Bi-Polar with an Eating Disorder
Still not sure how we got to this place...
My 16 yr old DD was diagnosed with an eating disorder several months ago. Despite "catching it early" and getting a treatment team in place, it got worse quickly, and evolved to include self harm (cutting). On June 27th, we had her hospitalized for the ED. She was released after 4 1/2 weeks in the hospital - they suspected there might be some bi-polar II, but didn't seem worries as she had was already on Lemictal and had not had a severe hypomanic episode. 3 days out of the hospital, the partial program she was on called 911 because she had cut in program - long story short, she has been back in the hospital ED unit the last 2 1/2 weeks and had a scary hypomanic epiosode 2 weeks ago. That confirmed the bi-polar II diagnosis and caused all sorts of med changes. She is not on Seroquel 400, Lemictal 100 and Lithium 600. Meds appear to be helping, but who knows.
Even though her mood is more stable, she continues to not be recovery minded on the ED and we are petrified of what will happen when she is discharged. That being said, she has now been in the hospital for almost 8 weeks (other than a 3 day "break" and we want her home! She will either succeed and be able to get back to school or flame out and end up in a residential program, I guess.
Anyone have any words of support or encouragement or dealign with the same wonderful bp/ED combo?
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Ed F.
Is she in a treatment program specifically for eating disorders? Are they comfortable dealing with both dx's? Based on everything I've seen here over the years, whenever someone has a dual dx like your dd (more frequently it is BP and substance abuse), both dx's need to be treated together. You usually can't get good results trying to treat one and then the other. They're just too intertwined.
I know ED's are very difficult to treat. I guess the root problem starts for awhile before it becomes apparent as an ED, which may be why it's so difficult to treat even if you catch it early like you did. I don't know which places are the best for treatment, hopefully someone else will have experience with that. I found this website for searching for treatment centers. I don't know if it's any good, but you can check it out.
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Brenda,51, CABF Parent to Parent Volunteer
Mom to A, 16, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel, Allegra
E, 15, BP,AS: Seroquel, Eskalith CR, inositol, Buspar
B, 14 & H, 11
Married 18 years to DH, 50
FROM CABF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.
Ed,
I recommend that you look for a ED treatment program that uses Dialectical Behavior Therapy (DBT). ED, self-injury, etc is frequently a poor coping skills that develops as a way to deal with strong emotions. Medication can help stablize mood, but therapy is necessary to address the poor coping skills. DBT rapidly addresses ED, self-injury, etc. by providing effective healthy coping skills to use when there are strong emotion before addressing the underlying issues that resulted in the poor coping skills. Clinical studies have found DBT to be effective for Bulimia Nervosa and binge eating. Many ED treatment programs are adding DBT.
My son was self-harming. He started self-harming during his second hospitalization, which was for 12 days. He continued to self-harm at a partial hospitalization program and after 7 days they referred him for residential treatment. For the first 2 weeks he was in the residential treatment, he made progress and continued to make suicide attempts and self-harm. After 2 weeks they moved him to the DBT unit. After 7 1/2 weeks on the DBT unit, he no longer had suicide idealation, the frequency and severity of his self-harm was greatly reduced and he was discharged. He went to a partial hospitalization program for 6 days and is now seeing a DBT trained therapist 2x week. 3 weeks after coming home he completely stopped self-harming and has been self-harm free for 2 weeks.
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Beth
DH - Husband & Father
DS 16.2 - Cyclothymic Disorder or BP II (psychiatrist is still considering which one is the correct diagnosis), NVLD, GAD, Transgender (female to male) and gifted
Geodon 40mg AM/PM, Prozac 20mg PM (tapering off) and Buspar 15mg AM/PM
In 11th grade at a small alternative hybrid competency based public high school in Northern California, with IEP for ED & SLD