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Expert Q&A

	By Tracy Underwood Child and Adolescent Psychologist Children's Medical Center of Dallas

My 16-year-old daughter was hospitalized twice a year ago for severe depression and psychosis. She has been off medication for four months and is having a recurrence. She is on mild medication now. She suspects manic/depressive disorder but her doctor will not diagnose it this early. She has been spending lots of time on a Web site for bipolar people. She feels it is a support for her. Should I let her continue to spend time on this Web site?

You and your daughter have been through a lot the past two years. I am sorry for the rough journey you have traveled. It is very empowering to give a name to a problem (e.g., manic/depression) and soothing to feel a sense of camaraderie with others who have suffered in a similar fashion. People who have depression, anxiety, bipolar disorder (another name for manic depression) and other such challenges often feel very alone and misunderstood. I suspect that your daughter has found a way to not feel so alone by connecting with others who have struggled with the debilitating effects of emotional problems. Her involvement with this group can be a very good source of support for her provided that the other individuals are emotionally healthy enough to offer support and sound advice.

It would be ideal if your daughter felt comfortable telling you about the kinds of people she is talking to, the kinds of things they discuss, and any advice they offer her. Teenagers are very strict about their privacy and are hypersensitive about parents seeming too intrusive. Your daughter may shy away from these confidences with you. Query her in a supportive fashion that is based on curiosity and that conveys your trust in her. At the very least, have a serious discussion with her about the dangers of the Internet and how she should not arrange any meetings with any individuals without your permission. Likewise, she should not give out any identifying information such as where she goes to school, where she lives, works, etc.

Be concerned if your daughter begins withdrawing from friends and family to spend time on the Internet with her new support group. Chat rooms should never take the place of being with people. Depressed individuals, especially, need to have a support group of friends with whom they can do things. If you believe that her time on this Web site is destructive for her then try reasoning with her while conveying respect and trust in her judgment. Try to determine if her needs that are being met on the Web site can also be met through friends, family, or her therapist. If she doesn't have a therapist it may be a good idea to find her one. Try to find a local support group that is run by a credentialed therapist. You really cannot restrict her from accessing this Web site because she can access it when you are not home, or from a friend's house or from school, etc. Forbidding her use may make her become secretive and you lose credibility as a parent for implementing a rule that you cannot enforce.

Communication and a good relationship with the prescribing physician are also very important. Perhaps he cannot diagnose it this early but he can take the time and provide her with information about her condition, about bipolar disorder, when he can diagnose it, similarities/dissimilarities he has noticed between her condition and bipolar disorder, and answer any questions she has. If her current physician is unavailable to answer these questions then you may wish to find someone who will. Remember that information is empowering and comforting in a case like this."

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