Hello doctor, I have three kids. My oldest is 16 years and she is a bit hard to deal with. I have been noticing her change of moods everyday. My mother, older sister, and younger brother told my middle son, that they hate her, no one wants her close. She had a rough break up, she says she hates life and has no friends. I understand the pain that she feels, but what worries me is that after a great day she suddenly has a mood where she cries, shuts off the world, without anyone telling her anything. She has suicidal thoughts. I have noticed she gained wait and lost interest in fun activities. She stays up all night crying on the phone texting or I do not know. She cries a lot. I try to talk to her, but she does not talk at all and just cried. She listens to sad music. I could say she has bipolar disorder (depressive). Is it possible?
Hello. Going by the description of your daughter's life circumstances and events, she seems to be in depression definitely. Is she in bipolar depression can only be determined if she exhibits the following. 1) Cycles of depression and mania. 2) There should be discrete episodes of depression lasting days to months (like the one she is currently) and mania also lasting days to months. 3) There ought to be periods of normalcy between maniac and depressive episodes. 4) Maniac episodes consist of irritability or euphoric mood, over activity, decreased need for sleep, over-talkative, grandiose, hyper sexuality, the flight of ideas and pressure of speech. And yes, the treatment will depend upon whether she is suffering from unipolar depression or bipolar depression. Another important thing I like to highlight is her gaining weight. This can be due to depression per se, or it may due to underlying medical problems such as hypothyroidism, which in itself could lead to presentation mimicking depression. She should be investigated to find the cause of gaining weight. Finally, the most important thing I would like you to look at is her suicidal ideations. This should be taken very seriously. You should keep the following things in the mind: 1. Never take a person’s expressed wish to die non-seriously even if expressed in anger. 2. A person who repeatedly threatens suicide but does not commit suicide is at higher risk to commit suicide. 3. It has been seen that a person who has committed suicide has had given some sort of forewarning. 4. Always keep a vigil on people with chronic illnesses and psychiatric illnesses. 5. Once a person has attempted suicide but could not succeed, extra care should be taken. Rules to be followed when a person expresses a suicidal idea or has attempted suicide are: Contact a psychiatrist to assess the person’s suicidal risk by scales. If the person has been identified with a psychiatric illness it should be treated promptly. Keep an eye on the person and keep dangerous things out of his reach. There may be a need for hospitalization. Do not criticize a person for the act but extent full family support for the speedy recovery and moral support so that the person does not repeat the act. Depressed patients coming out of depression are at a particularly high risk of suicide called paradoxical suicide and should be under supervision until complete recovery. So it is very important for you to contact a psychiatrist and start treatment as soon as possible. I hope that your daughter comes out of this depression quickly and leads a healthy life ahead.