A Convoluted Treatment Odyssey of a Severely Drug-Addicted Bipolar Disorder Woman in Her Early 20s

Abstract

Psychiatric treatment of this woman was initiated when she was 20. Her behavior became increasingly erratic and perilous. Bipolar disorder was diagnosed along with her rapidly increasing drug dependence. Her resistance to conventional treatment with psychotropic medication made development of a secure therapeutic alliance imperative for treatment to be sustained and succeed. A strong association between her psychiatrist/therapist and parents also proved important for treatment success. After tenacious resistance by the patient and several failed attempts to involve her in a drug treatment program, the patient voluntarily committed herself for residential treatment. This case illustrates the importance of skillful physician case management in an interpersonally and medically complex case.