Q. My 14 year old daughter was diagnosed april of 2003 with major depression. Her new doctor recently diagnosed her with bipolar 1 when I asked for a more recent diagnosis. She is taking 1200mgs of lithobid, 3mgs of risperdal, and 150 mgs of effexor and seems to be more stable than ever, however sleeps about 14 hrs a day and has gained a significant amount of weight. She isn't motivated to exercise and still craves carbs and sweets, but is down on herself about her weight. First, how sure can I be that the bipolar dx is accurate? She never seems to have reached the ecstatic manic state, being more depressed, irritable and angry, cutting, and impulsive. Second, any info helpful regarding losing weight? Thanks in advance for any advice, Jeanne

A. Hi Jeanne and thanks for your questions. First of all, I am not a medical doctor or a psychiatric doctor so I can't tell you whether the amounts of medication your daughter is on is right for her or could be the cause of her lack of motivation and weight gain. Speaking from personal experience, I know that some of the medications I have been on in the past have had the adverse reaction of weight gain, and there really wasn't anything I could do other than request to change drugs until I found one without that side effect. It could take a couple tries, but there are many drugs out there to choose from. With regard to your questions about DX. Seek a second or even a third opinion. DX is seen differently by different people, even though most mental health workers use the same materials, some therapists, or docs, will lean one way with a DX where some will lean another. If you feel it is wrong, seek another opinion and find out if you are right. Even if you are or aren't, ask your daughter's doctor about her lethargy, lack of motivation, and weight gain. See if there may be something that she can swtich to and eliminate some of these issues. Good Luck to you.

You might want to bring up specific medication related questions with Anna.

Jeanne