/quote]

We are lucky in that my son is doing really well, but it was a long road.  I appreciate your thoughts.  Our PNP won't do out of state work so it might be hard to start up with her because she will want to have a lot of appointments in the beginning.  She checks location at every single appointment my son says.  We have a house in Delaware and if he has to talk to her while he's there, he has to drive to MD for the conversation.  It's just one more thing that makes getting care difficult.

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