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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7664
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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My 30 yr old daughter, a psychologist, is in her 1st manic

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My 30 yr old daughter, a psychologist, is in her 1st manic episode. After initially starting therapy on Zyprexa, her doctor switched to Lamictal dose pack 2 weeks ago. She has gotten much worse and now refuses to talk to family or friends that try to help. Also has not been back to psychiatrist. She has lost her job and been reported to state licensing board also. She is also making horrible financial decisions. All family lives over a 1000 miles away. I think in her current mind set, going there will not accomplish anything. She is convinced she has another job lined up, but they have not tried licensing her yet in that state. She does not appear to be a threat to herself or others at this time. Do have any options other than just waiting for her to self destruct?

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

Your daughter needs intervention right away and making the long tip may be the last resort. I am sure that you do not want to miss that opportunity to help her even if you feel that it is a long-shot.

Elliott, LPCC, NCC :

Her reckless behavior is due to the mania, which she cannot control and maybe cannot even see. That includes the terrible financial decisions she is making.

Elliott, LPCC, NCC :

Perhaps the best medical intervention would be lithium a safe, tried and true way of stabilizing her moods.

Customer:

She refused to take lithium.

Elliott, LPCC, NCC :

Here is a British psychiatric article on mania drugs that will give you insight on the drugs available.

Customer:

She won't even come to door if I go there. I know my daughter.

Elliott, LPCC, NCC :

http://www.rcpsych.ac.uk/mentalhealthinfo/problems/bipolardisorder/medicationsformania.aspx

Elliott, LPCC, NCC :

Has she mentioned suicide? I ask because this may be the only way of getting temporary control of her.

Customer:

She also doesn't appear to be going to her psychiatrist. I have kept the doctor up to date by email. She knows what is going on. But cannot reply to me per daughters request

Customer:

No she has not mentioned harming herself or any one else

Elliott, LPCC, NCC :

I understand about the HIPAA restrictions.

Customer:

I am told that would be necessary to force her into hospital

Elliott, LPCC, NCC :

Unfortunately it will.

Elliott, LPCC, NCC :

Are you sure that she would refuse to see you after a thousand mile journey?

Customer:

Her lamictal rx will eventually need to be refilled, but I think dose pack takes her another 4-6 weeks

Elliott, LPCC, NCC :

If it is not stabilizing her then it is not effective. Perhaps doctor could up dosage at refill.

Customer:

at this time I am sure she will not see me. I have tried calling often and she will not answer.

Elliott, LPCC, NCC :

How is she supporting herself?

Customer:

She is only 2-3 weeks into the increasing dose, so is not at therapeutic level yet.

Elliott, LPCC, NCC :

This may be the best hope then, that it will kick in.

Elliott, LPCC, NCC :

Why won't she see you?

Elliott, LPCC, NCC :

Or even answer calls?

Customer:

I assume she has sick time and unused vacation. She resigned as of April 3 from her job at the VA, but they are not letting her work. which has made angry enough to send a manic sounding letter to the President of the American Psychology Society complaining about her superiors.

Customer:

She also somehow got a loan

Elliott, LPCC, NCC :

Then you have no financial leverage, alas.

Elliott, LPCC, NCC :

I assume that she is not taking antidepressants, correct?

Customer:

She won"t see me or answer calls because we have voiced concern and haven't been "excited enough" about the new opportunities she has going for her. She is doing perfectly well as far as she is concerned.

Elliott, LPCC, NCC :

Humor her and "support" her new opportunities. You must stroke her as she is not seeing things clearly.

Customer:

She tells me only Lamictal and low dose thyroid that was started about a year ago when she tested low

Customer:

and I am pretty sure BCPs

Customer:

We have just started to try to humor her in response last night to her announcement that she just bought a new car.

Elliott, LPCC, NCC :

Is psychiatrist aware of here BCPs and thyroid condition? She will listen to him/her.

Elliott, LPCC, NCC :

Both can profoundly affect her moodl

Customer:

I hope when the new license gets denied and her current license gets suspended it might force her to show adequate treatment and get her back to the doctor. I also think she stopped seeing the psychologist. It is made worse by the fact she has her doctorate in psychology. She knows the ropes well

Customer:

yes she knows of the other meds and thyroid

Customer:

she wont listen to anyone who questions her. I am pretty sure she isn't answering calls from psychiatrist.

Elliott, LPCC, NCC :

You will have to give her as much positive affirmation as possible. Don't expect replies. She will still hear your love and concern.

Elliott, LPCC, NCC :

Don't show "concern" but only unconditional love with no attachments, demands, requests, or suggestions.

Customer:

Depending on her mood. She tells me she deletes messages without reading them. But I suspect she does read them. We will try that

Elliott, LPCC, NCC :

Talk about familiar things, people, etc.

Elliott, LPCC, NCC :

She will read them. Try snail mail.

Elliott, LPCC, NCC :

Try sending her a small thoughtful present that she likes (chocolates are good and soothing).

Customer:

This is compounded by the fact my wife and I are supposed to leave March 9 for 2 weeks to a medical mission in the

Customer:

d

Customer:

Dominican Republic. We are the primary anesthesia providers. Project will suffer immensely if we don't go

Customer:

Present good idea.

Elliott, LPCC, NCC :

Send her simple greetings. She will survive and. You must avoid all mention of jobs, her condition, or anything other than a letter to the daughter you love who has nothing wrong with herl She will let you back in slowly as she rebuilds trust.

Customer:

Will try the positive approach. It is just so hard to not express concern

Elliott, LPCC, NCC :

If it is any consolation or encouragement, my supervisor during my internship was an MD psychiatrist had active bipolar disorder but was under care of HIS psychiatrist and was chief resident of a major teaching hospital, and had previously been a pediatrician . Very functional and lovely manl

Elliott, LPCC, NCC :

Keep your concern to yourself. She does not want to hear that she is causing you worry and pain and will be angry with you for letting her know.

Customer:

She has one more friend that she is close to, would it be a bad idea to approach her to help? I think she may only be a little bit aware of what is up from the bizarre facebook posts she has made

Customer:

Probably not a good idea from what you have just been saying. It might only succeed in destroying that freindship

Customer:

Expressing concern seems to be where we have been going wrong with her then

Elliott, LPCC, NCC :

I agree. Her friend is not a professional and may make your daughter feel that her friend has betrayed her. Having that old friend there is a positive link to her normal past. It is a good thing. Someone who knows the old "her" and will treat her just the same and help the old "her" respond as before.

Elliott, LPCC, NCC :

Express unconditional love and you will make the biggest strides.

Customer:

How long do these manic episodes go on? Hers appears to have become apparent in mid January

Elliott, LPCC, NCC :

They are not predictable. Some with bipolar are mostly depressed, some mostly manic, some mostly neither. Some cycle slowly and some have rapid cycling. The most dangerous is when they occur together.

Customer:

Should I at least let her friend know of the diagnosis?

Customer:

she is an attorney in another state

Elliott, LPCC, NCC :

I asked about antidepressants before because sometimes a person with bipolar depression (looks like unipolar or regular depression) will take an antidepressant which will actually trigger a manic episode.

Customer:

She had been on something for a number of years. Maybe effexor. It has been stopped

Customer:

but she has been on something for depression for at least 10 years off and on. Mostly on

Elliott, LPCC, NCC :

No, do not tell anyone unless they voice concern and then tell them only in the strictest confidence. You do not want to be her betrayor.

Elliott, LPCC, NCC :

And if she had bipolar and was getting only an antidepressant, then this could have been the trigger.

Elliott, LPCC, NCC :

Let her psychiatrist know everything you can remember or document.

Customer:

this is the first manic episode that was bad enough to be noticed

Customer:

Psychiatrist has been sent multiple emails with details. Knowing my daughter, she may have fired her by now as her doctor

Elliott, LPCC, NCC :

It can be manifested by high drive to accomplish, or reckless behavior, or rapid speech or racing thoughts.

Customer:

I hope she is still on the lamictal. Pretty sure she was as of Monday from remark she made that is seemed to be helping.

Customer:

She was actually so psychotic mid january she went out at night, lost her car and called a friend for help. Friend was also psychologist and took her to ER in the morning. She checked herself out AMA and has not talked to this friend since

Elliott, LPCC, NCC :

Then give it time. Enjoy your mission to DR. Continue to bless others with your help and feel confident that with positive energy and love of God that you will receive blessings back upon your house.

Customer:

She has not been that confuse since then

Customer:

I just hope she doesn't get in trouble while gone. Her mother and sister live 2000 mile away from her and she has been estranged for 15 plus years from her mother

Elliott, LPCC, NCC :

You are already far from her and have no input. You will have to remain hopeful and positive not just for her but for yourself as well.

Customer:

Thank you. I think you have given me some where to go with her.

Elliott, LPCC, NCC :

I will continue to keep her and you in my prayers.

Elliott, LPCC, NCC :

You are very welcome.

Customer:

I have been praying day and night. Hard to know if it has helped...

Elliott, LPCC, NCC :

It can only help and never hurt, and is good therapy for you.

Elliott, LPCC, NCC :

I wish you great success, much loving patience, and God's blessings.

Elliott, LPCC, NCC :

Warm regards,

Elliott, LPCC, NCC :

Elliott, MAE, LPCC, NCC, CCMHC

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