Hello I am new to the forum and new to bi-polar. My teen daughter was just diagnosised with bi-polar II about a month ago after 8 months of seeing a counselor. In those eight months she was treated for depression and the counseling was mainly about how to control her anxiety and mood swings with her boyfriend, church friends, and the family. She was placed on Zoloft and it worked for about 6 months. I then noticed that she was having more and more mood swings and just started to get very defiant with me and her dad. Getting up in my face and telling me NO something she has never done before. She was not acting right and I knew it. So then the dr said he felt that she needed to see a psychiatrist since the medication had stopped working. I then took her and filled out all the paper work. We went into his office and there he asked a few simple questions and then told us that chances were she is bi-polar II and proceeded to tell me that she was ADD as well. He put her on Lamictal 25 mg, and Abilify 1mg. Then two weeks later he increased the Lamictal to 5o mg and then added Wellibutrin 150 mg then two weeks later he up the Lamictal to 100 and the Wellibutrin to 300 mg. That is where she started yesterday and is having the side effects bad today.

Now here is the question and concerns I have. How does one just ask a few questions and make a diagnosis. I am not convinced that what he said is right. Let me back up and say that the only thing that I noticed in my daughters 15 years is that she has had a very hard time dealing with being seperated from me. I home school her due to this, and she deals with anxiety, and compulsive behavior. Not OCD type but just like if she gets something in her head to do then she will continue until it gets done or you want to scream cause she will not let it go. Also she has a very hard time making decisions on her own. She was depressed when I sent her to the dr and they treated her for that, but then it got worse and now she is on all this medication and I just feel overwhelmed with all this going on. I want to make sure that I am doing the right thing for her as a parent by getting her help and I do not want to second guess the doctors but how can you know for sure this is right.

Then he told me next month he will begin to treat her ADD. I did not even know she had ADD,:( I know that she does not have the manic, and the depression is not so bad she wants to die. She has never had thoughts of killing herself and if the boyfriend situation would ever get better she would be happier. Please don't get me wrong I know that this is very serious and much more than a boyfriend issue. But I just want to make sure that she is not getting all this medication for no reason.
The dr asked her if the medication was helping her and her response was a very quick OH YES and the thing is it has helped but then how could it not help. Any input you can give will help this mom.

She is still seeing the counselor once a week to talk about the things that she is dealing with expecially with the boyfriend they broke up this past week and she is going through a very hard time. They break up all the time so this is nothing new.

ADD and Bipolar II cannot be diagnosed with simply a few questions, so I support your doubt.

I also note you say she's never been manic: so she's never had trouble with sleeping, never had the need? Happily stay awake for days on end?

Have you looked into if she might be have Aspergers?

I would definitely go for a second opinion...JMO

No she never has had problems sleeping except from about the age of 3 she would wake up at night crying and crying and then finally come out of it. This has continued up to her teen years where she had the same dream. It has gotten better now that she is older she just wakes up and sometimes will come to me with the fact she had the dream, but not usually crying. The dream is something in a black cape with hood that is after her.

There was one other thing as well. Dry hands and feet. Now her skin does look dry when she complains but nothing seems to help. When she was in 1-3 grade daily we would have to go through this with her crying. Of couse I took her to the dr and nothing he can find but lotion. She still has this as well but not the crying. That is about it as far as I know.

The psychiatrist is well known and respected in the community. So how to you diagnosis bi-polar? Are there medical test to do this?

As for the Aspergers I had not even heard of it so I went to check it out. I am just not sure. I know that the psychiatrist seems to know his stuff but he is all about the medication. The first day we went to see him I did most of the talking because I thought he would want to know what was going on in her life and I can talk fast. LOL
He was there looking over the chart and her background and I was just a talking. He probably wanted to medicate me to shut me up. The thing is I thought that you go to the psychiatrist to talk. LOL So I was giving him a ear full of what was going on in a net shell. Finally when I got finished he looked at my daughter and said your mom gets frustrated with you doesn't she? I then said no I just want my daughter to get help and to be all that she can be in life that is why I have brought her here. He smiled at me and that is when he told me that she was more than likely ADD and Bi-polar II.
One other thing I did forget to mention as a child about the age of 4 she would pick a scab on her head and twist her hair when she would watch TV. So much that it would leave a bauld spot. I finally broke her of that by telling her no when I would see her doing it. Not sure if that means anything or not.

Bipolar is not MANY mood swings that change thru out the day with various settings and people.

Bipolar is mood [affective] states that can last for weeks. (Bipolar II's don't go as high as Bipolar I's.]

Bipolar is a VERY serious mental illness diagnosis (psychotic disorder) and I agree with Poster #2 and #3.

My SO is a psychiatrist and he says the new trend is to overdiagnose bipolar in people with emotional coping issues, trauma issues and personality disorder issues.

[Part of the reason is insurance-driven. American Insurance co.'s will not cover LT treatment for Axis II disorders (personality disorders), but it will cover Bipolar. :( ]

Your kid needs more assessment.

(And you need to 'be quiet' in the interview, so the doc can do his job. So far it sound like all he is getting is that you tend to dominate in the parent-child dyad... hence his 'comment'. Let go of the control and the explaining -- and let the kid's assessment happen.)

I can assure you that with 4-6 years of Post-MD training in his field, he knows how to interview and assess.

have you let her get an assessment without you in the room with her? There may be things that she notices and doesn't tell you for what ever reason.

And with the mania. I didn't think I had mania because I would not stay up for days or weeks. But there are many of nights when I would just lay in bed tossing and turning, hardly sleeping at all. And the next day I would not be tired. I just thought I had too much caffeine or something.

A second opinion is always an option. Good luck and remember to breathe

1) If your daughter is significantly depressed, don't assume that she is not or has never been suicidal. I was many times as a teenager and chose never to tell my mother. In my case I was protecting my mother because I did not think she could handle it and my job was to be "fine" for her. I'm not saying this is the case with your daughter, but I wouldn't discount it either.

2) I don't blame you for being concerned about your daughter's welfare! If you feel that the doc was too hasty in his decision, certainly get another opinion from someone equally qualified.

3) I used to do the hair twirling thing too. It is profoundly comforting for some of us, I guess. I grew out of it. I left a small bald spot as well.

4) My intuitive sense is that your daughter is dealing with some kind of trauma. A lot of my anxiety and depression stemmed from different kinds of abuse. I concur with Queens U that bipolar is too often labeled for those of us who have instability due to PTSD or childhood trauma.

5) Mania does not always express itself as sleeping 2 hours, spending all your money, etc. Even when I had a psychotic mania I still slept okay. My mania is expressed similarly to how your daughter's is - -anger, irritability, etc.

6) Your daughter is obviously suffering, and even if they aren't quite sure what is causing her symptoms, the same medications can be effective regardless of the root. It's great that your daughter is in counseling. It's important to medicate when young if indeed bipolar is the accurate diagnosis, because it could save her untold suffering.

7) Depression/anxiety and ADD can look very similar. I'm 34 and I'm still trying to figure out one from the other!!

Let me just say here that I do trust this doctor, and when I was doing the talking at the first visit with him it was because I was new to the psychiatrist and I thought that was want he wanted, for me to fill him in on what my daughter was facing in a need shell. Like the lashing out and the anger and the depression. So I talked. The thing was I did not yet know that most psychiatrist are there only to give the medications. Remember this is all new to my family and I do not know the up and downs as of yet. My daughter went in 10 months ago over what we thought was a boyfriend issue with depression, and ended up finding out that it is more than just about a bf. I thought she was acting out due to this bf that she has had for two years as that is when the main issues began. Yet I know that it is common for things to surface in the teens years. I thought it was just typical teen depression and rebellion. I have since found out it is more and that my dd needs help and I will be there for her. In answer to the question has see been seen alone with the therapist? The answer is yes. That is the way it is done. They talk to me then her. I do not really even know what they discuss. I just go in and tell her what I have seen for the week and then she talks to my dd.
Thanks for your help everyone and I am glad to be here. I have so much to learn and feel I have come to a place I can ask question and get answers.