I am a single parent. My son was diagnosed with oppositional defiant disorder a month ago. He cannot go to school. A teacher comes to our house for two hours each day. He is on Paxil, but he seems to be getting worse. Because he is at home, I cannot work. I am not dealing with this at all. I have been diagnosed in the past with bipolar disorder. I am not on medication currently. I tried going to counseling so that I could get back on meds, but the counseling center won't let me bring my son to my appointment, and I can't leave him alone. I am going to try St. John's wort for the time being. What else can I do? My son is in therapy now, but I'm not. What can I do to help myself?

M.C.

Any single parent has her (or his) hands full, but a single parent with a psychological or emotional condition like bipolar disorder who also has a child with oppositional defiant disorder deserves a medal -- or at least combat pay.

You're wise to consider how you can help yourself as well as your child, because your son will benefit from your being as strong and healthy (both emotionally and physically) as you can be. But the obstacles you're encountering as you try to get help yourself must seem daunting. I can't make specific recommendations about your situation without talking with you personally and getting more information. But I'll mention some things that come to mind, which you can explore further if you wish.

You mention that your son's in therapy, and that he's on Paxil, which doesn't seem to be helping. (I'm not surprised about the Paxil, because to my knowledge there's no pharmacological treatment for ODD itself, although sometimes co-occurring conditions may be treated with medication. Some children with ODD are also diagnosed with depression, anxiety, or attention deficit disorder.) Let whomever's prescribing the Paxil know ASAP any changes you see in your son since his starting the drug.

Then I'd recommend talking with your son's therapist about things YOU can do at home to help contain or manage his behavior. Most therapy for children does involve the parents in some way. Family therapy, for instance, is often very helpful. While learning and using new strategies in dealing with your son will take some time and effort, if you stick with them they can really pay off for BOTH of you.

I don't recommend medication as the sole treatment for bipolar disorder or any other psychological, psychiatric or emotional condition, because medication won't help people learn new ways to reduce and manage the stresses that can exacerbate their problems. So I do hope you can find a way to get individual counseling as well. Can you find someone else to look after your son for the couple of hours it might take to get to and from a counseling session? What about a family member, a neighbor, another single parent with whom you can trade childcare efforts? Or could you schedule your therapy session during the time your son's teacher is working with him, or during his own therapy session? (Perhaps another person could agree to take your son to and from his therapy session so you can see your own therapist at the same time.)

In addition to these options, you may be able to find some online support at a website devoted to parents of children with behavioral problems, such as the one at ConductDisorders.com. Good luck.