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awolfe
01-11-2004, 10:17 PM
Dear Dr. Bradley,

It was wonderful to receive your response to my post in the late spring of last year - you asked for me to send an update, so here it is. It took me until September to figure out that the real problem is that our daughter must have stopped taking her medicines sometime very early in 2003. I finally thought of counting her pills when she never asked for refills, and her blood levels were dropping. The problem is that while she appears to get along with no major rages, manias or depressions, a typical aspect of unmedicated bipolars is that they don't have good self-evaluation abilities, and she doesn't realize how much lack of meds has changed her. Sure, no longer taking depakote means she has lost about 40 pounds, and so she is absolutely gorgeous. Maybe this is why she quit - finally got info that this med puts on weight - or maybe it is in an attempt to be "normal". I checked my journals from 9 years ago, just before she started on meds, and the complaints are exactly the same. Uncommunicative with me, doesn't want my help, wants to do her own thing, goes where she wants, doesn't want help with her problems, tells me to "go away", even that typical bipolar response of threatening to jump out of a moving car. Not a very serious threat last summer, but she threatened it anyway. When I get mad at her for being late, or if I ask too many questions, give too many opinions - she gets mad at me! She is making a desperate attempt to remind me not to take over her life again, I think.

So the problem is that unmedicated she doesn't see how she is acting, the rift in our relationship, and her poor ability to make decisions. She is a bright senior, and is apparently not applying to college (I don't even dare ask anymore, doesn't seem productive), doesn't care much about her work, and wants to spend as much time with her boyfriend as possible. He is actually quite nice, but I feel since she won't tell him, he has absolutely no idea what he is dealing with. He is thinking of marriage - I don't know what she is thinking. As long as she has a clean car, her hair looks good, and she can spend time with him - her world is fine - never mind the future. At least that is how it seems to me. She has a number of speeding tickets, and if our state could count, her license would be revoked.

I don't see how this can change unless she decides to take meds. We tried to talk her into Topomax for the weight loss positive side effect (from her perspective) and it helps with headaches as well. But her pdoc wouldn't do it without informing her of all the side effects, so now I don't think she'll ever try it. She won't even go to the pdoc anymore. She thinks all is well, and probably even thinks she is being nice to me and reasonable, and I am the one out of line. I don't know how to convince her to take meds, or get her to listen to me about important things at all. Not sure what the solution is - any ideas? I think I would prefer those nuclear bomb defusing you mentioned!

Anna

Mike Bradley
01-12-2004, 06:00 PM
Dear Anna,
How deep are your pockets? I ask because it might be time to consider a bribe. If you've tried the direct approach and she still cannot understand how vital the med is for her, the next step would be to negotiate some reward she earns if she agrees to some form of the following:
-that the family consult with a psychiatrist on all of the medicine options for her disorder.
-that she select one med option and stay on it for 3 months.
-that you and she keep journals regarding how life seems for each of you.
-that WHILE STILL ON THE MED she and you sit down with the M.D. after the 3 month trial to review how things went.

The only way for her to make a good decision is to have that type of personal data where she can begin to "see" her own illness.
You will need some way of verifying that she is actually taking the med. Many bipolar kids enjoy the manic phase of their disorder and are very reluctant to end it with a medicine.
Good luck and please keep us posted.

awolfe
01-19-2004, 10:24 PM
Dear Dr. Bradley,

Thanks so much for your reply. I had been considering the bribery method, and wasn't quite sure if I should - very tempting though. She certainly needs the cash to pay for her cell phone bill, speeding tickets, and whatever else she wants. So your response threw any doubt I might have out the window, and I promptly instituted it. She seems to be taking her Topomax, and perhaps I am just hallucinating (I certainly feel entitled to this state of mind!), but in five days I think I'm seeing quite a change. She is more open to discussion, brings up things that previously she would have fallen silent, or screamed, or left the room if I had brought up, and she is more cheerful and way more pleasant to be with.

I just so hope this lasts and continues to improve, and that the medication agrees with her so she keeps up with it. I'll keep you posted.

Many thanks!!

Anna

Mike Bradley
01-20-2004, 03:58 PM
Dear Anna,
Sounds great so far! I'll keep my fingers crossed. And at the risk of telling you something you likely already know, let me add one other thought (for the benefit of other parents of bi-polar kids).
Be sure to hug the heck out of your now "non-bipolar" daughter and tell her how wonderful she is. That reinforcement can help her to distinguish between her two "selves", and help her feel that the medicated self is the one that is truly her. It is critical that she come to see her med as a thing that doesn't change her into someone else, but rather allows her to be who SHE wants to be.
Great job! Please continue to give us updates. Thanks.