Family Ties – When to Let Go

Written by Margaret Paul, Ph.D.

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Title: Family Ties – When to Let Go Author: Margaret Paul, Ph.D. E-mail: Copyright: © 2004 by Margaret Paul URL: Word Count: 702 Category: Relationships

Family Ties – When to Let Go By Margaret Paul, Ph.D.

Ruth consulted with me because she was confused about what to do regarding her mother, her brother, and her son.

Fromrepparttar 126105 time Ruth was born, she never felt like she belonged in her family. Her mother ignored Ruth, obviously preferring her brother, and consistently allowed her brother to beat Ruth up. Ruth had some connection with her father, but he was a weak man and never stood up for her or protected her.

Ruth was a loving child and tried in any way she could to please her mother and brother, to no avail. She could never understand why her family didn’t like her.

As an adult, she married an emotionally unavailable man, a man very much like her mother. As with her mother and brother, she tried in many ways to get his love and never succeeded. Her son, Dylan, was eight years old when they divorced.

Dylan always seemed to prefer his father, and finally went to live with his father when he was sixteen. Once again, Ruth was completely inrepparttar 126106 dark regarding why her son didn’t like her. She had been such a devoted mother, so why was he rejecting her?

Ruth finally married again, this time to a loving man, and had another child. Her current family was totally different from her previous family and from her family of origin. However, she still hoped to have a relationship with her mother. She would send her mother birthday and Christmas cards, but rarely heard from her. The final blow that sent her to seek my help came when she found out that her son had gotten married without telling her, and that her brother had moved her mother into a nursing home and sold everything without telling her.

What is the Treatment for Bipolar Disorder?

Written by Michael G. Rayel, MD

How do we treat bipolar disorder? Specifically, how do we treat mania or depression associated with bipolar disorder? The treatment of these two clinical states is notrepparttar same.

The treatment of mania is dependent upon its severity and acuity. For mild to moderate mania, mood stabilizers such as lithium and valproic acid (Valproate) are stillrepparttar 126103 standard of treatment and may be sufficient to containrepparttar 126104 symptoms. Lithium starts to work after 10 to 14 days while valproic acid, about 7 to 10 days.

Also, recent studies have shownrepparttar 126105 effectiveness of atypical antipsychotics such as risperidone, olanzapine, and quetiapine even when used alone to treatrepparttar 126106 acute phase of bipolar disorder.

These drugs are relatively safe but they don’t come without side effects. Nausea, vomiting, tremors, and dizziness duringrepparttar 126107 initial phase of treatment are commonly experienced. The more serious side effects such as renal and thyroid problem from lithium, liver dysfunction and pancreatitis from valproic acid, and increased risk of diabetes and high cholesterol from atypical antipsychotics are uncommon. However, regular blood tests are required to monitor any abnormalities.

For moderate to severe cases, atypical antipsychotics such as risperidone and quetiapine should be added torepparttar 126108 mood stabilizers duringrepparttar 126109 acute phase. Oncerepparttar 126110 illness has stabilized andrepparttar 126111 symptoms have subsided, thenrepparttar 126112 atypical neuroleptics can be gradually tapered off. Butrepparttar 126113 mood stabilizers should continue. Regardless of severity, patients usually do well on a combination of mood stabilizer and atypical antipsychotic duringrepparttar 126114 acute phase.

What isrepparttar 126115 treatment for bipolar depression? In general,repparttar 126116 mood stabilizers’ dosage should be optimized or ifrepparttar 126117 patient is not on any medication yet, a mood stabilizer such as lithium should be started. Physicians should make sure thatrepparttar 126118 medication maintains a “therapeutic level.” If not,repparttar 126119 dosage should be adjusted. Moreover, possible precipitants such as stresses at home should be addressed.

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