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I feel it's important to mention that you seek out a second opinion with another therapist (without any information from the prior doctor or the file on your child that has been labeled NPD.) This label is too often used. I had a nephew that saw 4 separate therapists and this was the diagnosis: Manic depression Mild depression Schizophrenic personality Yes, and even gay!!! He was a loner with the exception of one male friend. Eventually it was found that my nephew was not Manic depressive, Schizophrenic or gay and indeed suffering from general depression. He was put on medication for several years and felt lethargic and had no "get up and go." His grades slipped in High School, he refused to get his Driver's License and he had no interest in friends or girlfriends. He hid in his room most of the time hiding behind his computer. He was smart, articulate, and a real great kid. The trick with these SSRI's for depression should be used short term and not always long term. Depending on the nature of the diagnosis general depression should be used with short term meds and taken off slowly. The patient may have to go on an SSRI again in their lives, but it should be well controlled. Too often doctors can keep a patient on an SSRI and just keep writing out the prescriptions. Some of these medications can cause anger, lack of appetite, weight gain, moodiness, lethargy, an out of control appetite, and cravings for sweets. Without the proper tools to deal with any disease with the medication then the medication is simply a bandaide to cover up the real problem. As far as your other teenager these are the differences: NORMAL TEENAGER Moody (going through major hormone problems) Peer pressure Sulky and arguementative Know-it-alls Thinking they are independent, but not (trying out their wings before they leave home. Sloppiness (their bedroom looks like an explosion.) Staying out too late and arguing with you about it. Sneaking out of the house. On the phone or computer too much Suddenly experiencing lower grades in school or a lack of interest in something they use to love such as sports, drama class, etc. Refusing to do chores around the home. Girls acting like a drama Queen Too conscious of their weight and think they are too fat Yelling, having hissy fits, and trying to control the environment around them It's up to the parents to set strict rules and have the teenagers abide by them or hit the road if they feel they can do better out on their own. Once they get a taste of reality it isn't long before they slide right back home. Remember when our parents would say, "I just hope you have a daughter/son just like you so it's payback time." LOL How true! Please seek out that 2nd opinion for your first child, and go from there. There are great programs out there to help parents cope with problem kids. Just because teenagers flex a little muscle doesn't mean they will turn out bad. Some teenagers never cause any problems, while others can be a "wild child" but it's only a personality difference and usually not pertaining to mental illness. Good luck Marcy

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Q: How do you distinguish between the immaturity of a normal teenager and the immaturity of a teenager diagnosed with NPD?
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