13
Feb 25

Understanding Breakthrough Symptoms

anxiousteen.jpg“Help your teen track the frequency of a breakthrough symptom so that the psychiatrist can determine if things are worsening or remaining steady.”

You may be worried if your teen experiences breakthrough symptoms while on their medication. For example, a teen might have some depression every afternoon even though their antidepressant has worked reliably for several months. A teen with schizophrenia who has found peace on an antipsychotic may hear a voice once every two weeks. While this may worry you, chances are that a reliable medicine will continue to be serve your teen well. First, check to make sure of the following:

  • Is your teen taking the medicine at the same time every day, never missing doses?
  • If your teen takes more than one dose per day, are the dose times evenly spaced so that there are no gaps in the activation of the medicine?
  • If the medicine requires that food be taken along with it, is your teen consuming a sufficient number of calories?
  • Has there been additional stress in your teen’s life?
  • Has your teen grown and needs a dosage adjustment?

Some teens choose to live with occasional breakthrough symptoms, especially if the medicine is generally agreeable and the symptom is not too bothersome. For example, the teen who feels a stab of depression every afternoon may be able to shake it off with a short walk. This may be preferable to dealing with a higher dosage that may incite an undesirable side effect.

Help your teen track the frequency of a breakthrough symptom so that the psychiatrist can determine if things are worsening or remaining steady. See if your teen can identify a way to cope with the symptom. If your teen is worried about it, call the doctor. A teen who has been through a hard recovery may be scared and need the reassurance that they’re not relapsing.


10
Feb 25

Book Review: The Bipolar Teen by David J. Miklowitz and Elizabeth George

Teenager“…helping a teen recover from bipolar disorder requires an all-out effort”

The Bipolar Teen is the most important book you can own if your teen has been diagnosed with bipolar disorder. If your teen has not been diagnosed, but you are wondering if his or her depression or ADHD could actually be bipolar disorder, this book is for you as well. Davd J. Miklowitz has written some of my favorite books on teen mental illness. I was especially interested in this one with coauthor Elizabeth George because it approaches bipolar disorder from the family’s viewpoint.

We all know what a difference families can make. The first part of the book helps parents face the overwhelming diagnosis itself. The authors provide case histories to help parents understand what bipolar disorder can look like. They explain how to hold your marriage and family together. The frustrating behavior of a bipolar child can wear parents down. Miklowitz and George describe some of the unhelpful approaches parents often take with their bipolar teen. Then they explain constructive ways to deal with your teen’s difficult behaviors. If your teen is angry or explosive, this book will save you a great deal of heartbreak.

There can be many types of conflict within a family struggling through bipolar disorder. Sometimes a sibling feels shoved aside and resents the sick teen. Sometimes a sibling provokes the sick teen. The authors provide deep insight into the many dynamics that can arise between family members. One important point they make is that the sick teen’s place in the family must be preserved. It is important not to let the behaviors of the sick teen make him or her become the family scapegoat.

It can be difficult to determine whether a teen’s behavior is part of the illness or simply part of being an adolescent. The chapter “A Close Look at the Symptoms” will help you to understand how your teen experiences bipolar disorder. This chapter describes the sometimes subtle and sometimes not-so-subtle symptoms of bipolar disorder. It describes the criteria that physicians use to make a diagnosis. It also explains the different types of bipolar disorder.

One of the most challenging issues in treating bipolar disorder is getting the medicine right. The authors explain the different types of medicine available and the advantages and disadvantages of each. They explain how to work with your teen and the doctor in figuring out the right medicine combination. Again, this savvy author pair can prevent you from making mistakes. For example, they point out that parents and doctors often rush to an unnecessary and even risky medicine change when the teen is just going through normal adolescent angst.

The authors describe the different types of therapy in detail and even make recommendations based upon your teen’s personality and style. They also explain the benefit of therapy for siblings as well as family therapy. Although it may seem as though the authors ask a lot of parents, helping a teen recover from bipolar disorder requires an all-out effort. If you think about it, the sacrifices are actually quite small. The teen years are tough no matter what. By pulling together, your family will develop a strength and intimacy that will yield amazing rewards in the years to come.