- What’s Wrong With My Son?
QUESTION:
Dear Dr. Heller,
I have ordered your books and I can’t wait to read them. Thank you for the wealth of information which I found on your Website. It has been extremely helpful in arranging a treatment plan for my two adopted FAS sons who experience biological unhappiness. Perhaps you can answer a few questions for me.
The 17 year old (bipolar, ADHD, Type 1 diabetic) son recently got into trouble for impulsive sexual behavior with a younger child. I once read of a study done by two West Coast physicians which proposed that heightened or abnormal sexual impulses were an indication of approaching mania. Patients were treated with lithium and improved immediately. Do you know of any such study? How can laymen get access to such studies?
My son’s lithium level was .1 . Does low lithium level always indicate Bipolar Illness, or could it also indicate BPD? I know lithium is a salt, but where does it occur in the diet? Are there foods I should be serving to provide adequate lithium? Also, his BUN/CREA ratio was 13.0. Is this significant? The 18 year old had been treated with Zoloft for “Intermittent Explosive Disorder.” Is this a subcategory of BPD or a separate mental illness? He craves chocolate. (I would imagine that the chocolate affects the serotonin level.) He also refuses to eat with metal utensils, preferring plastic and rips off the top of his socks because they are uncomfortable. Are these indications of BPD? I would like to try him on Prozac, but I wonder how many years a patient can take this without having long-term repercussions?
Finally, he was treated in childhood for congenital adrenal hyperplasia. Should I be concerned about endocrine problems in adulthood? Thank you for your help and have a nice day!
Concerned Mother
ANSWER:
1) A low lithium level means nothing, it’s supposed to be low. The level only matters for individuals who are taking the medication, or are self-medicating with someone else’s medication. There are no foods that cause problems with blood levels of lithium for individuals not taking the medication. 2) Lithium is more effective for the suicidality of bipolar, but it can occasionally work very quickly for someone who is developing mania. 3) The elevated BUN/creatinine ratio most likely means he hadn’t had any fluids prior to the blood being drawn and was mildly dehydrated. 4) “Intermittent explosive disorder” is likely a form of the BPD where the person has anger problems but doesn’t fit criteria for the BPD. Seizure disorders can also cause this phenomenon. 5) Carbohydrate and chocolate cravings exist in many diagnoses, and aren’t specific for anything. 6) The refusal to eat with metal utensils and pulling off the top of his socks are probably related to obsessive compulsive problems – either or both the OCD and OCPD. They do not indicate the BPD. 7) Not treating him will likely have devastating consequences. Prozac appears to be safe – studies are now over a decade showing no problems. 8) Due to the congenital adrenal hyperplasia, a consultation with an endocrinologist seems a wise choice.
