Dear Cjmom, Thank you for sticking in with us here at JustAnswer and waiting patiently for your answer. First of all, I want to tell you that I agree with the prior Expert, so do please keep in mind her information, but I will attempt to address the additional concerns you mention. (For some reason the other Expert has opted out of answering further questions --she may not be available any longer today) As far as your son's medication being a 'risk factor' .... I think you are referring to the box warning to watch for suicidal ideation and/or psychosis
, which, when it does occur, typically happens at the initiation of medication therapy or at dose changes. This is indeed something that everyone needs to be aware of. This brings up the fact that you state he is taking a different dose on various days? Usually this medication is prescribed at a steady dose. Taking different doses might create some problems. It might be an inadequate amount to be of any help. It may also create an unstable mood. This medication does not work per dose, in other words, often no effect will be seen until after a month or two of taking it at a constant level. Please be sure he takes it as the physician ordered. If he has side effects or other problems are noted that keep him from taking the dose as prescribed, then the doctor needs to be informed of this immediately, so the dose or medication can be changed. And yes, seeing a Psychiatrist would be recommended. A psychiatric practice that includes in addition to the Psychiatrist, therapist and counselors such as Psychiatric Clinical Nurse Specialists, PhD or LPC Psychologists, Masters or Clinical Social Workers. One of the therapist in the practice should be trained to work specifically with children or adolescents, as well as their families. This way, proper assessment is provided, medication is managed and individual and group therapy is provided. If you are in a large to medium sized community, there should be several practices of this type. Regarding monitoring of symptoms that could indicate suicide risk: an individual may suddenly seem to do much better or even become hyper, irritable, or even manic before suicide attempt. At the time of improvement, the underlying depression is still in memory, and suddenly they have the energy to carry out a plan to harm themselves. So this is the danger of antidepressant...especially a risk for those with undiagnosed Bipolar illness -- which in the teen years is almost always not yet diagnosed. So yes, it is important that you observe your son, and keep communication open with him. Ask him how he is feeling. Have him contract with you (verbally or on paper) that if he has thoughts of harming himself that he will come to you to talk about it. Make sure he understands, that sometimes we feel bad, but this ALWAYS passes. By the way I would not encourage him to keep in contact with the family of his girlfriend, at least at this time. This might keep him focused on the past and keep him from moving on. You mentioned that he had few friends, and all his friends were mostly through her. This is a sign that he may need to work more on his own individuality. Being dependent on her for his whole 'world' could be part of the problem in the relationship. Every one wants to have a partner that they can bounce ideas off of, not someone that is dependent on them for their happiness. So this is his chance to discover his own interests, pursue them, and make friends. His future relationships will be much more fulfilling if he has more to bring to them. He will be happier, and people will be drawn to him. A hard lesson but one must of us have to learn, but he is young and has plenty of time to grow. We all feel sad
at the end of a relationship, and feel like there will never be anything that compares. The truth is if we learn about our part in what went wrong, the next relationship is better. This is a life lesson. Because his father is Bipolar, your son does have a higher risk of developing Bipolar than if there were no person with Bipolar in the family. Bipolar is in large part genetic, although factors like stress
are involved as well. Often it initially presents as depression, and many do not get an accurate diagnosis until they are much older. This is not to say your son has Bipolar illness, but it is important that his health care providers know that his father is Bipolar so that he can be monitored. Keep in mind though, that if your son was found to have Bipolar illness it can be treated. There are many successful individuals with Bipolar, more than any other type of mental illness (there are many famous examples, such as Ted Turner) Regarding your son's current sadness: A criteria for distinguishing normal grieving (grief of lost relationship included) from depression is whether the symptoms have resolved in 3 months. If problems are continuing after 3 months, then this is one sign that this is a more serious than simple grieving. The other Expert mentioned other signs of serious depression such as an inability to function in school; additionally, lack of personal hygiene, significant weight loss or gain, are other signs of depression. I hope this additional information is helpful. If you have more questions or need anything clarified, please reply to this post. Also note.. if I do not get back to you right away, it may be because I am in a different time zone, and you can be assure that I will be sure to get back to you as soon as possible.