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Psych Central: Ask the Therapist
By Kristina Randle, Ph.D., LCSW
Our daughter is 8 years old and has recently been diagnosed with bipolar depression. Her biological father is bipolar, as well as her grandfather on her mother’s side. We have been taking her to regular therapy sessions with a psychologist, and she has seen an actual psychiatrist once. He prescribed Risperidone to treat her illness. The medication has helped, but her behaviors have still not toned down enough to make her manageable. She constantly lies about even the smallest things. She threatens to stab or kill people, she always says she wants to kill or harm herself, she is very self centered and inconsiderate of others and their feelings, has no respect for anyone or anything, She sometimes hurts her three year old sister, and has extreme mood swings. She cannot bear to be away from her mother and always needs to know where she is and what she is doing, and will have a tantrum if she can’t be included. She cannot occupy herself at all. She absolutely has to be doing things with someone else and cannot play or read or color or do anything by herself. She will not listen when she is told to do something by her mother or me, and will throw a fit when she is made to do the task. We are at our wits end and have no answers. We are scheduling her an appointment with a different psychiatrist who can see her immediately. This little girl brings so much drama and turmoil into this family and we just don’t know what to do because we love her and we want to help her. She will not talk to us or share her feelings with us, and when we ask her questions the only answer we ever get is “I don’t know” or a lie. What can we do? What advice do you have for how to manage her?
I’m sorry you’re having so much difficulty with your daughter. It is painful to feel that there is little you can to do to help, especially when someone is so much in need of help.
I’m familiar with cases like yours. This is a very, very difficult situation. It is especially concerning that your daughter is violent and has access to a younger sibling in the home. Her threats to harm others should be taken seriously. This means, as you noted, that she needs to be constantly supervised. Among the cases I am familiar with, the parents were forced to quit their jobs and to stay at home with the child. It was necessary because of the risk to the other family members, as well as the risk to the child in question. In other cases, parents were forced to place the child in impatient residential treatment. I understand that these options may not be ideal but they may be necessary.
It is essential that you get the very best help for your daughter. I would recommend contacting local universities, treatment centers or taking your daughter to various physicians and specialists until you find the proper help. You may be able to locate a specialist by searching on national mental health websites or through bipolar blogs. Below are links to a few that may be helpful:
I would also recommend contacting the National Alliance on Mental Illness, a large organization whose goal is to help the family members of individuals with mental illnesses.
Medication may be helpful to your daughter but it often requires finding the right combination of drugs. She is currently on a drug that does not seem to be fully effective. Other drugs or combinations could be. Perhaps she could benefit from a higher or lower dose of her current medication or an adjunct medication. Finding the right medication is usually not an easy process. It takes time and requires patience, on the parts of the physician, the client and the family.
Unfortunately, there is no easy solution to this problem. I would recommend trying to utilize all the resources of the mental health system. I would also encourage you to contact other families who are dealing with similar situations. Family members who have experienced similar circumstances would likely serve as a valuable resource and support network. I would also encourage you to explore the possibility of a residential treatment facility, where your daughter would live outside the home and receive constant supervision by psychiatric staff. While living in the inpatient facility, she will have access to daily psychiatric treatment, she will be supervised 100 percent of the time and the staff can keep her safe. Of course, this is not the ideal situation but knowing that she will be safe may bring you peace of mind. Given the circumstances, it may be the best option at this time.