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Question
Posted by: Maci | 2010/08/12

Testing (Bi-Polar, etc)

Good day Doc

Kindly advise if I would be able to arrange for the following tests for my daughter, without having to be referred by a pschiatrist/psychologist, please (the psychiatrist we went to didnt feel that these tests or medication is necesssary and I feel that she only enabled my daughter''s behaviour, not having addressed the discipline issues we''re experiencing and not giving us any ''coping mechanisms'' to work with in the meanwhile):
Bi-Polar
Chemical Dependency
Chemical Imbalances
Hormonal Imbalances
She is nearly 15 and is acting out - refusing to go back to school after the holidays, but we''ve managed to get her to go back (she was doing quite well at school initially), having lost interest in friends, very moody (withdrawn then quite chatty) and is smoking. I would like to rule out any medical issues, before arranging appropriate counselling for her.
How would I go about having these tests done (through my GP?) or can I request them myself and where, please?
In the meantime, apart from school, we have decided to enrol her in a karate class and dance class (she seems to be very interested and excited to attend) - in an attempt to keep her mind busy and maybe this way, hopefully, she may get some focus again...
Thank you!

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Our expert says:
Expert ImageCyberShrink

She may be acting out in a particularly annoying and upsetting way, but it is extremely ordinary for kids of that age to act out and become, at least for a time, a thorough pain in the neck.
It is hardly ever ( probably never ) caused by chemical or hormonal factors outside of the ordinary changes of adolescence, and such changes are not, anyway, detectable by tests that are practical to do.
Bipolar Disorder is impossible to diagnose by chemical tests, and only a careful assessment according to the internationally accepted criteria can make the diagnosis. Chemical dependency also depends on a clinical assessment which could be backed up by some blood or in some cases urine tests - it all depends on what dryg is involved. But many of the drugs kids abuse can't be identified on normal testing, and most are excreted rather fast, so tests can easily miss their presencem because they're gone before the sample is taken.
Problems that could be well dealt with in counselling are by FAR the most likely cause for the problem you describe, which one does not see caused by the factors yiou are suspecting. So starting counselling would be very wise.
The counselling would help, anyway. If the counsellor noticed further factors suggesting more is involved, further asessment could be done then.
The classes she has started sound like an excellent idea, if these are activities she herself would or did choose, rather than only your idea. Not only do such classes give her an opportunity to let off steam, but they can get her so involved in pleasurable activity, that drugs or other distractions would be unwelcome to her.
Now, I am not convinced by the work of Schlegel and Barry. Such problems are undoubtedly common in Western teenagers and some others. Yes, it is not inevitable nor seen in every culture. In fact, in many cultures and in our own history, "teenage" is a fairly recent invention - a couple of centuries back, kids were considered to be small adults, deserving no special indulgence, and controlled by strong codes of discipline. I agree that this is not caused by hormonal factors ( though they don't help - and remember there has been a dramatic lowering of the age of sexual maturity ( physically and hormonally ) over the last century or more. )
But as an interaction between the physical and changes in social status and expectations, I think the problems are created by this situation - but you can't put your own teenager on hold till society rights itself, and must still deal with the current problem.

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4
Our users say:
Posted by: anon | 2010/08/12

I wonder how many people realise that " teenage rebeiilion"  is by no means inevitable and has in fact been debunked as a myth by current scientific research (Schlegel and Barry 1991). The phenomenon would seem to have far more to do with society''s approach to the teenage years than any inherent hormonal or psychological dictate. Were it inevitable, it would be pervasive across all cultures which is in fact not the case.

Perhaps one needs to examine this preconception and the militant approach proposed by Maci?

Reply to anon
Posted by: Jordan | 2010/08/12

She sounds like a normal teenager to me. They go through tremendous hormonal changes and it is all very confusing for them and they act out. Karate and dance class sound like very good choices as they let out alot of frustration. Good Luck.

Reply to Jordan
Posted by: Liza | 2010/08/12

Unfortunately there isn''t currently bipolar testing per se. You can''t just draw blood and say that yes- this person is bipolar. You can have DNA screening done (usually very expensive) that would let you know whether she has the POTENTIAL to become bipolar. These tests are also not all that conclusive either.

So having ''tests'' done is not going to be all that helpful. What would be helpful is to take her to a qualified child/teenage psychologist for some counseling sessions. If the psychologist finds anything troublesome, your daughter can then be referred to a qualified psychiatrist for specialist treatment. It is very important however for your daughter to be comfortable with the counselor and discussing personal issues. If she isn''t, the counseling will not be productive.

Good Luck
Liza

Reply to Liza
Posted by: cybershrink | 2010/08/12

She may be acting out in a particularly annoying and upsetting way, but it is extremely ordinary for kids of that age to act out and become, at least for a time, a thorough pain in the neck.
It is hardly ever ( probably never ) caused by chemical or hormonal factors outside of the ordinary changes of adolescence, and such changes are not, anyway, detectable by tests that are practical to do.
Bipolar Disorder is impossible to diagnose by chemical tests, and only a careful assessment according to the internationally accepted criteria can make the diagnosis. Chemical dependency also depends on a clinical assessment which could be backed up by some blood or in some cases urine tests - it all depends on what dryg is involved. But many of the drugs kids abuse can't be identified on normal testing, and most are excreted rather fast, so tests can easily miss their presencem because they're gone before the sample is taken.
Problems that could be well dealt with in counselling are by FAR the most likely cause for the problem you describe, which one does not see caused by the factors yiou are suspecting. So starting counselling would be very wise.
The counselling would help, anyway. If the counsellor noticed further factors suggesting more is involved, further asessment could be done then.
The classes she has started sound like an excellent idea, if these are activities she herself would or did choose, rather than only your idea. Not only do such classes give her an opportunity to let off steam, but they can get her so involved in pleasurable activity, that drugs or other distractions would be unwelcome to her.
Now, I am not convinced by the work of Schlegel and Barry. Such problems are undoubtedly common in Western teenagers and some others. Yes, it is not inevitable nor seen in every culture. In fact, in many cultures and in our own history, "teenage" is a fairly recent invention - a couple of centuries back, kids were considered to be small adults, deserving no special indulgence, and controlled by strong codes of discipline. I agree that this is not caused by hormonal factors ( though they don't help - and remember there has been a dramatic lowering of the age of sexual maturity ( physically and hormonally ) over the last century or more. )
But as an interaction between the physical and changes in social status and expectations, I think the problems are created by this situation - but you can't put your own teenager on hold till society rights itself, and must still deal with the current problem.

Reply to cybershrink

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