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NeuroDoc1, Doctor
Category: Mental Health
Satisfied Customers: 211
Experience:  Board Certification by American Board of Psychiatry and Neurology
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My son is 22 year old enrolled in a California University.

Resolved Question:

My son is 22 year old enrolled in a California University. He
Submitted: 8 years ago.
Category: Mental Health
Expert:  NeuroDoc1 replied 8 years ago.



I believe your question may have been posted before you completed it. You can edit your post and resubmit it, or feel free to reply with the full question you want to have answered.


Thank you.

Customer: replied 8 years ago.
I I wrote the whole thing. can you not be sent that? My computer is not allowing to edit and resubmit
Customer: replied 8 years ago.
I I wrote the whole thing. can you not be sent that?It has all the details.
My computer is not allowing to edit and resubmit. My son's main problem isuniversity and class related anxiety. This is second year he had to take break because of poor result and missing classes. He is a bright student. Is it depression Is he Bipolar aaaaadoes he need low dose antidepressant or he needs mood stabiliser?
Customer: replied 8 years ago.
Do you need more information?
Expert:  NeuroDoc1 replied 8 years ago.



I am sorry for the confusion, now I see your whole question.


The symptoms that you describe your son having sounds as though it very likely may be either depression or bipolar disorder with a strong anxiety component. Because of his "overreaction" to the antidepressant he tried, this very well may be bipolar disorder since this often happens if bipolar disorder patients are treated too aggressively with antidepressants not balanced with a mood stablizing medication to prevent the extreme "highs". I understand that this must be very difficult to deal with since your son sounds like a very intelligent young man.


This is probably bipolar II disorder rather than bipolar I since it does not sound as though your son has had full blown manic episodes (except perhaps with the use of the antidepressant). Bipolar II is usually characterized by primarily depressed mood with occasional hypomanic episodes (elevated mood, enegery, perhaps some racing thoughts but not to the extreme of severe manic episodes). The best treatment for this is usually a low dose antidepressant along with a mood stabilizing medication such as valproic acid, lamotrigine or lithium. Counselling and sometimes anxiety medications such as clonazepam or antipsychotic medications like seroquel may also be needed.


Though I cannot recommend a specific doctor in California for you personally, I suspect that his university would have on-staff counsellors or psychologists who would be able to refer him to a local psychiatrist to confirm his diagnosis and begin treatment. If he goes to a university affiliated with a medical school (there are many in California), he also could contact the Psychiatry department there and set up an appointment.


The following link may be helpful, though since you have a background in Psychiatry you may not need this! Please let me know if you have further questions.



Customer: replied 8 years ago.
I did not say that there was over reaction to medication. He took Bupripion for a while. I am waiting for detail from him as he is currently in Japan. I will get back to you.I wanted to know what the diagnosis and would there be danger if he took low dose antidepressant only.
Customer: replied 8 years ago.
Sorry about the delay.His yesterday's e-mail said he thought he gets" hypomanic" episodes but he did not know there was a term for it. For a couple of hours at most he felt things speeded up and he had lots of ideas and thoughts. Today he said he bought lots of books when he was in this mood but nothung more than that He was not on antidepressant or alcohol or any drugs. When he has lots of thoughts(but not weired thoughts) he can not sleep. This sleep problem has been there a long time.He was here many months before going to Japan. Apart from sleep problem I have never seen him getting hyper.
Expert:  NeuroDoc1 replied 8 years ago.



Yes I agree that your son likely has bipolar II disorder. The issue that may occur when bipolar patients are only on an antidepressant is that they may begin to have more severe and more frequent manic episodes. Their depression certainly may improve but if they are also not on a mood stabilizing medication at the same time, they can "swing" too far toward the manic end of the spectrum. Therefore, if a low-dose antidepressant is prescribed on its own, your son should certainly be followed closely by a psychiatrist to monitor for worsening of his hypomanic episodes. My suspicion is that after examining your son, a psychiatrist would recommend both a mood stabilizer and an antidepressant.


Again, if your son can make an appointment with his university's counsellors or psychologist, I suspect they would be able to refer him to a local Psychiatrist to begin treatment.


Best wishes.

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