bipolar disorder, Dr. Paul Markovitz  Q. In September of last year, my 13 year old daughter was involved in a car accident. She was taken to the hospital unable to move her right leg. An MRI supposedly showed blood on her spine, compressing the nerves. Emergency surgery was scheduled. Several hours later, I was told there wasn't as much blood as was thought and no surgery would be necessary. A few days later, I was told there was nothing physically causing her symptoms, that it was all in her head. A psychiatrist pronounced her "depressed' over the separation of her father and I, 3 years ago. After 8 weeks of therapy, she regained her ability to walk. 2 weeks after being released from the hospital, she entered a mental facility due to suicidal ideation. She was diagnosed bipolar and put on Zyprexa, Depakote and Paxil. A month after that she attempted suicide by overdose of Zyprexa and entered another mental health hospital. She was put on Lithium and Risperdal. The psychologist said she was a deeply disturbed young lady with possible bipolar/bpd symptoms. The neuropsychologist, after testing, said he thought she suffered from post-traumatic brain injury from the accident and that she would probably recover in a couple of years. Her current psychiatrist says it doesn't matter why she's the way she is, it only matters that we try and fix it. She's now being treated with Lithium, 900 mg., Seroquel 25 mg., Celexa 30mg and Amantadine, 200 mg.

My question is, could the trauma from the accident "bring on" bipolar symptoms? She was always a high-spirited child, never easy, but also not depressed. She was a gifted athlete, gifted student, very popular with teachers and classmates, class president, etc. Now within one year, she's become a totally different person and I am so confused as to what caused what or why this change occurred so rapidly. Can you please shed some light for me?

  A. Anything is possible, but is pretty unlikely that the accident caused the problems that she now has. I do not know what her diagnosis or symptoms are entirely, and would need to do an evaluation myself to be comfortable with a working diagnosis. However, it does seem she has some type of mood disorder, and I agree with your psychiatrist that the bottom-line is fixing the problem. Many folks develop their first strong manifestations of psychiatric problems in adolescence, so the time line is right. Review your concerns with the psychiatrist treating her, and see what he has to say.