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Has slashed forearm. On drugs. Take ambien to sleep. Treatment?

Dec 2014
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Practicing since : 2007
Answered : 4792 Questions
This is regarding our 34 year old daughter. She has slashed her forearm two times, she is totally irresponsible, fiscally and every other way. She does not pay rent in the condo I bought for her, makes 54k per year and is always broke. She is not on drugs, went to see Dr. Ribori, but abandoned it. She smokes, drinks wine and takes Ambien to sleep. Oddly enough she is good at doing her job. She was divorced five years ago, was a trim good looking girl, now she gained a lot of weight, does not care about her personal appearance and had become a total recluse. In a way it may be my fault, because I gave into many potential battles, rather than go to an emotional war, I am 78. She has never bought a car, every one was given to her, has squandered all funds which I deposited for her future, etc. You get the picture by now. Thanks, XXXXX
P.S. With the new health care act, perhaps there are treatments which could be covered as such.
Posted Tue, 29 Oct 2013 in Mental Health
Answered by Dr. Seikhoo Bishnoi 50 minutes later
Brief Answer:

Detailed Answer:
Welcome to Health Care Magic

I have read your query and I can understand your problem. You are 78 years old and your daughter is having problems. She is 34 years old, otherwise healthy female with good occupational history. She is divorced about 5 years back and currently she is showing abnormal behaviors. She tried to kill herself by slashing her wrist. As per you she earn adequate money but she dont pay rents, she is totally irresponsible, she is not concerned about her personal appearance. She is taking ambien for sleep. She also smokes and take alcohol. She has wasted a lot of money even the funds you bought for her future.

Now coming to management.

After reading the available history I can tell you that she is definitely having some problem and it should be properly managed by a Psychiatrist.

First possibility we can think in her is bipolar disorder although detailed evaluation is needed to make this diagnosis. She has history of irresponsible behavior, failure to control spending, drug taking behavior etc. Along with this there is suicidal attempt also. All these point to bipolar disorder with mixed episode or depression. There is need for mood stabilizers and anti-dperessants. Drugs as Valproate, Lithium carbonate, lamotrizine, topiramate etc are commonly used. Apart from medicines psychotherapy especially Cognitive Therapy is needed for her management.

Second possibility is some Personality disorder. It may be borderline personality disorder. Suicidal attempts, reckless behavior is commonly seen. Such cases are managed by proper psychotherapy and mood stabilizers.

Before consulting a Psychiatrist talk to her directly about her behavior. Tell her that what are your expectations. Once she is ready to listen then try to shape her behavior and then consult a Psychologist first. If needed then consult a Psychiatrist.

Thanks, hope this helps you, if you have more queries you can ask again.
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