Expert: Libby Bonner - 8/26/2008

Question
My daughter, who is 22, has been having panic attacks and depression as well as manic activity spells.  She went to a psychiatrist who said, "we can make a case for bipolar" and prescribed Lamictrol (or something like that).  She took the drug, then ran out and had a major depressive incident, which made her see that even if she didn't think it was working, it was doing something.

She isn't worried at all about the diagnosis.  She is grateful to know what it is and that there is something that can help her.  

My issue is that of extreme depression over the diagnosis.  Is this typical, and as she adjusts to life on the medication, will her tendency to be so dependent retreat a bit?  She is, of course, beautiful and bright but intense.

Thank you.

Answer
How do these two sentences reconcile??  "She isn't worried at all about the diagnosis.  ...My issue is that of extreme depression over the diagnosis."    

And when you speak of the "extreme depression," above, do you mean that which followed running out of the med???  Being out of the med permitted the return on the depression that preceded her diagnosis, yes??  

And she is dependent upon what or whom?  On the med?  On you???

I am thoroughly confused - can you clear things up for me w/ another email?

And/but FYI - to develop any chronic illness at a young age, one that will need tending and managing forever, is a terrible shock. [At 22, she may have believed that she is immortal.  Most at that age do.]  They are shocks to the self-image, to one's sense  of invulnerability, sometimes to one's imagined future, to plans and hopes.  

Also, it's early days here.  I hope the doc plans to see her fairly frequently until doc is certain that the med/s and the dose/s are right.  It's a normal situation, and sometimes take a while...to have to tinker w/ meds.  I would not assume, today, that there would not be at least a second drug added, or a change in dose of the lamictal.  But the new meds are terrific, and a combination probably will be found that stabilizes her and lets her get on w/ life.

Also, FYI, psych meds sometimes take 2-3 or even more weeks to fully kick in,  and so doubt creeps in.  It's an unfortunate thing, and the drug companies are working on it.   Finding and sticking w/ the right meds are the keys to success.