Is She Bipolar?

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My daughter has been diagnosed with Obsessive Compulsive Disorder (Ocd) and Obsessive Compulsive Personality Disorder (Ocpd) and potentially Bipolar Disorder, but that last diagnosis is not confirmed yet ...right now she is unable to go to school - anxiety and panic attack when the morning comes. We are very hesitant to go the home-school route, because of the probability of the anxiety transferring to an additional one area --especially if she has not industrialized the skills to tackle it when she experiences the anxiety/panic.

I saw on your website the concept of getting her to have 'going back to school' become her idea ...any magical ways of getting that to happen??? Her father and I are at the end of our creative strategies rope (her father is a clinical psychologist and also has Ocd) ...words of wisdom?

Answer:

You've raised a lot of issues here. Let's first identify each one:

1. Ocd/Ocpd

2. Maybe Bipolar Disorder

3. Anxiety/Panic

5. Unable [i.e., unwilling] to go to school

Re: Ocd/Ocpd -- Is she on an antidepressant? If so, does it help? A complicating factor is that when anti-depressants are given without mood stabilizers to people with bipolar disorder, the antidepressants may induce mania or hypomania. So her psychiatrist will need about a year of experimentation (the art side of pharmacotherapy) in order to get the right combinations and dosages of medication. It will be leading that every person in the house be patient with this process.

Re: Bipolar Disorder -- Bipolar disorder is difficult to identify in young people because it does not fit precisely the symptom criteria established for adults, and symptoms can look or co-occur with those of other base childhood-onset thinking disorders and may be mistaken for general emotions and behaviors of children and adolescents.

As a result, Bipolar kids are often given any whole of psychiatric labels (e.g., Adhd, Oppositional unyielding Disorder, conduct Disorder, Obsessive Compulsive Disorder, divorce Anxiety Disorder, etc.).

Too often they are treated with stimulants or antidepressants -- medications which can precisely worsen the bipolar condition.

Having said that, it has been my experience that when bipolar is suspected, it is ultimately diagnosed (i.e., if her physician believes she may be bipolar, she probably is). Is whatever else in the house bipolar (e.g., uncle, grandparent)? As you probably know, bipolar is very genetic.

So my advice, based on my experience with others in similar situations, would be to begin focusing on the bipolar issue because (a) she probably is bipolar and (b) once the bipolar symptoms are stabilized, the other symptoms (anxiety, panic, Oc behavior, etc.) will get addressed by default (at least from a healing standpoint).

Re: School -- Going on the assumption that she is bipolar (and again, it is just an assumption at this point): Bipolar children will not function well in a quarterly school setting - so that's out, period!

However, the bipolar kids I work with do very well in alternative school environments or Ged programs where the classes are small and they get adequate amounts of one-on-one attention.

They do miss a lot of class time (e.g., "I got a headache" ..."I'm sick to my stomach" ...bla bla bla), but most alternative schools are willing to deal with poor attendance within inexpensive limits.

In any event, your task will be to have a relaxed attitude about all things -- model "having a relaxed attitude" throughout the day, everyday!!! Your daughter will pick up on it at an unconscious level. Then you'll be working your magic.

I Cannot Emphasize This Enough: The more you and your husband institute the "art of letting go," the less she will stress. The less she stresses, the fewer symptoms she will experience. The fewer symptoms she experiences, the more she can focus on the precisely leading things in life (relationships, school, work, play, etc.).

It sounds like the whole house may be in "survival mode" (i.e., spending a lot of time and energy just trying to keep the boat from sinking). One can escape from this mode by practicing "having a relaxed attitude," a "grateful heart" and a "sense of humor." If you think you plainly can't do this right now, then fake it anyway (i.e., "act as if" you are relaxed, grateful, and finding things to laugh about). With practice, this becomes habit.

In summary, the real issue here as I see it is "stress." every person is feeling pressure. And I can promise you that if every person is uptight most of the waking hours -- you will have a long, hard road ahead.

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