My 16 year old daughter was diagnosed with bipolar type 2 3 years ago. She has since been on mood stabilizer and medication for focus. She uses comcolit (lithium) and aripiprazole. She gets a very warm face daily and her learning is still a challenge. She struggles to study and retain information. How do I assist her?

Mr. Saul PereiraPsychologist52yrs exp

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I think your daughter may be treated for Bipolar 1. I suggest you take her immediately to a counselor and treat her with talk therapy too. In her later adolescence, there are likely to be some unresolved issues that may go as far as prenatal influences. It comes up at this time seeking a resolution. But unfortunately not many are aware of this and will go untreated and compound the disorder. Both parents must also accompany her to help trace the problems encountered in childhood. There are certain adaptations that will suit her during the elation phase and there are certain behaviors that are required during the depressed phase. In the meantime, she can do certain things that will give her benefits anyway. Emotional therapy will alleviate a lot of the problems faced by this condition because it is a mood disorder. She needs to particularly look at her levels of anger both for its reasonableness and to express it appropriately. I suspect that much of this anger may have origins in early childhood that she may never be aware of now. This information will help the counselor too. Also, you will need to check whether there is any genetic factor involved. She must exercise regularly, eat healthily, and sleep normally too. If her motivation and cooperation are good much can be achieved. She must have a time-structured schedule filled with interesting and reasonable activities and it must be monitored for compliance and delivery. The reason I say this is that many times she will be inclined to have grandiose notions and confidently believe that she can do without the medication. This will set her back many months in the treatment and delay and sabotage the recovery: forewarned you are forearmed. If this combination of medication with therapy is maintained for at least three years without any episodes or breakdowns, it is possible to taper the medication in consonance with the doctor. Her age is in her favor if she cooperates. 

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