Any parents of teens out there?

Q.My 14 year old son has taken lithium and notrtriptyline for over a year. He has been doing extremely well but will always be a difficult child. When he was 8-9 we diagnosed him with ADHD. He took ritalin and it worked for him. When he went into junior high we switched to dexedrine (longer acting). He started having real problems in school and we noticed signs of clinical depression. He started Prozac which didn't work. Then he was physically attacked at school in a vicious hate crime. There were no witnesses because it was before school started (he was on his way to resource center). He hid the scars on his stomach and didn't tell us although he told some friends.

A.There is no excuse for what happened to your son, but it sounds like he has done well for himself in his recovery from this vicious attack. It's not germane to this discussion, of course, but I'm curious: was any form of justice meted out to the cretins who attacked him? A word of caution: just because someone is taking lithium, it doesn't necessarily mean that they are manic-depressive. Lithium is prescribed to potentiate the effects of antidepressants with increasing frequency. (I'm not a doctor or medical professional of any kind... just an aggressively self-educated person with Bipolar Disorder... but I know at least two folks who have a diagnosis of severe clinical depression, are *not* manic-depressive, and who take lithium to potentiate the effects of their ADs.) There is no question that traumatic life events can cause an illness to manifest itself, or to make an existing episode worse. Most researchers agree that affective disorders like depression and Bipolar Disorder have a strong genetic linkage... that they run in families, and can be passed on from parent to child. However, that's not the whole story. Psychiatrists often speak of the "biopsychosocial" model of mental illness. Basically, this means that certain kinds of mental illness definitely involve biological processes... in the case of the mood disorders, the processes involved are thought to be difficulties in the regulation of chemicals called neurotransmitters, which have a profound effect on mood and cognition (thinking.) Nobody really knows why antidepressants and mood stabilizers work to correct this or reduce the bad effects, because nobody really fully understands the processes at work here... but researchers are making great strides in understanding the underlying processes. The "psychosocial" part of that five-dollar word, "biopsychosocial," means that environment, personal and family history, and other external factors also play a role--sometimes a major role--in triggering an illness, or in making the recovery from an illness harder or easier.

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