Brief Answer: Relapse is likely. Detailed Answer: Hi, Thanks for writing to us, Early onset bipolar disorder, at the age of ten years is a more serious disorder than an adult onset disorder. It is more difficult to treat. Prophylactic medications are usually required for a long term despite which the risk of relapse remains. Medications should not be stopped without consulting a psychiatrist. Taking substances or drugs, in a case of bipolar disorder can be a symptom of an episode onset, which may mean that he has relapsed, or it may trigger an episode in some individuals. Either ways it has to be viewed with caution. It may mean that he needs to be started on his regular medications again. Any experienced psychiatrist is recommended to treat his condition. It is also recommended that a person accompanies the patient to the clinic because many of the symptoms can be concealed by the patient. If he has threatened to kill himself he needs to be taken to a psychiatrist at the earliest. If this behavior is of recent onset then it is likely that he has relapsed and needs medication to avoid progression of his illness. Hope this helps, Dr A Rao

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