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New bipolar diagnosis--will lithium improve conduct disorder?
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<blockquote data-quote="seriously" data-source="post: 449095" data-attributes="member: 11920"><p>Have you had any contact with parents of these other kids? Do they know that their kids are doing pot or are selling?</p><p></p><p>Have you reported this to the school?</p><p></p><p>You have hit the nail on the head in terms of dealing with substance abuse issues. Distancing from the "friends" who did those things with him is absolutely necessary to reach and sustain sobriety for 99% of the people who try to get off drugs/alcohol.</p><p></p><p>This is particularly hard to do with teens who have to go to school every day and see these same kids all the time. Unless they change schools there is constant contact or opportunity for contact.</p><p></p><p>Even changing from one public school to another may not help because of "associations" that cross school boundaries.</p><p></p><p>This may be why the psychologist said that sending him to an inpatient or residential treatment facility may be necessary.</p><p></p><p>And it is no guarantee of course.</p><p></p><p>It's very promising that the mood disorder piece has finally been identified. sorting this out with kids and teens is really difficult but given the family history I would have thought the psychiatrist would have been inclined to treat him more aggressively sooner. But most of the BiPolar (BP) medications carry a significant risk of metabolic or systemic side effects that can sometimes be dangerous. Until they feel the sx and signs are pretty clear they are reluctant to use these medications since they do not want to medicate someone who doesn't need it.</p><p></p><p>Has he only shown hypomanic behaviors or have you also seen/he has reported sx of depression?</p><p></p><p>Lithium is usually very effective in treating mania but doesn't seem to have much punch when it comes to treating the depression that goes with BiPolar (BP) II. If he's only had hypomanic sx then that would be the correct diagnosis - or BiPolar (BP) not otherwise specified.</p><p></p><p>Do you see any kind of pattern to his mood shifts? Does he have periods where he seems "normal" or not?</p><p></p><p>Unfortunately the marijuana (and any other illegal drugs) make everything a lot more complicated in terms of both diagnosis and treatment. So it's going to be trial-and-error with medications and settings, perhaps for a year or more.</p><p></p><p>If you have the financial resources to send him to a therapeutic boarding school, my frank advice would be to do it straight out of the treatment facility he's in now.</p></blockquote><p></p>
[QUOTE="seriously, post: 449095, member: 11920"] Have you had any contact with parents of these other kids? Do they know that their kids are doing pot or are selling? Have you reported this to the school? You have hit the nail on the head in terms of dealing with substance abuse issues. Distancing from the "friends" who did those things with him is absolutely necessary to reach and sustain sobriety for 99% of the people who try to get off drugs/alcohol. This is particularly hard to do with teens who have to go to school every day and see these same kids all the time. Unless they change schools there is constant contact or opportunity for contact. Even changing from one public school to another may not help because of "associations" that cross school boundaries. This may be why the psychologist said that sending him to an inpatient or residential treatment facility may be necessary. And it is no guarantee of course. It's very promising that the mood disorder piece has finally been identified. sorting this out with kids and teens is really difficult but given the family history I would have thought the psychiatrist would have been inclined to treat him more aggressively sooner. But most of the BiPolar (BP) medications carry a significant risk of metabolic or systemic side effects that can sometimes be dangerous. Until they feel the sx and signs are pretty clear they are reluctant to use these medications since they do not want to medicate someone who doesn't need it. Has he only shown hypomanic behaviors or have you also seen/he has reported sx of depression? Lithium is usually very effective in treating mania but doesn't seem to have much punch when it comes to treating the depression that goes with BiPolar (BP) II. If he's only had hypomanic sx then that would be the correct diagnosis - or BiPolar (BP) not otherwise specified. Do you see any kind of pattern to his mood shifts? Does he have periods where he seems "normal" or not? Unfortunately the marijuana (and any other illegal drugs) make everything a lot more complicated in terms of both diagnosis and treatment. So it's going to be trial-and-error with medications and settings, perhaps for a year or more. If you have the financial resources to send him to a therapeutic boarding school, my frank advice would be to do it straight out of the treatment facility he's in now. [/QUOTE]
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