Is Bipolar an excuse for bad behavior?

[harper]

Originally Posted by Milosboy

My girlfriend of four and a half months is bipolar.

Isn't she kind of young to be dating?

[BillyTheMountain]

Originally Posted by Nurse Ben

A healthy relationship is easy and requires minimal maintenance.

That is a much a myth as "a healthy body requires minimal maintenance."

a Healthy relationship and healthy body both take work to achieve and maintain over the long haul.

[BillyTheMountain]

Do fptketnoi01 and hanchjcha91 need an excuse for bad behavior?

[Nurse Ben]

Billy,

The work of maintaining a relationship should not be hard, but that doesn't mean there's no work. Work is everything we do to maintain our lives. There can be pleasure in work, even when maintaining a relationship.

The idea that a relationship is full of turmoil and lacks compromise, that is not a healthy relationship no matter how you cut it.

Each person has a different idea of how much is too much, but I think that if you find yourself thinking about whether it's too much, then it probably is

[BillyTheMountain]

Originally Posted by Nurse Ben

Each person has a different idea of how much is too much, but I think that if you find yourself thinking about whether it's too much, then it probably is

Ben,

I appreciate that there are many different view on this issue, based on what we saw growing up and what we've learned since then. I also respect your viewpoint as the skilled mental heath professional you are.

I might say: If you find yourself thinking about whether it's too much, it may or may not be. You may just be dealing with an exacerbation of your partner's chronic illness or severe stressors related to economic or other factors.

You may find yourself thinking about whether it's too much, in a relationship or in a marathon race. It could mean you simply lack the training to follow through, or your resources are just low on that particular day.

I hate to see people sell themselves short and give up perfectly viable relationships because they subscribe to a MYTH about their own lack of ability to endure. See a qualified couples therapist.

Billy

[Milosboy]

Originally Posted by BillyTheMountain

You may find yourself thinking about whether it's too much, in a relationship or in a marathon race. It could mean you simply lack the training to follow through, or your resources are just low on that particular day.

I hate to see people sell themselves short and give up perfectly viable relationships because they subscribe to a MYTH about their own lack of ability to endure. See a qualified couples therapist.

I can agree with that.
However, I tend to believe that someone with a personality or mental disorder needs to figure their stuff out before they can commit to a relationship. Otherwise there's simply too much stress; their partner would need an awful lot of resolve to stay with them.

[Nurse Ben]

I tend to believe that someone with a personality or mental disorder needs to figure their stuff out before they can commit to a relationship. Otherwise there's simply too much stress; their partner would need an awful lot of resolve to stay with them.

So how far will you go to stay with someone?

There are just too many variables, which is why folks should attend counseling when they have problems and learn how to resolve their differences and/or learn when it's time to say when.

Relationships should be easy, not easy in the sense of no struggle, but easy in the sense of healthy and mutually beneficial.

Most relationships are unhealthy because the premise behind them is false: a relationship is not about love, excitement, or sex, it's about partnering together to create something new. Would you join a financial partnership without being clear on the strategic plan, potential pitfalls, milestones, expected outcomes, etc...

If people took the time and the effort to work on their interpersonal relationships, the world would be a different place. But instead we watch Twilight and Dr. Phil, and this becomes the lens through which we view our lives.

I read something recently, I can't remember the source, I think it was Thich Naht Han:

At the end of our life we finally learn that working to overcome challenges is what makes life worth living.

If only I could convey this to the many young people I see

[Zzagg]

Originally Posted by Nurse Ben

...I think it was Thich Naht Han

Is he/she/it one of the korean spambots we've seen around here recently?
Just asking.

[BillyTheMountain]

http://www.nytimes.com/2013/02/03/us...tion.html?_r=0

[Nurse Ben]

Addiction is addiction, it's not the medication that's the problem, it's the user.

Granted, after reading that article it leaves the reader with the impression that the prescriber should have known the adderall was being abused, but reporting facts is a gray area at best. What should be taken away from that article is that any person can abuse medication, even smart kids from wealthy families.

Typically stimulants are written for extended release fomulations that will cover school time only, though on occassion the kids will receive a post school kicker for homework. As often as not, I write a non stimulant for after school or nothing at all because after school stimulants cause too many problems with sleep and appetite.

To clear ip a misconception: You can't write a prescripton for ninety days of adderall. Per Federal law, Schedule II medications can only be written for one month scripts. You can write a maximum of three, thirty days scripts, with the second and third script post dated. I do this on occassion to save folks from having to drive to the clinic every month. Stimulants cannot be called into a pharmacy, a hard copy script is required.

I have prescribed thousands, tens of thousands, of stimulants in the past decade, in my experience stimulants are not addictive, but they do cause plenty of problems including: insomnia, irritable mood, depression, anxiety, and weight loss to name a few.

For the most part, kids don't want to take medicine, which is a nice thing for me since then I don't have to worry about stopping medications as the kids will often stop them before they should

There a few good practices which I use to reduce stimulant abuse and diversion:

I prescribe vyvanse and concerta as much as possible as they are harder to divert.
I won't write stumulants to kids who are abusing other substances
I write non stimulants such as strattera, guanfaine, and intuniv
I avoid writing short acting stimulants
I stop stimulants if there is even a hint of diversion or misuse
I stop stumulants when the kids are no longer in school
I don't prescribe stimulants to kids whose parents or sibling abuse substances
I advocate for behavioral changes before trying medication, so increase studying, developing study skill, improved sleep hygiene, developing structure in the home, tutoring, and modified work.

On the bright side, stimulants do work and can help those who need them and want them.

Billy, try not to throw the baby out with the bath water, it makes them cry, then when they grow up and want to buy assault weapons