Tough Love for Your Unruly Teen

"Well, I took the car away because he missed his curfew last night by 50 minutes. Total attitude all day. Now he has packed his things and left - after a big scene. I tried to remain calm, did not chase but am obviously concerned as to where he is. I think I am dealing with a child that is beyond what I can handle. We have tried counseling at a local level and were unsuccessful since he manipulated it. A lot of money and weak results. He refuses to go back. We may need an intervention program/boarding school. Suggestions on how we investigate that? Thank you again."

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Bipolar Teen

Mark-

The diagnoses is in - he's got bipolar. This is what we thought all along based on the info on your site and your emails. Do you know how this is treated?

Thanks,

F.

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Hi F.,

Once the diagnosis of bipolar disorder is made, the treatment of children and adolescents is based mainly on experience with adults, since as yet there is very limited data on the efficacy and safety of mood stabilizing medications in youth.

The essential treatment for this disorder in adults involves the use of appropriate doses of mood stabilizers, most typically lithium and/or valproate, which are often very effective for controlling mania and preventing recurrences of manic and depressive episodes.

Research on the effectiveness of these and other medications in children and adolescents with bipolar disorder is ongoing. In addition, studies are investigating various forms of psychotherapy, including cognitive-behavioral therapy, to complement medication treatment for this illness in young people.

Lithium is a naturally occurring substance. As a medication, lithium reduces chemicals in the body that cause excitation or mania. Lithium is used to treat manic episodes of manic-depressive illness. Lithium helps to prevent and control symptoms of mania such as hyperactivity, rushed speech, poor judgment, reduced need for sleep, aggression, and anger.

Valproate is also an excellent mood stabilizer and is superior to lithium for mixed, chronic, or atypical forms of bipolar disorder in children. It has also been successfully used to treat aggression in patients with FXS and in children with autism.

Good luck - stay in touch,

Mark
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