Q. We have a 15 year old son he is diagnosed with bipolar disorder, attention deficit hyperactivity disorder, oppositional defiant disorder, tourette syndrome, & was sexually abused by my ex-husband at a very early age until he was 4. I am remarried to a wonderful man who accepts my son as his own but, my son's behavior is nothing to be desired. He has been aggressive. swearing. talking sexual, very disrespectful, & disobedient his new big thing is stealing. He does not want to do chores or anything we ask of him. He has this I don't care attitude all the time. He will do something wrong, turn around and say he is sorry & means it & 5 minutes later, he does it again. Is stealing part of the bipolar disorder? We have done everything we could think of to discipline him with in reason without spanking him, nothing works. He is Rx lithobid, adderall, rispardol, tennx. celexa. We just bought a book, "Survival Strategies for Parenting Children with Bipolar Disorder". We are at the end of our rope.

  A. My guess is that your son may have borderline personality disorder, too. It would explain many of the other behaviors/symptoms, including Tourettes. In cases where Tourettes is present, I tend to favor Luvox at 300-400 mg daily as a treatment. This is only a guess, however, as I know little about him. It would be possible, but unusual to have two diseases (Tourettes and Bipolar) as opposed to one-- an illness with mood swings, tics/Tourettes, irritability, concentration problems, etc. Chances are he has a single disease, and if the correct medication exists, it should eliminate all his symptoms. Discuss it with your doctor, and see what he thinks. If your current doctor is not helping, get a second opinion. I have my patients do it all the time if I cannot help them. The worst that can happen is nothing. At best, the patient gets better. I am never embarrassed to refer someone on, if it will help them get better. I always tell them to come back whenever they want, whether they are better or not.

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