A 19 year old family member who was diagnosed with ADD as a teen and recently diagnosed as bipolar refuses to get professional help. He has had previous drug issues as well as law issues. no violence just dumb but it is straining our family, we never know what’s going to happen next. any suggestions?

A. This is a difficult problem. You cannot force people to do things they don’t want to do. You may be able to leverage him into treatment. By this I mean that your family bands together and informs him that he cannot live in your home if he’s unwilling to enter treatment. It may be the only way to convince him to participate in treatment.

Before getting to that point, there are other ideas to consider. Consult a family therapist. A family therapist can assist your family in determining the best way to intervene. Your family member may be willing to participate in treatment if other members of the family are also willing to participate in treatment.

Contact your local chapter of National Alliance on Mental Illness (NAMI). NAMI is a nonprofit organization that provides mental health education, advocacy and support for both individuals who have a mental illness and those who have a family member with mental illness. Most communities offer free support groups for family members who are dealing with problems like you are facing.

It’s not unusual for individuals with a diagnosed mental illness to refuse to seek help. It may be that he doesn’t believe he’s mentally ill. It also could be that the stigma associated with having a mental illness is preventing him from seeking the proper help. In any event, it’s important that your family continues to encourage him to seek help. There is a limit as to what you can force him to do but you should try everything within your power to ensure that he receives treatment for his mental illness. I wish you the best of luck. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

Hi! I get mood swings that can last from an hour to a day where I can be depressed or really angry and I just I cant control myself sometimes but I cant concentrate very well and sometimes I just cant sit still. I was just wondering could that be just normal teenage behavior or bipolar or ADHD? And I have ADHD and OCD in my family. Thanks

A: Thank you for asking this question. It must be difficult for you to have these mood swings and concerns and still try to manage. But there is too little information from what you’ve told me to know if there is a diagnosis. But what I can say is that what you have described sounds well within the range of symptoms that go along with being a teenager.

The more important thing is that they bother you. I would talk to your school guidance counselor or your parents and go to your general practitioner to get a checkup. He or she will know if these things are outside of the norm.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

I don’t know how I feel; my feelings and actions are confusing to me. Okay. So this is probably going to be long and confusing for everyone reading this. I have a hard time expressing my feelings, and maybe it’s genetic because apparently my mother is the same way. My family has never been terribly close, and I have lived out if home with my boyfriend for a year or so before (I like to he independent), although I’m back home now. Here are some characteristics that I know about myself, I’m kind of a tom boy, I’ve always gotten along better with boys than girls, I feel I have to be the strong one, and don’t want to show my feelings in front of other people, I also do not like being the center of attention. I have very poor concentration and memory (possibly due to ADD but the symptoms only appeared a few years back); I have little memory before the age of 7. And up until junior high I don’t have very clear memories but I can remember things if people say something that reminds me, very different from memories of when I was younger where I don’t recall major things. I don’t think I had a bad childhood that could have affected me, even when I think about the worst parts I don’t really care, (divorced parents, little money, unhealthy father, abusive mother, sexually abused by brother(s)? not sure if more than one, I even watched my friends father die (heart attack) and it didn’t phase me. kind of sounds like bragging huh.). Every once in a while, it seems things just build up, although I’m not sure what things, and I have a bit of a breakdown. I used to cut (more of for something to do and attention, although I didn’t let anyone find out) and feel suicidal just because I didn’t feel that there was anything for me to do in this world, I felt what was the point of growing up if you’re just going to work for so many years doing the same thing over and over, and then die. Sometimes I still feel this way, like life is pointless. I do enjoy drinking and prescription pills just because it is something to do that makes me happy, and makes my day less dull. I have an extremely hard time interpreting my feelings, I don’t know if I’m happy or depressed or confused, I know I have a bit of anxiety I inherited from my father, I have been on pills for it, and I liked that they made me feel numb which made me happier but I drank almost everyday. I didn’t want to stop the pills because it was a different kind of drunk but I had to because you aren’t supposed to mix them and I ended up in the hospital after a while. Sometimes I get into this sort of numb mood where I can just zoom through my days and not remember much without someone reminding me or thinking really hard about it, it’s usually when I’m down. Sometimes I don’t want to talk to anyone, and other times I want to be around everyone. I feel like I’m masking my happiness whenever I’m around people, maybe part of staying strong. Also, I’ve been to a therapist before I got anxiety pills, and I really wanted to talk but I couldn’t get myself to speak truthfully because I don’t like the idea of talking to someone who is paid for it and really doesn’t care about you as a person, it’s just their job. I have never talked to any of my close friends about these things because they come to me with their problems looking for advice, and I don’t want to burden them with my problems. The situation is the same for this one teacher who always looked out for me, and kind of knows how my life really is, and I always wanted to open to him about everything, but I can’t bring myself to make my problem his problem too. Anyways, I don’t even know what my problem is yet. I really hope people don’t just ignore this question, I don’t know what is wrong, but I can never seem to think as clearly as everyone else can, every one seems to he able to do things so much easier than I can. One last thing, hopefully I don’t remember anything else, I’ve noticed in my relationships at the beginning everything is wonderful, I want to be with them and be affectionate, but then suddenly, not gradually, my feelings change, and everything about them bothers me, and I turn into a bitch and pick them apart constantly. I don’t want them to touch me or kiss me anymore; I don’t want to be around them at all. And then the relationship usually ends. One last thing, I have constant migraines or headaches everyday that the doctor said are tension headaches? That(s everything I can remember for now that I’m confused about. I’ll add more if I think of it. I just want to understand my own feelings.

A: Whew! It sounds like you have been doing a lot of thinking! I wouldn’t pretend to be able to respond adequately to all of what you are putting forward—but I do see a place where I think we could make some progress. That is your comment about the therapist who “really doesn’t care about you as a person, it’s just their job.”

Therapists choose their profession because they do care about people and know how to help. You saying that you don’t want to go because you believe the therapist doesn’t care about people probably comes from the fact that in your family the people who were supposed to care for you properly failed at their job. You think the therapist won’t care enough either.

My very strong suggestion is to give therapy another chance. Just do it for you—help yourself feel better by talking to someone who is trained to help. He or she is likely to do a far better job caring for you than you have said your family has done.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

First, I would like to explain that I am a Psych major and have been in counseling for years for PTSD and now ADD, among other issues. I believe this person I will describe does have BPD, but I’m not a professional and can’t diagnose.

MY RELATIONSHIP WITH HER
Her boyfriend left her to date my ex, which led to us talking. We both attached quickly, started having sex, and two months in started dating others at her insistence. I told her I loved her, but she only “liked me a lot” and three weeks later she broke up with me. During this time, I was reading a book on ADD and caught a section about BPD, and thought “wow, that’s her”. We didn’t talk for nearly three months, then she comes back to school where I am. Since then, we’ve been having sex and seeing each other almost daily. While being “just friends” I have learned much more about her personality, and strongly believe she has BPD.

BEHAVIOR
She very quickly attaches herself to new people. She hates to be alone, and sleep alone – she sometimes sleeps with a particular stuffed animal. Also shows signs of anxiety when around unfamiliar groups. She is prone to mood swings, and seems to almost have multiple personalities. She was neglected by both parents, and shows ambivalent attachment qualities. She smokes marijuana daily, shoplifts, and has unsafe sex. She was a cutter, history of depression. She “hates herself”, and sees herself as ugly despite being very attractive. She has medical problems, including possibly never being able to have children. Lies and keeps secrets almost effortlessly.

RELATIONSHIPS
She was date raped as a teenager. Physically abused by another ex boyfriend. She has a hard time letting go of ex boyfriends (including myself) insisting on remaining friends with them. She quickly attaches herself to new people, seemingly having a new “best friend” every few months.

To me, it seems clear that she may have BPD, but I could be wrong. How can I best approach her to get her considering treatment?

A: While I admire your desire to help I am also aware that there are too many possibilities to consider when trying to diagnose a person. The list of symptoms and issues listed here could be a variety or combination of concerns. The question I would have is: “Why are you in this relationship”? Why do you want to be with a person with so many issues? Why do you “love” a person who only says she “likes you a lot”?

Since you are both in college I would encourage you to go to the counseling department together and ask to have a couples session. The therapist can then see and ask questions that would be helpful to the relationship, and if your friend needs help they can make the recommendation.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

I am perfectly healthy and in my mid 20′s, and I recently got married. My husband is very loving and supportive of me in every way, including my decision to not take ADD medications that I used to be prescribed in huge doses. I made the decision to stop taking drugs because for years through college, I struggled with identity crisis issues, who was I without the concerta, could I live with out it, etc. The trouble is, I still have days, even weeks where I can’t focus, I feel completely out of control and totally ineffectual. And I especially struggle with the resentment I feel towards my parents- they are wonderful people, but they didn’t know how to deal with a hyperactive child and when I was in second grade they started me on a heavy dose of ritalin because the doctor said it’s what I needed. I have now done a great deal of my own research, and signs point to the idea that I may have been able to recover better from my ADD without having been medicated for so long- which is a possibility that has really plagued me with anger, and occasionally even hatred of my very caring and devoted parents. I know they were only trying to help me. And I have found this site now because I am hoping for some advice on how to forgive them, as well as a little insight into the why now, 2 years after going cold turkey from my meds, am I suddenly wishing to be back on them. Thank you for your input, it will be greatly appreciated.

A. Though I don’t know with certainty, it sounds as though you stopped taking your medication without the assistance of the prescribing physician (i.e. “cold turkey”). That is not recommended. Physicians slowly reduce the medication dosage in a safe and controlled manner. They do this because stopping “cold turkey” has the potential to be medically dangerous.

That was two years ago and hopefully you did not experience any unpleasant or medically dangerous side effects.

I would recommend having the discussion about whether you should take medications with a psychiatrist. He or she could assess your symptoms and help to determine if you should be taking medication, on what dose and for how long. It’s in your best interest to see a specialist about medications.

With regard to your parents, they were in all likelihood doing the best for you that they could think of. They did not fully understand attention deficit disorder (ADD) or how to treat it. They were not researchers in the field of ADD. They were not specialists. They took their child to get professional help. While they may have been wrong in light of newer thinking, they were following standard medical practice. If they were wrong, so were millions of other parents who tried to get their child the best standard of care. While your anger is understandable, it’s not helpful. They can’t change the past and neither can you.

In many ways, your situation is no different from that of many people. Very few people were raised by parents who did not make any mistakes. In fact, many people who enter counseling are attempting to correct the mistakes made by their parents. Fortunately, as an adult, you have the means to heal those early childhood wounds.

A low-dose medication may help you feel more focused. You may also want to consider psychotherapy for the purpose of learning behavioral approaches to focus your concentration. Please take care.

Dr. Kristina Randle

Well I didn’t used to be like this. Recently, id say within the last 6 months or so, ive had uncontrollable anger issues. I keep getting mad at everyone and throwing things or screaming over the smallest, stupidest(is that a word?), stuff and I know that its something that isn’t worth getting mad about but I do and cant control it. Especially towards my family who have done nothing wrong but love me unconditionally. I also think about me dying or my family members dying all the time. its interfering with my life a lot now and im not sure whats going on. Im not more stressed than normal I dont think, so i was just looking for some possible insight before I pay lots to go to the doctors to get a brain scan. Thanks!

A. Though it may not be clear at this moment, there is a logical explanation for the change in your behavior. I would encourage you to think deeply about what that explanation might have been. Did you start a new job? Did you recently move? Was there a recent death in your family? Something has to account for the change in your behavior. If it wasn’t an event, then illicit drug use is another possible explanation. You did not mention drug use but without many details I can only speculate. A significant behavioral or personality change might be indicative of an organic brain disorder but that occurs only on very rare occasions.

With regard to your focus of your family dying, that is a sign of anxiety. Some individuals with a particular type of anxiety disorder (obsessive-compulsive disorder) focus their anxiety on a potential future loss. The anxiety associated with that potential loss creates a great deal of fear. Individuals who are anxious and fearful can feel upset and potentially angry over the loss of control associated with that which they fear. Again, it is difficult to know what may be wrong without knowing more about your symptoms and your personal history.

I don’t necessarily think that you need a “brain scan” but it would be advantageous to meet with a mental health professional. A therapist could delve deeper into your issues and analyze what may have led to your recent change in behavior. Generally speaking, there is a logical explanation for why you are fearful, angry and unable to control your anger. Something is causing you to feel angry even if the reason is not self-evident. The advantage of seeing a therapist is that he or she can provide an objective assessment of your situation and can perhaps identify life patterns and trends that you may be overlooking. I hope that you will consider seeing a therapist. Please take care.

Dr. Kristina Randle

Something I have wanted to know for a while now. I have split personality disorder, Attention Deficit Hyperactive Disorder and Obsessive Compulsive Disorder. For a while now I’ve wanted to know if there is a way to completely get rid of a split personality?

A. I’m not sure what you mean by “a split personality disorder.” When you use that expression, perhaps you mean that sometimes you are feeling very strong emotions regarding one aspect of your life, and the next day you feel completely different. If so, that is a common experience among teenagers.

It may be possible that you are referring to multiple personality disorder which is now called dissociative identity disorder. Many people also confuse schizophrenia with dissociative identity disorder but the two are very different.

Dissociative identity disorder is a relatively rare disorder. Individuals who have the disorder are not typically diagnosed until adulthood.

I am not certain what you meant by the expression “split personality disorder” so it is difficult to give you a specific answer. I would recommend seeing a mental health professional about your symptoms. It is always wise to seek a professional opinion about unusual or concerning psychological symptoms. Please take care.

Dr. Kristina Randle

I’m 15 years old with ADHD and depression. About 4 months ago my mom and I had discovered my father cheating- and it seems he has not been faithful for about 9 years. During this time, I have gained 20+ pounds due to binge eating, and my grades have dropped significantly. I started cutting, and while looking at myself in the mirror I feel sick looking at how overweight I have become. During all of this, my one close friend replaced me with someone else, and I feel like I am worthless.

Whenever I try to talk about this with my mother she gets upset and says nothing is wrong with me and that I need to “get a grip”. When I try to tell her that I think I may have an eating disorder, she simply says that I’m “using food for comfort, and it is not a big deal”. I haven’t told her that I cut myself, because I know she would either over-react or not believe me.

My acquaintances have all noticed the scratches on my arms and they ask if I have been self harming, which I’m happy for for some reason, but yet I lie and tell them no. I don’t understand why I get so happy when someone notices, or why I need to feel like I need to lie to them. I want to stop binging and I want to stop cutting, but I don’t know how! I have a therapist, but he spends more time talking to my mother than to me, and the things they say stress me out more- and in turn- increase my desire to cut. What should I do???

A: It sounds to me like you really, really need your mom but your mom is dealing with her own trauma so she’s not available to you. It may be that your therapist is responding to her distress and maybe isn’t seeing yours. So here you are, wanting help, but not getting it from the two people who would usually be the people to give it.

Instead of sending out “hints” about the level of your distress, like having scratches on your arm, you need to be more direct. Show your letter and this response to your therapist. I hope the therapist can help you and your mother be more supportive of each other. You need a mom. She is in such pain that she probably doesn’t understand that she stands to lose the relationship with you as well as the relationship with your dad. You need help expressing your anger and sadness without being self-destructive. If the therapist can’t treat the two of you, ask for a referral for your own therapist.

I’m very glad you wrote. Now please take the next step and have an honest conversation with the therapist.

I wish you well.
Dr. Marie

i’m thinking i am diagnosed with adhd but im still not sure.my behaviour is becoming worse and so is my concentration i really need help on what to do.i need some simple advice on how i can get better and whearther i should tell my parents PLEASE understand me as im only 12 and in desperate help for youre adivice.

A: I’m sorry you are so upset. By all means, talk to your parents. Please don’t decide that you have ADHD – at least not yet. The symptoms of ADHD can also be explained by other things.

It’s important to get a medical checkup first. Believe it or not, food allergies and seasonal allergies can look a lot like ADHD. So can a thyroid problem. These are only a few examples.

If your doctor determines there is nothing medical going on, you then should be evaluated by a mental health professional. Just as with medical problems, there are a number of mental health problems that can look like ADHD but are not. Depression and anxiety disorder are the most common. And sometimes learning disabilities like dyslexia present like ADHD.

In order to get the correct treatment, you have to have a correct diagnosis. You’ve apparently been reading quite a bit. I certainly applaud you for trying to figure yourself out. But reading alone isn’t going to confirm a diagnosis. For that you need training and experience. Please talk to your folks about taking you to the professionals who can help determine what the problem is and how best to manage it.

I wish you well.
Dr. Marie

I’m a 19 year old female and have been experiencing issues with my mood. I’ve always been a very emotional and sensitive person but recently it’s gotten out of control. I describe it like a light switch, it’s as if my mood is controlled by someone that is switching on and off a light switch. I can go from happy and excited to depressed to hostile and angry, without any warning. I become self-destructive, often trying to get my boyfriend to break up with me, then an hour later I’ll be crying and saying sorry. When I get in these moods it is almost impossible to get me out of them. I know he hates this and he wants me to get help. I am in school to be a child and youth care counsellor so part of my program is learning about mental health issues. From what I know about bipolar disorder I don’t think that it is that extreme. I just want to find out if there was anything like bipolar but is less extreme that could fit what I have been feeling.

A: Thank you so much for writing and for being so responsible. It’s important to address this problem both for yourself and for your future. Children need a counselor who is stable!

Instead of exploring diagnoses on the Internet, you really need to get some expert advice. The first stop should be with your physician. Although it is true that mood lability can be due to bipolar disorder or borderline personality disorder, it can also be caused by several medical conditions. You want to be sure you aren’t missing an undiagnosed medical problem. Thyroid disease, for example, can cause significant changes in mood.

If you are fine medically, then it’s important to have a mental health assessment. What you are describing may be symptoms of depression or anxiety, ADHD, or cyclothymia, to name only a few possibilities. If you in fact have a diagnosable mental illness, the mental health professional will offer you suggestions for what to do about it.

The mood changes you are describing sound very painful and upsetting. Please take care of yourself and get the help you need.

I wish you well.
Dr. Marie

I am a 45-year-old widow–currently being treated for depression and anxiety. I am suspecting more and more lately that i have ADHD in addition to or instead of those disorders. I have done research on adult ADHD, and–quite frankly–much of what I have read is discouraging. Many adults seem to struggle to function even if on medication. So I’m wondering–is it even worth it to try to find out if I have ADHD, and if I am diagnosed, is there any hope for me to have a productive life, and is taking ADHD meds worth the expense and risk, or will i just have to struggle forever??

A: You sure have a lot on your emotional plate. 45 is very young to be a widow. You are already being treated for depression and anxiety. And now you are worried that you have yet another condition that will make life a struggle. No wonder you’re discouraged.

First, there are many, many people with ADHD (both children and adults) who learn how to manage it, with and without medication. Some people with ADHD even argue that it is a positive in their lives. But more to the point, when I read your letter, I hear the anxiety and depression talking.

I hope you are being treated with counseling as well as with medications. Both anxiety and depression respond better with that combination than by medication alone. Cognitive-behavioral therapy has been found to be especially effective. If you aren’t currently seeing a therapist, I urge you to do so. If you are seeing a therapist, please take your letter and this response to your next session and ask to work on your feelings about your present and your concerns about the future.

The support of some good friends and involvement in work or volunteer efforts that give your life meaning will also help you feel better. I hope you will reach out for that as well.

I can tell that things look bleak to you right now. You still probably have half of your life to go. I hope you will get the treatment you need so that the next half can be what you’d like it to be.

I wish you well.
Dr. Marie

How do I know if my 2 year old has ADHD? He is not talking. He will not sit still for story time. He is a climber, runner, and so on. Bed time is not easy he thinks it’s time to play. He will say words every once in a while. He will sit still at dinner time. My Husband thinks there is nothing wrong with him. But as mom I am see red light for a problem with him.

A: As a mother, it’s important to trust your “gut” if you sense something is not quite right with your child. I suggest meeting with your pediatrician to discuss your concerns and see if your child is on target developmentally. Watch the rest of my response below…

Thanks for writing in. Take good care of yourself and your child!
Julie Hanks, LCSW

I’m not sure where to start. I am a 14 year old freshman in high school and I have been constantly noticing that I might have ADHD or something, I can’t pay attention and am always confused along with other symptoms. Anyways I’m not completely sure how I would bring this up with my parents to get help. I’m afraid they are going to laugh at me and tell me I’m useless like they always do. What’s the best way to ask someone for help in a situation like that?

A: Thank you for writing in. If you’re not comfortable talking to your parents about your concerns, you may want to talk with a school counselor or your physician to see if they can help you bring up your concerns to your parents. Watch the entire answer in the video below…

Take good care of yourself!
Julie Hanks, LCSW

I just finished my first semester at a major university in New York City. I failed miserably and I know it was my fault. It was a mix of laziness, ADD and depression. I have been dealing with depression since I was 13 (18 now). I have never felt pretty, smart, or worth anything.
Everything has worsened after I got dismissed from college. I’m confused about what to do next. It is too late to register at a community college for Spring Semester and I at a standstill. I cry every night and I HATE myself so much. I dont know if I am ever going to be something in life .
I also have to write an appeal to my academic dismissal. I want to explain that I can do better if allowed to stay. Should I do it, what are the chances that the university would let me stay?
I really need help. I have hit rock bottom.

A: I don’t know if an appeal will get you back in. It’s always worth a try — IF that’s what you really think you should do. Sometimes people “fail” as a way to tell themselves that they aren’t really ready to do something. It’s too bad it’s termed a “failure” when it could be termed a realization.

It sounds to me like you have some serious personal work to do before you are ready to take on the challenges of a college education. Unless you do something about the depression and ADD, it’s not likely that another semester would go any differently. I think it’s Einstein who is quoted as saying that insanity is doing the same thing over and over again and expecting different results.

You didn’t mention if you have been getting treatment for your mental health issues. Sitting in your room isn’t going to change things. Hating yourself definitely isn’t going to make things better. It’s time to get busy doing the things that will make a difference. That means seeing a mental health professional for an evaluation and to discuss a treatment plan. You may need some medication to help ease the depression. You certainly need some talk therapy to learn how to manage the depression and to learn skills to compensate for the ADD.

It also means finding a job that gives you enough money to live but that leaves you with enough energy every day to spend time taking care of yourself. And it means seriously disciplining yourself to eat right, get some exercise every day, and to get enough sleep.

In short, rather than beating yourself up for what you didn’t do at university, put yourself fully into the school of life for awhile. Once you have the depression under control and have reliable ways to manage the ADD, you’ll be able to succeed in school and in life.

I wish you well.
Dr. Marie

My dilemma is about my relationship of 3 years with my partner. He has ADHD (according to him). Every now and then when something triggers the disorder I ended up his emotional punching bag. He says very hurtful things and at some point it lowered my self esteem. I had been depressed early this year, lost weight, slept less and can’t find the reason to live (but never attempted suicide or hurt myself, I just wished I would die.) Eventually I overcome everything but now it is happening again. He puts me in high state of happiness and takes it away when his mood changes. He can be hyper/energetic in the morning after yoga exercise and very low in the afternoon for minor reasons. Since he tends to say hurtful words, later on when he comes back to his senses he don’t remember much of it. It is difficult to ask for professional help as he never consider it and he is a Psychiatrist himself specializes in Child and Adult mental health. Help please as I am emotionally drained.

A: ADHD is about concentration, focus, and distractibility. It’s not about being mean to someone you love. It’s not usually wise to try to diagnose oneself. We can’t see what others see. Your boyfriend would probably benefit from having an evaluation by another doctor who is not in any kind of professional or personal relationship with him.

That being said, your problem is not your boyfirend. Your problem is that your emotional state depends on your boyfriend’s mood. I urge you to take a look at why you let yourself be a punching bag. Why do you let his comments lower your self-esteem? Clearly he isn’t very smart about himself. Why do you think he is smart about you? Surely 3 years of mistreatement is enough to convince you that he isn’t going to change and that you can only expect more of the same if you stay with him.

At 35, you need to be thinking about whether you want marriage and a family. Please think hard about whether this man offers you the kind of future you want for yourself. Is he a good role model for children you might have? Is your relationship something you want children to copy in their treatment of you, of each other, and of their own partners someday?

If you can’t either change the dynamics in your relationship or extricate yourself, I hope you will seek out a counselor to give you emotional support and to help you confront whatever it is that makes you accept unacceptable behavior. You deserve better.

I wish you well.
Dr. Marie