Unsettling diagnosis pre college

Parents Forum
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<p>My niece, a graduating senior, is a great kid and very good student who started to struggle the second half of the school year with her mood, energy levels and motivation. She was either highly "stressed" or distant or angry. We questioned whether this typical was teenage behavior, but a few months ago when she started having self-harm thoughts it was clear that she needed help. My sister took her to her physician for an evaluation and found a counselor who my niece now sees her every other week. She also started on medication and began feeling better. We were optimistic.</p>

<p>My sister got a call today from the therapist, with my niece's permission, saying that, although my niece is feeling much happier, she confessed to engaging in risky behavior recently -- shoplifting and driving very fast. These behaviors are so far out of her norm that the therapist suggested she may be exhibiting signs of bipolar discarder. My sister is making additional doctors appts. now to follow up.</p>

<p>My sister's a mess and I'm trying to be more measured but it's difficult. A little background…. My now-deceased mother had as extreme a case of bipolar disorder as anyone I've ever heard of. It was a lifelong struggle that colored every aspect of my childhood. It was like being on a runaway train with no hope of getting it under control. For my sister who was often on the end of my mother's rages, it was even worse. And, yes, my mother had continuous medical care and treatments. So, we're reacting to this news in this context.</p>

<p>But, I'm posting on this site because I have practical concerns about college. My niece is planning on going away to school in the fall. The deposit is in and she's very excited. I just got off the phone with her now. She's working on her writing placement test and is talking about room decor. She'll be about 1.5hrs away. It's the first time she's ever been away from home and would be a huge adjustment even without knowing she'd be dealing with these issues. I was very straightforward with her when I spoke with her by phone about needing to treat this very seriously and make sure she has the support in place when she goes away? But what is possible? Any advice on how to approach this? Anything practical that we should do or look into?</p>

<p>Should we contact the school or will that hurt her?</p>

<p>I think she should continue to see a therapist/doctor every other week, perhaps even coming home to see the same doctors. It's close enough.</p>

<p>She's getting a lot of financial aid and taking out loans. What happens financially if she has issues during the semester or year that force her to withdraw? I know I'm borrowing trouble but... </p>

<p>Just trying to figure out where to start. My sister is focusing on my niece's medical needs right now. I'm trying to gather the information we need to make decisions before she starts college in the fall.</p>

<p>One note: I completely understand that our top priority is her well being. I just want to advice on what to do in advance of her starting school this fall.</p>

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<p>If she has tuition refund insurance or similar read the fine print carefully to be sure there is no Pre-existing condition diagnosis that would disqualify payment if things worsen. Would ask for her therapist’s help in figuring what choices make the most sense at this point.</p>

3

<p>You can get tuition insurance, so I’d definitely look into that. I’d also look into what sort of mental health care is available and have the info handy. I wish your niece all the best.</p>

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<p>if relative was not bipolar would the neices behavior be seen as bipolar so quickly? </p>

<p>give her a chance for heavens sake. don’t have her failing before she leaves. be postive, loving supportive and not so quick to assume the worst</p>

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<p>Getting the medications at the right levels take trial and error, and time. There are often side effects while trying to find the right ones. </p>

<p>I agree with your concerns about her going away. What does the therapist think about it? On the positive side, at least she is confessing to the shoplifting and speeding, which means she has a good relationship with her therapist. Any chance of her taking a leave of absence for a year prior to starting college? </p>

<p>Does her therapist think therapy every other week is sufficient? Having seen many people in this situation, I know that often weekly - or even twice weekly - is indicated, in order to monitor the fluctuations of the illness when the person is in a destabilized state. Her therapist is obviously the best source of information as to her particular case. </p>

<p>The good news: there are many more medications nowadays than when your mother was raising you. And if you catch it early (as you clearly are), the bipolar person’s brain doesn’t have to go through all those highs and lows, and will likely be more stable because of it.</p>

<p>My husband’s father was bipolar, and his life did not end well, to put it mildly. Our oldest son inherited the disease. We were devastated. But because we caught it very early, we were able to get him on meds quickly, and he is really doing very well. He is a senior in college 4.5 hours away. </p>

<p>He first started showing symptoms in grade school. It took 2 years to get his meds correct, but he’s been much better since then. This is why I am concerned about your niece going away in the fall. The meds may take more time to regulate. Once she is stable, she will likely be able to go away with a good support system.</p>

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<p>Kelbee, I’m sorry to hear this about your niece. I suggest that she sign a HIPAA waiver and a school records privacy waiver, and also give a medical power of attorney to your sister so that the school/health facility will be able to share what otherwise would be confidential information with your sister. Otherwise, at 18 they can’t tell your sister anything about her condition, whether she’s getting treatment, missing classes, etc.</p>

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<p>Thanks, everyone, for their feedback. Seahorsesrock, we absolutely intend to give her every chance to succeed but this is a serious illness and she’s about to embark on a dramatic life change without people who know her well around her. I think we need to worry and think this through carefully.</p>

<p>Calla1, thank you for sharing your story. It helps to know that your son is doing well. It is probably the right decision to defer school for you but it feels almost impossible to imagine holding her back at this point. She certainly hasn’t even considered that this is a possibility. I honestly can’t imagine making this decision that quickly, and gaining her support which I think would be crucial. I don’t want to her to think we’re punishing her for being so open with us… If we had eight months to prep for the idea of a year off that would be one thing…eight weeks is hard. We need to speak with her doctors though and get their advice. And, if she could embrace the idea, I’d fully support it.</p>

<p>pkdof13, we will definitely look into the HIPAA waiver and power of attorney. I take an individual’s rights very seriously but I think this sounds smart.</p>

<p>We’ll also explore tuition insurance.</p>

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<p>I would ask her therapist for recommendation of another therapist close to the school she plans to attend and let her make an appointment prior actually starting to see if she feels comfortable with them. One and a half hour away can be a very long distance if there was a crisis situation.<br>
Does she have friends going with her to college?
Bi-polar disorder is difficult but as Calla says there are many more medications these days as options.</p>

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<p>If niece has a formal diagnosis and is prescribed medication, then she should notify Student Services (medical records group), providing a letter from diagnosing MD to confirm medication and HIPPA waiver for parents’ access to staff and records, notify academic services group if academic accommodations are recommended/requested, and possibly Housing Office to request a single and/or substance-free dorm room if recommended by diagnosing MD. I’d suggest also contacting Dean of Students, perhaps anonymously first, to notify them of the recent diagnosis and submit paperwork for parental access to academic records, etc.</p>

<p>If your niece is motivated to closely observe all physician’s instructions, medications, and prudent lifestyle choices, then she certainly has a reasonable chance of success. If she starts partying like a recently-liberated teen away from home’s restrictions and monitoring, then things could derail. Family members should plan to visit her, perhaps every weekend, to ascertain condition. “Helicoptering” is certainly warranted here under this situation during first year; parents/family should not be discouraged from doing so. Best wishes to your niece.</p>

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<p>staying close to home is a must (IMO) she must be working very closely with the psychiatrist and or neurologist. like somebody else said getting the right drugs and the right balance is tricky. mental health counseling will not help with a medical issue, it is not a substitute for medicine.</p>

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<p>As someone who works at a university, I can assure you she will not be the only student with serious mental health issues. It is important to let the school know what’s going on so they can help her (they will NOT rescind her acceptance . . . that would be illegal under ADA.) I can’t tell you how many students I have dealt with over the years where mental health or other problems were not disclosed and then when problems arose, support services were not in place making a bad situation far worse.</p>

<p>Have your niece or her parents contact the student health center at her university for guidance. If, for any reason they aren’t helpful, contact the Dean of Students office.</p>

<p>The suggestion to have your niece sign HIPPA and FERPA waivers so her parents can receive updates on her health and academic progress is a good one. I hate when I see a student struggling and I can’t say anything to the parents, even if they ask.</p>

<p>Good luck to your niece and your family.</p>

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<p>Excellent thoughts above about HIPAA. </p>

<p>I agree that it is important to keep her on board with this process. IMO, the most difficult situation is a young adult who resents parental “interference” and won’t allow information to or from the family, even while that young adult’s decision-making process is very impaired. Her goodwill and cooperation is crucial to her success.</p>

<p>One thing very important when dealing with bipolar is taking the meds on a REGULAR schedule. It is difficult enough to set up this habit in any circumstance, and for a sleep-deprived college student, it is all to easy to forget the medications. I suggest pairing the taking of meds with some other activity that is regularly done - like putting on deodorant in the morning. If the meds need taking in the p.m., maybe they can be taken at the dinner hour. Some thought will need to go into this, but it is very very important. Many people set their phones to give them a reminder, and some people carry their meds in their purse or backpack so when the reminder comes, they just pop them in their mouth.</p>

<p>Another option is those pill trays labeled for each day of the week. </p>

<p>One reason it is so important to take the medications regularly is, the doctor will be judging how effective they are. If there has been inconsistency, the doctor can’t make an accurate assessment. </p>

<p>I agree with the above comment about the family visiting weekly. This is not the time to worry about helicoptering. She will need the extra pair of eyes. When they visit, they should check to see if the meds are being taken.</p>

<p>OP, I know where my own mind would be going on this… just keep repeating the mantra “She is not my mother. We are catching it early. We are being proactive.” (((hugs)))</p>

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<p>Try not to get stuck on how things were for your mother. The newer medications work differently and are much more effective. This type of treatment has changed significantly in the last 30-40 years. </p>

<p>I would probably want to defer a year if it was my child. I’d want there to be time to make sure she was stable before adding in another stressor.</p>

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<p>OP’s family will have to make the decision to keep D home or not. That can be a huge form of stress in itself. In any case, helicoptering is in total order and the HIPPA forms are crucial (good reasons to be only supportive).
I personally don’t think single rooms are a good idea (you CCrs may correct me). Guess it depends on the roommate–a good friend who cares and is around can really help in keeping that extra eye which is needed sometimes.</p>