bipolar disorder, Dr. Paul Markovitz  Q. I am extremely concerned about a member of my family who (I feel) has some type of severe depression or other mental/personality disorder - I am, however, uncertain as to her diagnosis. As far as I can see her illness was triggered from having her (only) child and then being left by the father. She had severe depression following the birth (unsurprising in the circumstances) although I do not know if this "original" depression was post natal or not. She has never recovered from this depression - her son is now 12 and she seems to be getting worse.

Her symptoms include being excessively irritable/on the verge of hysteria and unable to cope with reality (I would describe her as permanently on the edge of /having a "nervous breakdown"), unable to accept any other opinion other than her own or to be reasoned with ( however sensitively or gently), inability to see the effect of her own actions i.e. irrational and "madcap" decisions with no sense of responsibility afterwards (instead blaming outside forces/other people for the outcome), inability/refusal to recognize that she may need to seek help, feeling persecuted and isolated. She is virtually unrecognizable from the sister I used to know. I am uncertain if she has "ups" or manic periods followed by "downs" unless her manic periods can be seen as irrational/irresponsible acts.

  A. It could be a form or bipolar illness or depression or borderline personality. In all of the cases, it can be treated, usually with good results. Have her get a professional evaluation by a psychiatrist, and see what they suggest. Make sure you get a psychiatric opinion for what to do next. It sounds as if she will need medication therapy.