13
May 24

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.

 


03
May 24

Hiring the Right Psychiatrist for Your Teen

Psychiatrist With Teen“There is no substitute for the highly experienced psychiatrist who seems to work magic by making tiny, just-right adjustments to the medicine.”

If you’re anything like my husband and I, you may be scared to let your child take “that kind of medicine.” It was when our son was hospitalized for depression that we realized we needed to do everything we could to help him get well. At the time, we did not know that he had bipolar disorder. Letting him start medicine was scary, especially when he seemed to worsen on the antidepressant he was prescribed. I later learned that patients with bipolar disorder often worsen on antidepressants. I also learned that medicine is the key form of treatment for bipolar disorder, so I’m glad we didn’t wait.

But you may still feel in the dark about what is happening with your teen, wondering if hiring a psychiatrist is too major a step. Fortunately, the psychiatrist himself can often give you the clearest answer. Taking your child for an assessment does not mean that the doctor will prescribe medicine. In many cases, he will not make an immediate diagnosis, though he may suspect a particular condition. Because there are no blood tests for diagnosing mental illness–at least not yet–the doctor may need time to observe the symptoms as they unfold. Mental illness often emerges slowly in teens so it can take time and even some medicine trials before the doctor can narrow down what the symptoms mean.

If you find yourself balking at the idea of hiring a psychiatrist too soon, keep in mind that the initial assessment takes about an hour and these appointments are often booked out by one or two months. Once the initial visit is over, shorter follow-up visits can be scheduled more easily. Even if you want to hold off on medicine, having that initial visit completed gives peace of mind that the doctor will be there if you need him.

If you’re fortunate to live in an area with a psychiatrist who is board certified in child and adolescent psychiatry, I suggest you start there. These individuals have a total of roughly fourteen years of education behind them. Treating children and adolescents is different from treating adults. Adolescents are often growing and their hormone levels fluctuate. They sometimes exhibit symptoms differently than adults do.

Locating a good psychiatrist can be more challenging than finding a therapist, partly because there are fewer of them. Listen out for the names of highly regarded individuals and make an appointment, even if it’s two or three months away, then get on the cancellation list. You can always cancel an appointment, but remember to cancel it in time so that another person can use it. Also, many therapists and psychiatrists charge a fee for missed appointments.

Some psychiatrists do not accept insurance. If you are having trouble finding a psychiatrist you like, and a cash-only psychiatrist has been highly recommended to you, consider hiring them. I know it may seem exorbitantly expensive to go outside of insurance, but if the psychiatrists you’ve tried can’t get your teen’s symptoms under control, it may be money well spent. There is no substitute for the highly experienced psychiatrist who seems to work magic by making tiny, just-right adjustments to the medicine. The initial evaluation fee may be as high as $400, but follow-up visits are likely to be only $100 or so. Your insurance may cover a percentage if you file a claim for an out-of-network provider. Also, once the illness is under control, your teen may need to see the doctor only every three months or so.

Best wishes with this sometimes formidable task. The right person is out there.