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Q:  Maturity Level is "Off"

 
My child was diagnosed with Bipolar Disorder, Obsessive Compulsive Disorder, Chronic Anxiety, and Schizo Affective Disorder. 25 year old adult; on 4 different meds; was diagnosed with all the above  approximately 4 years ago, although he had previous diagnoses throughout childhood.  My questions:  His maturity  level is off, at times her still thinks life a teen.  Is this part of the Bipolar or could this be something else?  Will he mature closer to his age?  Are any of these diagnoses for life?  Can they grow out of this or can it become lessen as years go by? Is there genetic testing available for Bipolar Disorder?  I would appreciate your time in responding to my questions.
A concerned mom.


Dear Karen -- 
Your concerns are certainly understandable.  Let's take those questions one at a time: 

1. Is this part of the Bipolar or could this be something else?  
"Yes".  In other words, his "off" maturity level, whatever exactly that means, might be associated with the mental health syndrome he has (whatever that is, it's pretty complicated, as usually all those different terms would not be used for a straight-forward bipolar disorder; however, all the terms refer to conditions that are either commonly found with bipolar disorder, or easily mistaken when really what's there is bipolar disorder in an odd, non-typical version).  And, yes, there could be something else that explains the maturity problem.  The most common such explanation is some form of drug use, which is widely thought to interfere with the usual maturation processes -- and which is very common in bipolar disorder, especially in the really complex versions such as it seems your son may have. 

Sorry, that doesn't help much, does it. 

2. Will he mature closer to his age? 
Unfortunately, that rather depends on the answer to #1, and obviously that was pretty vague; thus, so is the answer to this question.  Can't really say, based on the information we have here.  

3. Are any of these diagnoses for life?  
Bipolar disorder is generally a life-long condition although I prefer not to think of it that way.  Rather, I like to focus on the present, on getting a much-improved outcome right now.  Then, once that is done (and almost three quarters of all patients can get either clearly better or nearly well, with a smaller group completely free of symptoms) we then start thinking about "how long do I have to take this treatment?"

4. Can they grow out of this or can it become lessen as years go by? 
Treatment can be very effective (especially if he's in the 75% that get much better, or nearly well, or symptom-free, obviously), so even if the answer to this question was no, there is still hope that things could be much better soon.  But sometimes a young man's adolescent years are among the worst, especially if that stage is complicated by drug use, so sometimes just getting older can indeed make things better.  

5. Is there genetic testing available for Bipolar Disorder?
Not yet. But all of a sudden, there has been rapid progress on the genetic front in the last year or two.  So I think we might see a "test" for bipolar disorder in the next decade or so ( I remember thinking that ten years ago; but the rate of progress has been much greater recently). For example, there recently has been a stunning advance in the understanding of the genetics of major depression (a description is "under construction" on my website, should be done by December or so; see the
homepage, left side boxes).  

Dr. Phelps



Published January, 2005
 
 

 

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