Dr. Gorman: We are parents of a recently diagnosed 22 yr old daughter with bipolar disorder. Is it common for people with bipolar to push their loved ones away and be mean to them? She doesn't seem to care about the feelings of those who love her. She doesn't seem to have any kindness in her.

Is drinking to excess and acting out sexually common? What if she refuses to take medication, she seems to deny her situation, even though she has seen a psychologist several times and is scheduled to see a psychiatrist? Will the medication make her kinder and take her meanness away, make her more civil? She seems so mad much of the time.

We are new to this so any help is much appreciated.

Sincerely, Dwight and Geri.

Thank you for your question about your daughter. I am sure it has been very difficult, and I hope my answers help. Your first question about bipolar patients pushing their loved ones away is a question with many answers. Certainly, when patients are experiencing depression, mania, psychosis and mixed states, anger and fear are the order of the day. Often, once the patient is settled with treatment, those symptoms and the alienating behavior diminish significantly. Often when patients are in this state, they require hospitalization.

Drinking to excess and sexually acting out are common manic symptoms, along with dangerous driving. These are other reasons for hospitalization and medication. Often family therapy is necessary to help treat the fall-out after a significant mood swing also. The medication will help, but psychotherapy is also necessary to help re-integrate someone during and after recovery.

My advice is to try to understand that your daughter is not of sound mind in the middle of an episode and any one of us could behave in a similar fashion if in her state. I only hope she gets the help she needs so that her life and relationships can get back on track.

As you mention, it will require compliance on your daughter's part at some point. Your role is to help her get the help she needs. If all else fails, you can take her to an emergency department for access to a hospital if she is too ill to comply at this time.

Thanks and all the best.