When Your Adult Child Breaks Your Heart by Joel Young

Author:Joel Young
Language: eng
Format: epub
Publisher: Lyons Press
Published: 2013-11-06T16:00:00+00:00

Bipolar Disorder

Bipolar disorder, sometimes called manic depression, is characterized by extreme mood swings. Periods of normal moods alternate with episodes of mania and depression. Bipolar depression is hard to distinguish from major depressive disorder, but experienced clinicians report that the symptoms are more severe. Suicidal behaviors may become particularly intense. (Read chapter 8 for more information about suicide.)

Mania is unique to bipolar disorder; it is a period of high energy that may last for several weeks. A manic patient reports racing thoughts and euphoria. He has an inflated sense of his abilities and exhibits impaired social judgment. Stories of extreme shopping sprees and impulsive sexual activity with unlikely partners are typical.

The higher the manic mood, the farther the person can fall down into depression. In the life course of a typical bipolar patient, depressed phases are more common than manic periods. Some patients alternate very quickly from mania to depression. Rapid cycling bipolar disorder is a variation that is less responsive to medications. Bipolar disorder may first appear in the late teens or early adulthood.

A person with severe bipolar disorder may also develop psychotic symptoms, such as hallucinations or delusions, particularly if she fails to take her medication. Psychosis can occur on both sides of the mood spectrum. A manic person may believe that the CIA has pegged him for a special assignment, while individuals with bipolar depression may develop the delusion that they have committed a crime. Neither of course is true, but these psychotic symptoms are dramatic and for this reason bipolar disorder is sometimes misdiagnosed as schizophrenia.

Individuals with bipolar disorder are at high risk for substance abuse and attention-deficit hyperactivity disorder (ADHD).

Treatment for Bipolar Disorder

Several different medications are known to help the symptoms of bipolar disorder. Lithium carbonate, derived from the natural element, was the standard medication for many decades. When it functions properly, lithium prevents the patient from falling into deep depression and protects him from reaching treacherous mania. However, lithium causes tremors and weight gain, and kidney and thyroid function needs to be carefully monitored with regular blood tests.

Because lithium is an imperfect drug, other mood stabilizers have been introduced for the treatment of bipolar disorder. These medications are less effective than lithium but they are better tolerated. Divalproex sodium (Depakote), gabapentin (Neurontin), topiramate (Topamax), oxcarbamazepine (Trileptal), and lamotrigine (Lamictal) were first used by neurologists for seizure disorders.

Some atypical antipsychotic medications have been used to treat bipolar disorder, such as olanzapine (Zyprexa), aripiprazole (Abilify), quetiapine (Seroquel), risperidone (Risperdal), and asenapine (Saphris). Antidepressants are commonly used to treat the depressive episodes of bipolar disorder.

If bipolar disorder is treated, your child’s life may be indistinguishable from any other adult’s. However, if the condition is not properly diagnosed and treated or she stops taking her medication, parents may feel like they are trapped in the middle of a maelstrom.

A Case Study

Saul is a twenty-seven-year old medical student studying in Manhattan. He grew up in the Detroit area, and his parents, Henry and Rivka, remain there. They have four sons including Saul, all well educated and accomplished.

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