Posted by grapevine on February 26, 2010 at 12:52pm
Does anyone have a child that is bipolar and schizophrenic? I think my SD exhibits strong traits from both of these disorders. Would a pdoc be able to diagnose both at the same time?
According to my son (4th year college psychology major) Schizophrenia is very rare in children. Unless child has parent or grandparent who's dx schizophrenia its very unlikely as there is almost always a genetic component. Both mania and depression can exhibit psychotic symptoms in children including hallucinations.
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Nancy single mom unemployed because I can't find a nanny with a blackbelt and a psychology degree.
D 25yo son dx ADD currently working & college no meds A 15yo daughter bipolar or schizoaffective disorder, Asperger's, ODD daytreatment school/ public school meds Topomax, Seroquel, Levothyroxine R 13yo daughter mood disorder, LD's, central hypotonia public school with IEP meds Lamictal & Melatonin
My son is bipolar and the last time he was admitted into the hopsital it was because he was hearing "voices" so they told me that he is manci schizo. They changed his meds to help with the schizo so I don't know if that helps but since they have had him on this medicine he has done alot better and I know the voices were real!
we are also being told that our child could possibly have bipolar and schizoaffective disorder. Inpatient currently,Day program prior to that, private school normally meds Topomax, seroquel, celexa which they are removing and then adding strattera for the ADHD.
I just read a book on Schizophrenia in adolescence. I believe if they have bipolar too it is called Schizoaffective. My kids dad had both and his sister had both. I know he had an aunt who had it. A lot of people in his family are/were not undiagnosed. I know there were a lot of suicides including the aunt. Bipolar and Schizophrenia can go together and yes a Pdoc can diagnose both. My DS10's therapist thinks he has a chance of having both since his BP symtoms have been so severe at a young age. Through some research I found that there is different types of Schizophrenea. I thought I had read one that goes away after childhood. When I was a child I had dillusions, hullucinations, never talked, heard things, etc. I am now seemingly normal and 38- except tons of fatigue. I might hear a voice/see things maybe once a year or so. I am wondering if there is a mild type of schizoprenea. I plan to see a Pdoc soon- at least to try anti-depressants for fatigue.
If Your Adolescent Has Schizophrenia by Raquel Gur and Ann Johnson. There is also one called If Your Adolescent Has Depression or Bipolar Disorder. I am now reading- If Your Child Is Bipolar by Cindy Singer and Sheryl Gurrentz...I really like this one compared to other BP books I have read.
My younger daughter was briefly diagnosed bipolar, but because symptoms of schizophrenia were present with and without bipolar symptoms, she was diagnosed with schizoaffective. She'd had hallucinations since at least age 4. Her diagnoses evolved over time, and also included intermediate diagnoses of mood disorder - nos and psychotic disorder - nos.
Still, she is now, after many years doing well and at a university.
--"Naomi" Older dd: teen-onset bipolar: Off meds and over withdrawal symptoms. After over 13 years - STABLE! Treated: Sleep, Candida, food sensitivities, nutritional needs, extra thyroid med. Younger dd: Childhood-onset schizoaffective, with disabling migraines since infancy. Also off antipsychotic and meds for migraines. Stable - no hallucinations. Treated for multiple endocrine problems, food sensitivities, nutritional/mitochondrial needs, gut issues, SLEEP issues.
So did you go the route of no meds for her? We are trying very hard to teach her to be "in control", or at least how to be safe when she isn't. recently she has been really receptive to monitering her triggers, but there is still a lot of irrational beliefs, etc that effect her life. I know that if meds ever come up, it wil be a long hard battle to get her to take them.
Bipolar is a mood disorder (with cycles of mania and depression) where as schizophrenia is a thought disorder. The two very rarely exist together. Schizoaffective disorder is diagnosed when there are psychotic symptoms present with the absence of mood instability after a two week period. Childhood schizophrenia is extremely rare. Schizophrenia usually presents itself in the late teens/early twenties. With the average age being 18 for men and age 25 for women.
The criteria to dx childhood schizophrenia is the same as adult schizophrenia. Two or more of the following symptoms need to be present for at least a month. Delusions, hallucinations, disorganized speech, gross disorganized or cationic behavior, and/or negative symptoms. Symptoms are not attributed to a mood disorder, schizoaffective disorder, substance abuse, or other medical conditions.
My ds is adopted and he is the 3rd generation that we know of who suffers from bipolar. Schizophrenia also runs in his bio families history. A very wise pdoc told me that because of the generation gaps and progress in medicine it would be really hard to tell if past generations truly suffered from schizophrenia. My ds has a lot of treatment resistant psychosis and schizoaffective remains in the back of our pdocs mind, but so far all psychosis is still mood related.
FWIW, I have heard of many medical doctors that are not psychiatrists dx a child/teen with schizophrenia just because psychosis is present. This makes childhood schizophrenia misdiagnosis all to common. My own ds was given a dx of Schizophrenia by an emergency room doctor only because my ds was displaying psychotic symptoms at the time. His true diagnosis is bipolar with an additional dx of a psychotic disorder.
Treatment for both bipolar related psychosis and schizophrenia is the same.
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Jackie aka mom2one General & Med board moderator, FRT Mom to David, 17, BP, Psychotic Disorder, Anxiety Disorder, PDD, Cognitive Disorder Meds: Seroquel 900 mg., Risperdal 9.0 mg., Lamictal 600 mg., Lithium 1250 mg., DDAVP, and Synthroid .150 mcg Fish Oil and Vitamin D IEP, Therapeutic School Married to my best friend and rock for 21 years!
> Bipolar is a mood disorder (with cycles of mania and depression) where as schizophrenia is a thought disorder.
Jackie, someone once said that to me about my younger daughter, and the schizophrenia part of schizoaffective. I objected to the idea she had a thought disorder, since that is not a criteria for diagnosis of schizophrenia in the DSM-IV. Yet the person insisting this was a licenced clinical social worker (my daughter was diagnosed by a psychiatrist who'd known her for several years). But that IS apparently the thought about schizophrenia, although not actually in the diagnosis. But why should hearing voices or paranoia or catatonia be a "thought disorder" any more than the symptom of grandiosity in mania? I guess I am a bit sensitive about that terminology because I just don't see that, and feel proptective of my daughter.
And for the diagnosis of schizoaffective, the child must meet the criteria for schizophrenia, AND have a mood disorder. But I maintain my daughter (and my mother who was diagnosed with schizophrenia) didn't have a disorder of thought. They had psychosis, yes. Normally they had paranoia and hallucinations, but I really think their thought processes were pretty good. They had excellent reasoning and analytical skills, it is just that they were trying to interpret extraordinarily bizarre perceptions, along with feelings of paranoia, and well... of course they would come to the conclusions they came to. So would I.
The list of symptoms for schizophrenia is long, and the person can be "accurately" diagnosed with it while only having a minor subset of the many possible symptoms. Hearing voices is classic, which my younger daughter did even long before she had her first major depressive episode or symptoms of mania. I have read that what gets called "schizophrenia" may be 11 or more separate illnesses. I was stunned about two types I read about. One was a genetic condition they found in one family that affected just the men, who had just the positive symptoms and no negative ones. Another was found in a family that had mitochondrial dysfunction affecting just brain function. My own family's seems to strike just the females and be almost entirely positive symptoms. But we also have bipolar - again, just females. And now we are finding we also have Celiac running in the family... I can't help but wonder about the connection of it all.
Anyway, looking at it from my family's perspective, I cannot say one is "thought disorder" and one is "mood disorder" because I can also say that my older daughter's cognitive function and THOUGHT processes while sick with bipolar was VERY adversely affected. She made poor choices. Her reasoning and analytical ability went out the window, and it had been good before she got ill. They returned a decade later with stability.
Sigh. They have genetic overlap, and seem to be on the same spectrum.
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"Naomi" Older dd: teen-onset bipolar: Off meds and over withdrawal symptoms. After over 13 years - STABLE! Treated: Sleep, Candida, food sensitivities, nutritional needs, extra thyroid med. Younger dd: Childhood-onset schizoaffective, with disabling migraines since infancy. Also off antipsychotic and antiseizure meds (after >8 years). Stable - no hallucinations. Treated for multiple endocrine problems, food sensitivities, nutritional/mitochondrial needs, gut issues, SLEEP issues.
Reading your posts has given me a lot to think about. I am going to have to do some serious reading. I am going to press whatever dr we end up at to look hard into both as a diagnosis for my SD. She has the genetic aspects for both. SD definitely has mania, rages....the mood disorder, but she also has hallucinations, no friends, no reasoning and analytical skills, and paranoia/grandios ideas. Yesterday she was so out of sorts it was almost like dealing with three seperate people with different personalities. And what scares me most is she seems to have no conscience. there is no remorse for what she does. She "knows" it is wrong, but keeps doing it. She can tell you what you want to hear, but never shows she even wants to change or get help. She can spout out facts, but can't put them together. But at other times, she has plotted out master schemes that are intended to hurt or humiliate people(because she believes they are out to get her). I feel like all she does is make poor choices. I have really struggled with,is she just being defiant, or is this a disease, and which disease?
My ds didn't show any signs of remorse when he was younger either. Now he does and it has come with stability. When he is psychotic, his thought process is really off and he doesn’t show the same signs of remorse. My ds also has a lot of paranoia both at home and at school. He also has delusional thinking, often very grandiose. For him, it is still a part of the bipolar and medications have helped him tremendously.
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Jackie aka mom2one General & Med board moderator, FRT Mom to David, 17, BP, Psychotic Disorder, Anxiety Disorder, PDD, Cognitive Disorder Meds: Seroquel 900 mg., Risperdal 9.0 mg., Lamictal 600 mg., Lithium 1250 mg., DDAVP, and Synthroid .150 mcg Fish Oil and Vitamin D IEP, Therapeutic School Married to my best friend and rock for 21 years!
I did not consider either my younger daughter dx schizoaffective nor my mother, diagnosed with schizophrenia, to have actual irrational thinking. Paranoid, yes, but not really irrational. Psychotic? Yes... But, they seemed to have rational conclusions based on bizarre perceptions and feelings. Example: Hearing what sounds like movement in the ceiling, items that seem to go missing, water in the shower that turns yellow and smelling urine.... one concludes there is a man living above the ceiling that comes down at night, takes things, and during the day, urinates in the water line. Hearing someone insist there is a man living in her ceiling may sound "irrational", but it is the mind trying to make sense of the bizarre.
Anyway... my mother's thinking was disorganized at times, because she could not always articulate what she meant.
My older daughter, with just bipolar, also seemed irrational in that it was hard for her to think things through and see logical outcomes. Example, "This pill makes me feel good, so I'll just double the dose." Huh? Or take so much she has seizures, then insist the doctor said to take that much (He had said "NO NO NO!!!!") Or just turning the car into uncoming traffic without being able to see because she thought that some turns are supposed to be based on just blind faith (????)
Both daughters would get confused about where they were, the younger one because of hallucinations, and then ASK me for reality.
The older one with bipolar had poor thinking for years, but then, she wasn't stable for years. She now has her brains back.
The younger one lost a lot of ability, academically, and musically, after becoming acutely psychotic. In "recovery stage" as they call the years of stability but with residual hallucinations and reduced function, she did learn to adapt. She adjusted. Now that she is without hallucinations or the psychotropic meds, she has back some of her verbal IQ, but academics will never be easy for her again. Maybe too much of her childhood lost? I don't know. She'd had hallucinations to some degree for at least 15 years (since age 4), although she didn't get on the medication merry-go-round until she was 9. The biggest loss in cognition was sudden - just as she turned 12 along with major psychosis.
The older one says she still has effects academically from the years of being ill. She isn't the fast learner she used to be. Neither of them are. Oh - and they both used to be really good in math, but that was the hardest hit subject area.
So back to your original question - is the thought process off only when they are.... Yes, but they can be "off" for YEARS!
--"Naomi" Older dd: teen-onset bipolar: Off meds and over withdrawal symptoms. After over 13 years - STABLE! Treated: Sleep, Candida, food sensitivities, nutritional needs, extra thyroid. Younger dd: Childhood-onset schizoaffective, with disabling migraines since infancy. Also off antipsychotic and meds for migraines. Stable - no hallucinations. Treated for multiple endocrine problems, food sensitivities, nutritional/mitochondrial needs, gut issues, SLEEP issues.
The more brain and genetic research they do on mental illness, the more overlap they find between bipolar and schizophrenia. There are some people who are severely affected with BP and have a lot of psychosis. It's probably hard to determine in a young person whether it's A or B or even some other dx C. Perhaps at this point it is best to focus on treating the sx, trying to control the illness, whatever it is, so that your child can learn and grow to his max. potential. It seems like a lot of kids' dx's evolve over the years as they mature.
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Brenda,49, CABF Parent to Parent Volunteer Mom to Andrew, 15 1/2, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel Eric, 14, BP,AS, hypothyroidism: Seroquel, Eskalith CR, levothyroxin, inositol Brian, 12 1/2 & Helen, 9 Married 16 years to DH, 49 Tallahassee, FL
FROM CABF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.
The more brain and genetic research they do on mental illness, the more overlap they find between bipolar and schizophrenia.
This is information that is important to hear, but unsettling at the same time. I have wondered about Grant, because he has pyschosis, and I can't get a clear picture as to whether the medications help with it or not. He talks about voices, psychotic dreams and thoughts, at times, but nothing more severe than I've read about in all the books about pediatric bipolar. His psychiatrist has told him that voices are just his brain talking to him. His therapist has him reherse what to say back to the voices.
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Ashton (44), Anxiety/Mild Depression after - See Below! Meds PRN Bill (46), Anxiety/OCD/Narristic Personality Disorder, Meds
Grant (10), BP I, Lithium, Seroquel XR, Concerta/3 days a week.
Molly (9), PDD, ODD, OCD, Risperdal
Spencer (7), ADHD, Mood Disorder-NOS, Concerta
Jackson (5) Grant all over again! Budding BP I, likely! Clonodine, Lithium, Amantadine
> I have wondered about Grant, because he has pyschosis, and I can't get a clear picture as to whether the medications help with it or not. He talks about voices, psychotic dreams and thoughts, at times, but nothing more severe than I've read about in all the books about pediatric bipolar.
The major difference, from my point of view... She had voices even when she was stable. They were just a part of her life. And she started hearing other things - sirens, dorrbell ringing. She put bells hanging on her bedroom door so she could know if people came in. She often liked "Them" - the voices. Sometimes though, she didn't, and they eventually grew mean.
She also had "psychotic dreams" sometimes even continuing when she woke up. She got PTSD from them they were so real! She FELT the pain associated with things happening to her. I was sorry that it was so many years before she actually had a sleep study done, because that turned out not to be part of the schizoaffective "psychosis" but actual neurological sleep disorder, although in the end, we wondered what actually IS the schizoaffective vs everything else wrong with her. The psychiatrist's point of view was that everything together IS her "schizoaffective."
Anyway, the reason she was diagnosed with schizoaffective rather than schizophrenia was because her mood problems existed even when she was not psychotic.
And the reason she was diagnosed with schizoaffective and not bipolar or just major depressive disorder is that the hallucinations were there even without depression or elevated mood.
> His psychiatrist has told him that voices are just his brain talking to him. His therapist has him reherse what to say back to the voices.
Sounds like a good idea. My daughter thought of a solution to her multiple residual hallucinations that were a distraction to her, and of a concern, keeping her hypervigilant and interfering with her school work.
At home, she started using the little yappy dog as a reality check. At school, she just used the reactions of the other students as reality checks to know if what she was hearing was real or not.
When she was very very ill, though, it was very hard for her, and of course when she was actually psychotic she could not tell something was not real.
--"Naomi" Older dd: teen-onset bp: Off meds and over withdrawal symptoms. After over 13 years - STABLE! Treated: Sleep, Candida, food sensitivities, nutritional needs, extra thyroid meds. Younger dd: Childhood-onset schizoaffective, with disabling migraines since infancy. Also off antipsychotic and meds for migraines. Stable - no hallucinations. Treated for multiple endocrine problems, food sensitivities, nutritional/mitochondrial needs, gut issues, SLEEP issues.
My ds has said that he actually feels his brain in two parts. A good side and a bad side. The two sides are constantly fighting each other.
Stimulants like Concerta, can and more often than not, activate the bipolar condition resulting in mania and/or psychosis. Often mania is misdiagnosed as ADHD. Just make sure that it is actually helping and not making things worse for him.
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Jackie aka mom2one General & Med board moderator, FRT Mom to David, 17, BP, Psychotic Disorder, Anxiety Disorder, PDD, Cognitive Disorder Meds: Seroquel 900 mg., Risperdal 9.0 mg., Lamictal 600 mg., Lithium 1250 mg., DDAVP, and Synthroid .150 mcg Fish Oil and Vitamin D IEP, Therapeutic School Married to my best friend and rock for 21 years!
My SD hears things all the time. A lot of bellls and ringing, and voices, when she is "normal". Sometimes I watch her and I can see her facial expression s almost like she is having a conversation in her head.
A lot of stuff she does is intentional, though....almost criminal. Do any of your kids lie and manipulate and steal? I was wondering if she might have ODD or conduct disorder as well. At least one therapist we went to mentioned it, and they have all said we will be lucky if she isn't arrested as an early teen.
My son is now almost 8, but when he was almost 5 we realized something wasn't right. He is bipolar and possibly schitzophrenic also, but the meds they have him on help both. He also heard voices all the time. he would be totally fine one minutem and then freak out and start hitting, kicking or whatever else he could do to hurt you. His eyes were so different when that happened, it was like he wasn't the same child. When it passed, he would be fine again, but before we knew, he would of course get in trouble, but he honestly wouldn't know why. as he got a little older, he would know what he had done, but the only explanation he would give every time was that his "bad thinkers" or his "pretend friends" made him do it. we had no idea what he was actually telling us in those 2 phrases.
I understand totally about the expressions, and because of that, I have to believe that although it seems intentional like its a choice she makes, or an action she does, like lying or stealing, it doesn't mean she can control it. I strongly suggest trying her on an anti-psychotic to help her not hear them. you and her are in my prayers...
--Before my 14 year old son was diagnosed he was having rapid cycling and while in his manic phase he started to write his thoughts down and plan his course of action. I was able to read what he was thinking and found that he was certainly considering lying and stealing to get what he thought he needed and he also became singularly focused (somewhat like OCD). If an irrational idea took root in his mind it was impossible to change his mind, only another irrational idea could remove the thought but then he would cycle through all the irrational ideas depending on his mood. Once he was diagnosed and medicated we went through one last cycle (hopefully) and now all that disappeared. Of course finding the right combination of medications has taken some time and we continue to make adjustments.
The stealing maybe related to mania/impulse control.
What meds is she taking for her bipolar and psychosis?
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Jackie aka mom2one General & Med board moderator, FRT Mom to David, 17, BP, Psychotic Disorder, Anxiety Disorder, PDD, Cognitive Disorder Meds: Seroquel 900 mg., Risperdal 9.0 mg., Lamictal 600 mg., Lithium 1250 mg., DDAVP, and Synthroid .150 mcg Fish Oil and Vitamin D IEP, Therapeutic School Married to my best friend and rock for 21 years!
Nothing yet. It has been a long road to get DH on board with getting her help. We did try glyceine and teen link as suppliments, which helped a little. I am looking for a pdoc right now. DH will not take meds as an answer except if all other possibilities are out of the picture, and if it is from a specialist who deals with ped bipolar. Just yesterday he got upset that a neurologist mentioned she will need to be on meds.
That would make sense that stealing is impulse control. However, SD has also fabricated huge liles and scenarios to get lunches(for years) for free, etc. She has well planned out revenge plots. it is exhausting trying to keep up with all of the lies.
Her birthmother started criminal activity at about the same age, 11/12. She would steal from the worst of the crooks. Could it be a personality thing, or is it genetic, and part of a disease?
It's hard to tell. It sounds like you are in desperate need of having her properly evaluated. Delaying treatment can result in many costly and unwanted issues. Have you searched here for a psychiatrist who specializes in pediatric bipolar? If you don't find anything there you can search the AACAP site here. You could also start a new post stating what are you are looking in for a pdoc and see what responses you get. Another source would be asking in an online support group. You can join here. You might also want to take a look at this checklist of questions to ask when selecting a psychiatrist to treat your child. You dh is right in that all physical causes should be ruled out.
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Jackie aka mom2one General & Med board moderator, FRT Mom to David, 17, BP, Psychotic Disorder, Anxiety Disorder, PDD, Cognitive Disorder Meds: Seroquel 900 mg., Risperdal 9.0 mg., Lamictal 600 mg., Lithium 1250 mg., DDAVP, and Synthroid .150 mcg Fish Oil and Vitamin D IEP, Therapeutic School Married to my best friend and rock for 21 years!
Yesterday we found out all of the physical causes have been ruled out. The birthmother did do heavy drugs during the pregnancy, which woudl effect more of her functioning, I think. I might have to go to a developmental ped for that.
I did put a post up for drs in Fl. We are going to have to travel. I have it narrowed down to a few hospitals, and will be calling to make sure the pdocs are specialized. I have called around ten so far, and they always give me a real general answer, which I am not real comfortable with. I would rather know i am dealing with an expert who has a lot of experience with children like my SD.
I have a growing notebook of questions and research, and dr leads. I will have to gather all of my journals and notes too. One thing is certain, I am definitely her advocate.
One place I talked to said it was standard to have her in for a week for observation before they make a diagnosis. Should I go that route?
Knowing that her birth mother did hard drugs, it would probably be helpful to also have her evaluated for fetal alcohol exposure. Alcohol use almost always accompanies drug use. And prenatal alcohol exposure can result in permanent brain damage. The alcohol damages mid-line systems, and often negatively impacts impulse control, mood regulation, and executive function. (I've seen statistics indicating children with fetal alcohol spectrum disorder have a more than 90% possibility of being diagnosed with a mental health disorder.) Getting a diagnosis of FASD doesn't necessarily change medication approaches. But it does mean the medications may not be as effective or have paradoxical reactions. A diagnosis can also help you better assess what are "won't" issues and what are "can't" issues. And for the can't issues, it may be necessary to set up external controls or strategies.
I have been concerned about that. I did bring it up to the neurologist who tested for seizures. he did an eeg and a mri, but said everything looked normal. What kind of dr/tests would look for fetal alcohol? I need to research that some more. She doesn't have any of the facial features, but is very small for her age. Thanks for reminding me.
We went to a parent/teacher conference last night and really had it out with her teachers, decoding all of the lies. Surprisingly, she did everything that was expected of her today, came home and started her homework and did her chores. The teachers also said that just in the past few weeks she has been more focused on her work(not always doing it) and not so caught up i nthe social drama. Yes! Some things I am trying to teach her are sinking in. She also got permission to go work in the library when she is distracted. This is all really good new for not being on medication or having any special status at school.
yet last night she was screaming at me so much. she actually said, "I hate you! won't you adopt me already!" LOL
That's good to hear that she is showing some improvement. Even if she backslides some, at least you know your teaching is having an effect. I have found that with my ds15, he learns very slowly how to get on in the world. But slow progress is better than no progress.
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Brenda,49, CABF Parent to Parent Volunteer Mom to Andrew, 15 1/2, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel Eric, 14, BP,AS, hypothyroidism: Seroquel, Eskalith CR, levothyroxin, inositol Brian, 12 1/2 & Helen, 9 Married 16 years to DH, 49 Tallahassee, FL
FROM CABF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.
It is almost bittersweet having a good day, because it will more than likely not be there tomorrow. I am still thankful for it.
I just researched fetal alcohol some more. That could be her, too. They all sound so much alike. I did decided on going to the Mailman Center for Child Development in Miami. It looks like it covers all of the above and has a lot of specialists. I am praying we will get answers there.
Yes, we have a couple of pediatric pdocs here. We have seen the same one since the beginning. My pdoc also informally consults on Andrew from time to time.
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Brenda,49, CABF Parent to Parent Volunteer Mom to Andrew, 15 1/2, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel Eric, 14, BP,AS, hypothyroidism: Seroquel, Eskalith CR, levothyroxin, inositol Brian, 12 1/2 & Helen, 9 Married 16 years to DH, 49 Tallahassee, FL
FROM CABF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.
The Child Study site looks very similar to what I found in Florida. I wish I had found it four years ago. Reading all of the posts here makes me suspect either bipolar or schizoaffective for my SD, but she definitely has other behaviors that don't sound typical to bipolar kids. I am really looking forward to having her evaluated, and am in the middle of the entrance paperwork.
The Child Study site mentioned these traits to be high in foster kids and international adoptions. I have always wanted to have foster kids, but we can't right now, until SD is under control. Maybe she is my training for future foster kids(lol)!
I saw your question and had to respond. My daughter is adopted. Her bio grand father had bipolar and schizophrenia. I believe her bio mom has bp. Our daughter has psychosis when she is experiencing manic symptoms. At this time the diagnosis is bp with psychosis. However, I often wonder if schizophrenia is in her future. I hope and pray it isn't. Risperdal has been the most effective in treating the psychosis.
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Chandra mom to Micha 9yrs old BP with psychosis, adhd and RAD
Thanks for sharing Chandra. I am trying not to fear the worst with my stepdaughter. But, she is definitely following in her mother's footsteps, despite the change in environment and how we are raising her. From what I have researched of her past, she is doing the same things her birthmother did, at the same age. So we are being very protective of her, knowing it could get really bad soon, but hoping it won't.
It's interesting looking into birth families. I was adopted, too, and never met my birthmother. I did however behave a lot like her and make the same mistakes she made(at the same age). If I had the time I would stdy it more(lol)!
What sort of psychosis does your daughter have? Is it all the time?
My dd's psychosis is mainly voices. She says she has two sides to her head. One side is the devil and the other is God. We are Christians, but don't over emphasize the devil or evil. However, her psychosis centers around that. When she is very ill, she has visual hallucinations as well. She says she sees evil in people. She also sees angels in the clouds. The psychosis is only an issue when she is really unstable. Otherwise, it is mainly the mood stuff.
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Chandra mom to Micha 9yrs old BP with psychosis, adhd and RAD risperdal, trileptal, depakote, guanfacine and benztropine Braden 12 yrs old ADHD, anxiety adderall
My SD I am sure hears bad voices. She also hears bells, etc. She hears my voice a lot. The hearing stuff she has all the time. I know she has seen skeletons and bugs. She also used to watch a tv screen that would appear in front of her at school, instead of doing her work. I think that is what she is doing when she is staring off into space. We are Chrisitans, too. I have really pondered the role fo "evil" in all of this.
Grant has what his pdoc calls hyper religiousity when he's manic and psychotic. Talks with pressured speech about the bible, God, and evil. We are Christian but don't wear it on our sleeves. The pdoc said it is somewhat common for those with mental illness and psychosis to hyper focus on religion, or their health, medical issues. Anyone else heard of this? Our poor neighbor will never forget the hour long religious sermon he gave her the last time he was psychotic and manic. I found this link.
--I have heard that dark/light....heaven and hell..evil..good.. happens Alot with "our kids" I hold onto what we have taught about our faith is helping..and the unsettling talk is illness.
Michelle mom to Emily 13 bp, Scout 11, Nathan 9. married to doug 2 grown step kids
This is a good topic since I have heard so many conflicting things over the years. It is true that kids (and adults) can get misdiagnose as psychotic when they are in their manic phase. If it is mania, the psychotic symptoms should improve or go away completely once the mania subsides (which may take a while). Sx would include hallucinations, paranoia, ideas of reference and seeming completely out of touch with reality. If the diagnosis is childhood onset scizophrenia then tx with BP meds like lithium or lamictal wouldn't help much. It may not be "common" in general for a diagnosis of childhood onset schizophrenia, but I do think that a diagnosis of early onset bipolar has been linked with a much high risk of schizophrenia at a later date. And having any "mental illness" or neuropsychiatric disorder statistically ups the chance that there will be another diagnosis of this kind. I know of 2 children (unrelated) who were first diagnosed with schizophrenia due to psychotic symptoms, including delusions (hyperreligious as described above and other stuff). Once on lithium and seroquel the psychotic symptoms magically vanished in about 3 weeks.
Childhood schizophrenia in the general population may be rare, but not so rare for those already diagnosed with a neuropsych disorder. And family history is a very stong risk factor all by itself. One positive thing if your daughter has a diagnosis of schizophrenia is that some of the drugs used to treat it also can be useful for the BP. A very knowledgeable child psychiatrist should be able to sort this out. As a side note, brain scans can also help to diagnose schizophrenia. The brain image is quite different in schizophrenia. Find a really good doc if you don't already have one.
Reading back I wonder if having my dd observed as an inpatient for a week early on might have gotten us to a diagnosis sooner. She seemed to be able to Keep it Together for short periods and so the doc didn't have a chance to see things first hand for quite a while. She still does better at school so I know the teacher's think I am really exagerating when I try to spell it out for them. I'm so tired of "she's fine here", like "what's wrong with you"? At least we did finally get the diagnoses right and she's on the right track now. I'm remembering two years ago when she had a major episode how paranoid she was and she had some really strange ideas (morbid). When she got meds adjusted and improved, so did most of the weird stuff.
The Child Study site looks very similar to what I found in Florida. I wish I had found it four years ago. Reading all of the posts here makes me suspect either bipolar or schizoaffective for my SD, but she definitely has other behaviors that don't sound typical to bipolar kids. I am really looking forward to having her evaluated, and am in the middle of the entrance paperwork.
The Child Study site mentioned these traits to be high in foster kids and international adoptions. I have always wanted to have foster kids, but we can't right now, until SD is under control. Maybe she is my training for future foster kids
Some of you may already know Chrisa from bpkids support groups and chat. For those who don't, here's a bit about her:
"I'm Chrisa - a 40-something year old internet eCommerce professional, and proud to be mom to three teenagers and Tom's wife for 20 years and counting.
I've been a licensed foster parent in two states, and board member of a community teen health clinic, member of The Schofield's Village Project, and a CABF support group and chat moderator.
My son Tim has had an alphabet soup of diagnoses since the age of 4 - everything from an autism spectrum disorder to schizoaffective disorder. I came to CABF looking for...well, a lot. Support. Answers. A place to commiserate. I found that and so much more.
Our daughter is diagnosed with "bipolar 1 with psychotic features." Her psychiatrist said that if psychosis is present only when mood problems are active (In her case, mania) then it is bp, and if there are episode of psychosis when no mood episode is going on, it is schizophrenia. She prescribed Lamictal for mood, and then adds Abiilfy when psychosis occurs, which is withdrawn once the episode is over. Our daughter is now 18 and is off meds entirely. In my opinion, she does have both a "mood disorder" and a "thought disorder" and it really is hard to tell whether they coincide or are related or what. For her, psychosis means hearing voices that tell her what to do, getting messages from road signs, feeling special or God-like, etc. However, even when not psychotic, she has some irrational ideas that guide her decisions. At this point, I don't even care about labels...but it can be relevant to treatment choices.
It is scary to read that a psychotic episode affected academic skills. Our daughter got her GED last year, and seems less and less able to read books. I wonder...
One other thing about EEG's. Some people thing there is a lot of overlap between bipolar and temporal lobe epilepsy. If you google temporal lobe epilepsy, you will see that it covers a lot of behaviors and experiences, in our house, including feelings of unreality, disassociation, anxiety, sudden attacks of anger or sadness, difficulty recognizing people, trouble understanding words, babytalk, and periods of wandering with amnesia. It is important to know that EEG's do NOT pick up temporal lobe seizures (also called partial seizures), because the electrical activity is too deep in the brain. They actually sometimes put electrodes inside the brain to catch them, which is pretty far-fetched.
So, a negative EEG does not rule out TLE.
In my family, one child has TLE and one has bp w/psychosis. The one with TLE appears to have no psychiatric problems, but there have been times when she would appear, to someone who is not familiar with TLE, as "crazy."
My DD definitely has hallucinations all the time, and there is a history of schizophrenia in her family. But she does have very bipolar traits, too. But that could be the fetal alcohol manifesting. It is all so overlapping....She is still not on any meds, and is doing okay that way for now. I think once we get hre fetal alcohol eval finished we will know what role that plays in all of her issues, and the pdoc will move forward with his diagnosis then. But I am thinking the pdoc that we see is wary of labeling her with anyting as strong as bipolar or schizophrenic.
There seems to be so much that can go wrong in the brain, but they all cause similar symptoms.
My 8 yr old was diagnosed ADHD/ADD at about 3,since he was 2 he has been having hallucinations. BiPolar never even crossed my mind untill recently when it was pointed out he maybe and I delved deeper into it. I switched Pdocs and the new one almost immediatly asked for him to have a psych eval. He tried him on a low dos. Adderall,it turned my son into a zombie,so after a week we stopped that.after seeing a psychologist the pdoc put him on Methilin 5 mg at first,then when it didnt do anything 10mg. the second day on 10 he had trouble swallowing and breathing hard, he was taken to our local ER and the Methylin stopped. the psychologist hadnt had time to score the eval but told me just basd on what he saw on the test there is much more going on than ADHD, much more likely to be bipolar and scitzophrenic. He is hallucinating more and more,where when he was younger it was mainly at night,now he has episodes durring the day as well. we go back to the psychollogist at the end of this month,in the mean tiem his Pdoc put him on a med to calm him down(just got it yesterday forget the mane)it isnt an adhd med but more for severe anxiety and mental disorder is what the instructions said.
How do you find out a familly hisotry when u only really know one side of the familly and everything was hushed,and never spoken of? my sons father's familly is out of touch. we have no contact even with him,though mental retardation runs on both sides of our familly,as well as bi polar,adhd,and psosiopathic relatives.how does one find out about stuff that runs in families when there is no one to ask?
According to my son (4th year college psychology major) Schizophrenia is very rare in children. Unless child has parent or grandparent who's dx schizophrenia its very unlikely as there is almost always a genetic component. Both mania and depression can exhibit psychotic symptoms in children including hallucinations.
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Nancy single mom unemployed because I can't find a nanny with a blackbelt and a psychology degree.
D 25yo son dx ADD currently working & college no meds
A 15yo daughter bipolar or schizoaffective disorder, Asperger's, ODD daytreatment school/ public school meds Topomax, Seroquel, Levothyroxine
R 13yo daughter mood disorder, LD's, central hypotonia public school with IEP meds Lamictal & Melatonin
They are trying to label my son psyco effective....i have been told that if the Bipolar is not under control it can mimic schizo.
Belinda
Depression, Drug, Drinking
Invega, Lexapro
Tiffany 16 Stomach problems
My son is bipolar and the last time he was admitted into the hopsital it was because he was hearing "voices" so they told me that he is manci schizo. They changed his meds to help with the schizo so I don't know if that helps but since they have had him on this medicine he has done alot better and I know the voices were real!
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Angel
U
we are also being told that our child could possibly have bipolar and schizoaffective disorder. Inpatient currently,Day program prior to that, private school normally meds Topomax, seroquel, celexa which they are removing and then adding strattera for the ADHD.
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Faith and hope for my child! AJ
If diagnosed, she would be at least the 4th generation from her birthmother's side of the family.
I was just curious to see if anyone else had kids with both so I could compare.
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grapevine
I just read a book on Schizophrenia in adolescence. I believe if they have bipolar too it is called Schizoaffective. My kids dad had both and his sister had both. I know he had an aunt who had it. A lot of people in his family are/were not undiagnosed. I know there were a lot of suicides including the aunt. Bipolar and Schizophrenia can go together and yes a Pdoc can diagnose both. My DS10's therapist thinks he has a chance of having both since his BP symtoms have been so severe at a young age. Through some research I found that there is different types of Schizophrenea. I thought I had read one that goes away after childhood. When I was a child I had dillusions, hullucinations, never talked, heard things, etc. I am now seemingly normal and 38- except tons of fatigue. I might hear a voice/see things maybe once a year or so. I am wondering if there is a mild type of schizoprenea. I plan to see a Pdoc soon- at least to try anti-depressants for fatigue.
What's the name of the book?
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grapevine
If Your Adolescent Has Schizophrenia by Raquel Gur and Ann Johnson. There is also one called If Your Adolescent Has Depression or Bipolar Disorder. I am now reading- If Your Child Is Bipolar by Cindy Singer and Sheryl Gurrentz...I really like this one compared to other BP books I have read.
I read the Childhood Bipolar Q and A book. It is helpful, but definitely doesn't explain everything i see in my SD.
Thanks for getting back to me.
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grapevine
My younger daughter was briefly diagnosed bipolar, but because symptoms of schizophrenia were present with and without bipolar symptoms, she was diagnosed with schizoaffective. She'd had hallucinations since at least age 4. Her diagnoses evolved over time, and also included intermediate diagnoses of mood disorder - nos and psychotic disorder - nos.
Still, she is now, after many years doing well and at a university.
--"Naomi"
Older dd: teen-onset bipolar: Off meds and over withdrawal symptoms. After over 13 years - STABLE! Treated: Sleep, Candida, food sensitivities, nutritional needs, extra thyroid med.
Younger dd: Childhood-onset schizoaffective, with disabling migraines since infancy. Also off antipsychotic and meds for migraines. Stable - no hallucinations. Treated for multiple endocrine problems, food sensitivities, nutritional/mitochondrial needs, gut issues, SLEEP issues.
So did you go the route of no meds for her? We are trying very hard to teach her to be "in control", or at least how to be safe when she isn't. recently she has been really receptive to monitering her triggers, but there is still a lot of irrational beliefs, etc that effect her life. I know that if meds ever come up, it wil be a long hard battle to get her to take them.
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grapevine
Bipolar is a mood disorder (with cycles of mania and depression) where as schizophrenia is a thought disorder. The two very rarely exist together. Schizoaffective disorder is diagnosed when there are psychotic symptoms present with the absence of mood instability after a two week period. Childhood schizophrenia is extremely rare. Schizophrenia usually presents itself in the late teens/early twenties. With the average age being 18 for men and age 25 for women.
The criteria to dx childhood schizophrenia is the same as adult schizophrenia. Two or more of the following symptoms need to be present for at least a month. Delusions, hallucinations, disorganized speech, gross disorganized or cationic behavior, and/or negative symptoms. Symptoms are not attributed to a mood disorder, schizoaffective disorder, substance abuse, or other medical conditions.
My ds is adopted and he is the 3rd generation that we know of who suffers from bipolar. Schizophrenia also runs in his bio families history. A very wise pdoc told me that because of the generation gaps and progress in medicine it would be really hard to tell if past generations truly suffered from schizophrenia. My ds has a lot of treatment resistant psychosis and schizoaffective remains in the back of our pdocs mind, but so far all psychosis is still mood related.
FWIW, I have heard of many medical doctors that are not psychiatrists dx a child/teen with schizophrenia just because psychosis is present. This makes childhood schizophrenia misdiagnosis all to common. My own ds was given a dx of Schizophrenia by an emergency room doctor only because my ds was displaying psychotic symptoms at the time. His true diagnosis is bipolar with an additional dx of a psychotic disorder.
Treatment for both bipolar related psychosis and schizophrenia is the same.
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Jackie aka mom2one
General & Med board moderator, FRT
Mom to David, 17, BP, Psychotic Disorder, Anxiety Disorder, PDD, Cognitive Disorder
Meds: Seroquel 900 mg., Risperdal 9.0 mg., Lamictal 600 mg., Lithium 1250 mg., DDAVP, and Synthroid .150 mcg
Fish Oil and Vitamin D
IEP, Therapeutic School
Married to my best friend and rock for 21 years!
.
> Bipolar is a mood disorder (with cycles of mania and depression) where as schizophrenia is a thought disorder.
Jackie, someone once said that to me about my younger daughter, and the schizophrenia part of schizoaffective. I objected to the idea she had a thought disorder, since that is not a criteria for diagnosis of schizophrenia in the DSM-IV. Yet the person insisting this was a licenced clinical social worker (my daughter was diagnosed by a psychiatrist who'd known her for several years). But that IS apparently the thought about schizophrenia, although not actually in the diagnosis. But why should hearing voices or paranoia or catatonia be a "thought disorder" any more than the symptom of grandiosity in mania? I guess I am a bit sensitive about that terminology because I just don't see that, and feel proptective of my daughter.
And for the diagnosis of schizoaffective, the child must meet the criteria for schizophrenia, AND have a mood disorder. But I maintain my daughter (and my mother who was diagnosed with schizophrenia) didn't have a disorder of thought. They had psychosis, yes. Normally they had paranoia and hallucinations, but I really think their thought processes were pretty good. They had excellent reasoning and analytical skills, it is just that they were trying to interpret extraordinarily bizarre perceptions, along with feelings of paranoia, and well... of course they would come to the conclusions they came to. So would I.
The list of symptoms for schizophrenia is long, and the person can be "accurately" diagnosed with it while only having a minor subset of the many possible symptoms. Hearing voices is classic, which my younger daughter did even long before she had her first major depressive episode or symptoms of mania. I have read that what gets called "schizophrenia" may be 11 or more separate illnesses. I was stunned about two types I read about. One was a genetic condition they found in one family that affected just the men, who had just the positive symptoms and no negative ones. Another was found in a family that had mitochondrial dysfunction affecting just brain function. My own family's seems to strike just the females and be almost entirely positive symptoms. But we also have bipolar - again, just females. And now we are finding we also have Celiac running in the family... I can't help but wonder about the connection of it all.
Anyway, looking at it from my family's perspective, I cannot say one is "thought disorder" and one is "mood disorder" because I can also say that my older daughter's cognitive function and THOUGHT processes while sick with bipolar was VERY adversely affected. She made poor choices. Her reasoning and analytical ability went out the window, and it had been good before she got ill. They returned a decade later with stability.
Sigh. They have genetic overlap, and seem to be on the same spectrum.
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"Naomi"
Older dd: teen-onset bipolar: Off meds and over withdrawal symptoms. After over 13 years - STABLE! Treated: Sleep, Candida, food sensitivities, nutritional needs, extra thyroid med.
Younger dd: Childhood-onset schizoaffective, with disabling migraines since infancy. Also off antipsychotic and antiseizure meds (after >8 years). Stable - no hallucinations. Treated for multiple endocrine problems, food sensitivities, nutritional/mitochondrial needs, gut issues, SLEEP issues.
Thank you Jackie and Naomi.
Reading your posts has given me a lot to think about. I am going to have to do some serious reading. I am going to press whatever dr we end up at to look hard into both as a diagnosis for my SD. She has the genetic aspects for both. SD definitely has mania, rages....the mood disorder, but she also has hallucinations, no friends, no reasoning and analytical skills, and paranoia/grandios ideas. Yesterday she was so out of sorts it was almost like dealing with three seperate people with different personalities. And what scares me most is she seems to have no conscience. there is no remorse for what she does. She "knows" it is wrong, but keeps doing it. She can tell you what you want to hear, but never shows she even wants to change or get help. She can spout out facts, but can't put them together. But at other times, she has plotted out master schemes that are intended to hurt or humiliate people(because she believes they are out to get her). I feel like all she does is make poor choices. I have really struggled with,is she just being defiant, or is this a disease, and which disease?
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grapevine
Grapevine, the description in your last reply still sounds like bipolar. My older dd got her "brains" back with stability.
--"Naomi"
Grapevine,
My ds didn't show any signs of remorse when he was younger either. Now he does and it has come with stability. When he is psychotic, his thought process is really off and he doesn’t show the same signs of remorse. My ds also has a lot of paranoia both at home and at school. He also has delusional thinking, often very grandiose. For him, it is still a part of the bipolar and medications have helped him tremendously.
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Jackie aka mom2one
General & Med board moderator, FRT
Mom to David, 17, BP, Psychotic Disorder, Anxiety Disorder, PDD, Cognitive Disorder
Meds: Seroquel 900 mg., Risperdal 9.0 mg., Lamictal 600 mg., Lithium 1250 mg., DDAVP, and Synthroid .150 mcg
Fish Oil and Vitamin D
IEP, Therapeutic School
Married to my best friend and rock for 21 years!
Is the thought process off only when they are, or do they always have disorganized and irrational thinking?
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grapevine
I did not consider either my younger daughter dx schizoaffective nor my mother, diagnosed with schizophrenia, to have actual irrational thinking. Paranoid, yes, but not really irrational. Psychotic? Yes... But, they seemed to have rational conclusions based on bizarre perceptions and feelings. Example: Hearing what sounds like movement in the ceiling, items that seem to go missing, water in the shower that turns yellow and smelling urine.... one concludes there is a man living above the ceiling that comes down at night, takes things, and during the day, urinates in the water line. Hearing someone insist there is a man living in her ceiling may sound "irrational", but it is the mind trying to make sense of the bizarre.
Anyway... my mother's thinking was disorganized at times, because she could not always articulate what she meant.
My older daughter, with just bipolar, also seemed irrational in that it was hard for her to think things through and see logical outcomes. Example, "This pill makes me feel good, so I'll just double the dose." Huh? Or take so much she has seizures, then insist the doctor said to take that much (He had said "NO NO NO!!!!") Or just turning the car into uncoming traffic without being able to see because she thought that some turns are supposed to be based on just blind faith (????)
Both daughters would get confused about where they were, the younger one because of hallucinations, and then ASK me for reality.
The older one with bipolar had poor thinking for years, but then, she wasn't stable for years. She now has her brains back.
The younger one lost a lot of ability, academically, and musically, after becoming acutely psychotic. In "recovery stage" as they call the years of stability but with residual hallucinations and reduced function, she did learn to adapt. She adjusted. Now that she is without hallucinations or the psychotropic meds, she has back some of her verbal IQ, but academics will never be easy for her again. Maybe too much of her childhood lost? I don't know. She'd had hallucinations to some degree for at least 15 years (since age 4), although she didn't get on the medication merry-go-round until she was 9. The biggest loss in cognition was sudden - just as she turned 12 along with major psychosis.
The older one says she still has effects academically from the years of being ill. She isn't the fast learner she used to be. Neither of them are. Oh - and they both used to be really good in math, but that was the hardest hit subject area.
So back to your original question - is the thought process off only when they are.... Yes, but they can be "off" for YEARS!
--"Naomi"
Older dd: teen-onset bipolar: Off meds and over withdrawal symptoms. After over 13 years - STABLE! Treated: Sleep, Candida, food sensitivities, nutritional needs, extra thyroid.
Younger dd: Childhood-onset schizoaffective, with disabling migraines since infancy. Also off antipsychotic and meds for migraines. Stable - no hallucinations. Treated for multiple endocrine problems, food sensitivities, nutritional/mitochondrial needs, gut issues, SLEEP issues.
The more brain and genetic research they do on mental illness, the more overlap they find between bipolar and schizophrenia. There are some people who are severely affected with BP and have a lot of psychosis. It's probably hard to determine in a young person whether it's A or B or even some other dx C. Perhaps at this point it is best to focus on treating the sx, trying to control the illness, whatever it is, so that your child can learn and grow to his max. potential. It seems like a lot of kids' dx's evolve over the years as they mature.
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Brenda,49, CABF Parent to Parent Volunteer
Mom to Andrew, 15 1/2, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel
Eric, 14, BP,AS, hypothyroidism: Seroquel, Eskalith CR, levothyroxin, inositol
Brian, 12 1/2 & Helen, 9
Married 16 years to DH, 49
Tallahassee, FL
FROM CABF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.
The more brain and genetic research they do on mental illness, the more overlap they find between bipolar and schizophrenia.
This is information that is important to hear, but unsettling at the same time. I have wondered about Grant, because he has pyschosis, and I can't get a clear picture as to whether the medications help with it or not. He talks about voices, psychotic dreams and thoughts, at times, but nothing more severe than I've read about in all the books about pediatric bipolar. His psychiatrist has told him that voices are just his brain talking to him. His therapist has him reherse what to say back to the voices.
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Ashton (44), Anxiety/Mild Depression after - See Below!
Meds PRN
Bill (46), Anxiety/OCD/Narristic Personality Disorder, Meds
Grant (10), BP I, Lithium, Seroquel XR, Concerta/3 days a week.
Molly (9), PDD, ODD, OCD, Risperdal
Spencer (7), ADHD, Mood Disorder-NOS, Concerta
Jackson (5) Grant all over again! Budding BP I, likely!
Clonodine, Lithium, Amantadine
> I have wondered about Grant, because he has pyschosis, and I can't get a clear picture as to whether the medications help with it or not. He talks about voices, psychotic dreams and thoughts, at times, but nothing more severe than I've read about in all the books about pediatric bipolar.
The major difference, from my point of view... She had voices even when she was stable. They were just a part of her life. And she started hearing other things - sirens, dorrbell ringing. She put bells hanging on her bedroom door so she could know if people came in. She often liked "Them" - the voices. Sometimes though, she didn't, and they eventually grew mean.
She also had "psychotic dreams" sometimes even continuing when she woke up. She got PTSD from them they were so real! She FELT the pain associated with things happening to her. I was sorry that it was so many years before she actually had a sleep study done, because that turned out not to be part of the schizoaffective "psychosis" but actual neurological sleep disorder, although in the end, we wondered what actually IS the schizoaffective vs everything else wrong with her. The psychiatrist's point of view was that everything together IS her "schizoaffective."
Anyway, the reason she was diagnosed with schizoaffective rather than schizophrenia was because her mood problems existed even when she was not psychotic.
And the reason she was diagnosed with schizoaffective and not bipolar or just major depressive disorder is that the hallucinations were there even without depression or elevated mood.
> His psychiatrist has told him that voices are just his brain talking to him. His therapist has him reherse what to say back to the voices.
Sounds like a good idea. My daughter thought of a solution to her multiple residual hallucinations that were a distraction to her, and of a concern, keeping her hypervigilant and interfering with her school work.
At home, she started using the little yappy dog as a reality check. At school, she just used the reactions of the other students as reality checks to know if what she was hearing was real or not.
When she was very very ill, though, it was very hard for her, and of course when she was actually psychotic she could not tell something was not real.
--"Naomi"
Older dd: teen-onset bp: Off meds and over withdrawal symptoms. After over 13 years - STABLE! Treated: Sleep, Candida, food sensitivities, nutritional needs, extra thyroid meds.
Younger dd: Childhood-onset schizoaffective, with disabling migraines since infancy. Also off antipsychotic and meds for migraines. Stable - no hallucinations. Treated for multiple endocrine problems, food sensitivities, nutritional/mitochondrial needs, gut issues, SLEEP issues.
My ds has said that he actually feels his brain in two parts. A good side and a bad side. The two sides are constantly fighting each other.
Stimulants like Concerta, can and more often than not, activate the bipolar condition resulting in mania and/or psychosis. Often mania is misdiagnosed as ADHD. Just make sure that it is actually helping and not making things worse for him.
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Jackie aka mom2one
General & Med board moderator, FRT
Mom to David, 17, BP, Psychotic Disorder, Anxiety Disorder, PDD, Cognitive Disorder
Meds: Seroquel 900 mg., Risperdal 9.0 mg., Lamictal 600 mg., Lithium 1250 mg., DDAVP, and Synthroid .150 mcg
Fish Oil and Vitamin D
IEP, Therapeutic School
Married to my best friend and rock for 21 years!
My SD hears things all the time. A lot of bellls and ringing, and voices, when she is "normal". Sometimes I watch her and I can see her facial expression s almost like she is having a conversation in her head.
A lot of stuff she does is intentional, though....almost criminal. Do any of your kids lie and manipulate and steal? I was wondering if she might have ODD or conduct disorder as well. At least one therapist we went to mentioned it, and they have all said we will be lucky if she isn't arrested as an early teen.
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grapevine
My son is now almost 8, but when he was almost 5 we realized something wasn't right. He is bipolar and possibly schitzophrenic also, but the meds they have him on help both. He also heard voices all the time. he would be totally fine one minutem and then freak out and start hitting, kicking or whatever else he could do to hurt you. His eyes were so different when that happened, it was like he wasn't the same child. When it passed, he would be fine again, but before we knew, he would of course get in trouble, but he honestly wouldn't know why. as he got a little older, he would know what he had done, but the only explanation he would give every time was that his "bad thinkers" or his "pretend friends" made him do it. we had no idea what he was actually telling us in those 2 phrases.
I understand totally about the expressions, and because of that, I have to believe that although it seems intentional like its a choice she makes, or an action she does, like lying or stealing, it doesn't mean she can control it. I strongly suggest trying her on an anti-psychotic to help her not hear them. you and her are in my prayers...
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Jayden's mommy
--Before my 14 year old son was diagnosed he was having rapid cycling and while in his manic phase he started to write his thoughts down and plan his course of action. I was able to read what he was thinking and found that he was certainly considering lying and stealing to get what he thought he needed and he also became singularly focused (somewhat like OCD). If an irrational idea took root in his mind it was impossible to change his mind, only another irrational idea could remove the thought but then he would cycle through all the irrational ideas depending on his mood. Once he was diagnosed and medicated we went through one last cycle (hopefully) and now all that disappeared. Of course finding the right combination of medications has taken some time and we continue to make adjustments.
Me3
The stealing maybe related to mania/impulse control.
What meds is she taking for her bipolar and psychosis?
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Jackie aka mom2one
General & Med board moderator, FRT
Mom to David, 17, BP, Psychotic Disorder, Anxiety Disorder, PDD, Cognitive Disorder
Meds: Seroquel 900 mg., Risperdal 9.0 mg., Lamictal 600 mg., Lithium 1250 mg., DDAVP, and Synthroid .150 mcg
Fish Oil and Vitamin D
IEP, Therapeutic School
Married to my best friend and rock for 21 years!
Nothing yet. It has been a long road to get DH on board with getting her help. We did try glyceine and teen link as suppliments, which helped a little. I am looking for a pdoc right now. DH will not take meds as an answer except if all other possibilities are out of the picture, and if it is from a specialist who deals with ped bipolar. Just yesterday he got upset that a neurologist mentioned she will need to be on meds.
That would make sense that stealing is impulse control. However, SD has also fabricated huge liles and scenarios to get lunches(for years) for free, etc. She has well planned out revenge plots. it is exhausting trying to keep up with all of the lies.
Her birthmother started criminal activity at about the same age, 11/12. She would steal from the worst of the crooks. Could it be a personality thing, or is it genetic, and part of a disease?
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grapevine
It's hard to tell. It sounds like you are in desperate need of having her properly evaluated. Delaying treatment can result in many costly and unwanted issues. Have you searched here for a psychiatrist who specializes in pediatric bipolar? If you don't find anything there you can search the AACAP site here. You could also start a new post stating what are you are looking in for a pdoc and see what responses you get. Another source would be asking in an online support group. You can join here. You might also want to take a look at this checklist of questions to ask when selecting a psychiatrist to treat your child. You dh is right in that all physical causes should be ruled out.
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Jackie aka mom2one
General & Med board moderator, FRT
Mom to David, 17, BP, Psychotic Disorder, Anxiety Disorder, PDD, Cognitive Disorder
Meds: Seroquel 900 mg., Risperdal 9.0 mg., Lamictal 600 mg., Lithium 1250 mg., DDAVP, and Synthroid .150 mcg
Fish Oil and Vitamin D
IEP, Therapeutic School
Married to my best friend and rock for 21 years!
I appreciate all of the support.
Yesterday we found out all of the physical causes have been ruled out. The birthmother did do heavy drugs during the pregnancy, which woudl effect more of her functioning, I think. I might have to go to a developmental ped for that.
I did put a post up for drs in Fl. We are going to have to travel. I have it narrowed down to a few hospitals, and will be calling to make sure the pdocs are specialized. I have called around ten so far, and they always give me a real general answer, which I am not real comfortable with. I would rather know i am dealing with an expert who has a lot of experience with children like my SD.
I have a growing notebook of questions and research, and dr leads. I will have to gather all of my journals and notes too. One thing is certain, I am definitely her advocate.
One place I talked to said it was standard to have her in for a week for observation before they make a diagnosis. Should I go that route?
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grapevine
Knowing that her birth mother did hard drugs, it would probably be helpful to also have her evaluated for fetal alcohol exposure. Alcohol use almost always accompanies drug use. And prenatal alcohol exposure can result in permanent brain damage. The alcohol damages mid-line systems, and often negatively impacts impulse control, mood regulation, and executive function. (I've seen statistics indicating children with fetal alcohol spectrum disorder have a more than 90% possibility of being diagnosed with a mental health disorder.) Getting a diagnosis of FASD doesn't necessarily change medication approaches. But it does mean the medications may not be as effective or have paradoxical reactions. A diagnosis can also help you better assess what are "won't" issues and what are "can't" issues. And for the can't issues, it may be necessary to set up external controls or strategies.
I have been concerned about that. I did bring it up to the neurologist who tested for seizures. he did an eeg and a mri, but said everything looked normal. What kind of dr/tests would look for fetal alcohol? I need to research that some more. She doesn't have any of the facial features, but is very small for her age. Thanks for reminding me.
We went to a parent/teacher conference last night and really had it out with her teachers, decoding all of the lies. Surprisingly, she did everything that was expected of her today, came home and started her homework and did her chores. The teachers also said that just in the past few weeks she has been more focused on her work(not always doing it) and not so caught up i nthe social drama. Yes! Some things I am trying to teach her are sinking in. She also got permission to go work in the library when she is distracted. This is all really good new for not being on medication or having any special status at school.
yet last night she was screaming at me so much. she actually said, "I hate you! won't you adopt me already!" LOL
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grapevine
That's good to hear that she is showing some improvement. Even if she backslides some, at least you know your teaching is having an effect. I have found that with my ds15, he learns very slowly how to get on in the world. But slow progress is better than no progress.
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Brenda,49, CABF Parent to Parent Volunteer
Mom to Andrew, 15 1/2, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel
Eric, 14, BP,AS, hypothyroidism: Seroquel, Eskalith CR, levothyroxin, inositol
Brian, 12 1/2 & Helen, 9
Married 16 years to DH, 49
Tallahassee, FL
FROM CABF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.
It is almost bittersweet having a good day, because it will more than likely not be there tomorrow. I am still thankful for it.
I just researched fetal alcohol some more. That could be her, too. They all sound so much alike. I did decided on going to the Mailman Center for Child Development in Miami. It looks like it covers all of the above and has a lot of specialists. I am praying we will get answers there.
Brenda, do you go to local drs in Tally?
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grapevine
grapevine,
Yes, we have a couple of pediatric pdocs here. We have seen the same one since the beginning. My pdoc also informally consults on Andrew from time to time.
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Brenda,49, CABF Parent to Parent Volunteer
Mom to Andrew, 15 1/2, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel
Eric, 14, BP,AS, hypothyroidism: Seroquel, Eskalith CR, levothyroxin, inositol
Brian, 12 1/2 & Helen, 9
Married 16 years to DH, 49
Tallahassee, FL
FROM CABF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.
I'm glad that you've found a location that can provide a full assessment.
We received our fetal alcohol spectrum evaluation and diagnosis from the Children's Research Triangle in Chicago (www.childstudy.org).
The Child Study site looks very similar to what I found in Florida. I wish I had found it four years ago. Reading all of the posts here makes me suspect either bipolar or schizoaffective for my SD, but she definitely has other behaviors that don't sound typical to bipolar kids. I am really looking forward to having her evaluated, and am in the middle of the entrance paperwork.
The Child Study site mentioned these traits to be high in foster kids and international adoptions. I have always wanted to have foster kids, but we can't right now, until SD is under control. Maybe she is my training for future foster kids(lol)!
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grapevine
I saw your question and had to respond. My daughter is adopted. Her bio grand father had bipolar and schizophrenia. I believe her bio mom has bp. Our daughter has psychosis when she is experiencing manic symptoms. At this time the diagnosis is bp with psychosis. However, I often wonder if schizophrenia is in her future. I hope and pray it isn't. Risperdal has been the most effective in treating the psychosis.
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Chandra mom to
Micha 9yrs old BP with psychosis, adhd and RAD
Thanks for sharing Chandra. I am trying not to fear the worst with my stepdaughter. But, she is definitely following in her mother's footsteps, despite the change in environment and how we are raising her. From what I have researched of her past, she is doing the same things her birthmother did, at the same age. So we are being very protective of her, knowing it could get really bad soon, but hoping it won't.
It's interesting looking into birth families. I was adopted, too, and never met my birthmother. I did however behave a lot like her and make the same mistakes she made(at the same age). If I had the time I would stdy it more(lol)!
What sort of psychosis does your daughter have? Is it all the time?
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grapevine
My dd's psychosis is mainly voices. She says she has two sides to her head. One side is the devil and the other is God. We are Christians, but don't over emphasize the devil or evil. However, her psychosis centers around that. When she is very ill, she has visual hallucinations as well. She says she sees evil in people. She also sees angels in the clouds. The psychosis is only an issue when she is really unstable. Otherwise, it is mainly the mood stuff.
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Chandra mom to
Micha 9yrs old BP with psychosis, adhd and RAD
risperdal, trileptal, depakote, guanfacine and benztropine
Braden 12 yrs old ADHD, anxiety
adderall
My SD I am sure hears bad voices. She also hears bells, etc. She hears my voice a lot. The hearing stuff she has all the time. I know she has seen skeletons and bugs. She also used to watch a tv screen that would appear in front of her at school, instead of doing her work. I think that is what she is doing when she is staring off into space. We are Chrisitans, too. I have really pondered the role fo "evil" in all of this.
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grapevine
Grant has what his pdoc calls hyper religiousity when he's manic and psychotic. Talks with pressured speech about the bible, God, and evil. We are Christian but don't wear it on our sleeves. The pdoc said it is somewhat common for those with mental illness and psychosis to hyper focus on religion, or their health, medical issues. Anyone else heard of this? Our poor neighbor will never forget the hour long religious sermon he gave her the last time he was psychotic and manic. I found this link.
http://www.thehindu.com/mag/2010/01/03/stories/2010010350290600.htm
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Ashton (44), Anxiety/Mild Depression after - See Below!
Meds PRN
Bill (46), Anxiety/OCD/Narristic Personality Disorder, Meds
Grant (10), BP I, Lithium, Seroquel XR, Concerta/3 days a week.
Molly (9), PDD, ODD, OCD, Risperdal
Spencer (7), ADHD, Mood Disorder-NOS, Concerta
Jackson (5) Grant all over again! Budding BP I, likely!
Clonodine, Lithium, Amantadine
--I have heard that dark/light....heaven and hell..evil..good.. happens Alot with "our kids" I hold onto what we have taught about our faith is helping..and the unsettling talk is illness.
Michelle
mom to Emily 13 bp, Scout 11, Nathan 9.
married to doug
2 grown step kids
This is a good topic since I have heard so many conflicting things over the years. It is true that kids (and adults) can get misdiagnose as psychotic when they are in their manic phase. If it is mania, the psychotic symptoms should improve or go away completely once the mania subsides (which may take a while). Sx would include hallucinations, paranoia, ideas of reference and seeming completely out of touch with reality. If the diagnosis is childhood onset scizophrenia then tx with BP meds like lithium or lamictal wouldn't help much. It may not be "common" in general for a diagnosis of childhood onset schizophrenia, but I do think that a diagnosis of early onset bipolar has been linked with a much high risk of schizophrenia at a later date. And having any "mental illness" or neuropsychiatric disorder statistically ups the chance that there will be another diagnosis of this kind. I know of 2 children (unrelated) who were first diagnosed with schizophrenia due to psychotic symptoms, including delusions (hyperreligious as described above and other stuff). Once on lithium and seroquel the psychotic symptoms magically vanished in about 3 weeks.
Childhood schizophrenia in the general population may be rare, but not so rare for those already diagnosed with a neuropsych disorder. And family history is a very stong risk factor all by itself. One positive thing if your daughter has a diagnosis of schizophrenia is that some of the drugs used to treat it also can be useful for the BP. A very knowledgeable child psychiatrist should be able to sort this out. As a side note, brain scans can also help to diagnose schizophrenia. The brain image is quite different in schizophrenia. Find a really good doc if you don't already have one.
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Lisa W
Reading back I wonder if having my dd observed as an inpatient for a week early on might have gotten us to a diagnosis sooner. She seemed to be able to Keep it Together for short periods and so the doc didn't have a chance to see things first hand for quite a while. She still does better at school so I know the teacher's think I am really exagerating when I try to spell it out for them. I'm so tired of "she's fine here", like "what's wrong with you"? At least we did finally get the diagnoses right and she's on the right track now. I'm remembering two years ago when she had a major episode how paranoid she was and she had some really strange ideas (morbid). When she got meds adjusted and improved, so did most of the weird stuff.
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Lisa W
The Child Study site looks very similar to what I found in Florida. I wish I had found it four years ago. Reading all of the posts here makes me suspect either bipolar or schizoaffective for my SD, but she definitely has other behaviors that don't sound typical to bipolar kids. I am really looking forward to having her evaluated, and am in the middle of the entrance paperwork.
The Child Study site mentioned these traits to be high in foster kids and international adoptions. I have always wanted to have foster kids, but we can't right now, until SD is under control. Maybe she is my training for future foster kids
Panos K
Chrisa Hickey's blog for CABF is a good resource for information about schizoaffective disorder.
Some of you may already know Chrisa from bpkids support groups and chat. For those who don't, here's a bit about her:
"I'm Chrisa - a 40-something year old internet eCommerce professional, and proud to be mom to three teenagers and Tom's wife for 20 years and counting.
I've been a licensed foster parent in two states, and board member of a community teen health clinic, member of The Schofield's Village Project, and a CABF support group and chat moderator.
My son Tim has had an alphabet soup of diagnoses since the age of 4 - everything from an autism spectrum disorder to schizoaffective disorder. I came to CABF looking for...well, a lot. Support. Answers. A place to commiserate. I found that and so much more.
I write regularly about my family and our experiences on my blog, The Mindstorm: Raising a Mentally Ill Child, at http://chrisahickey.blogspot.com.
I also blog for CABF here: http://www.bpkids.org/connect/blog."
Thanks. I will definitely look into the links!
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grapevine, 34
DH, 44
stepdaughter, 12 undiagnosed, unmedicated
DS, 4
Our daughter is diagnosed with "bipolar 1 with psychotic features." Her psychiatrist said that if psychosis is present only when mood problems are active (In her case, mania) then it is bp, and if there are episode of psychosis when no mood episode is going on, it is schizophrenia. She prescribed Lamictal for mood, and then adds Abiilfy when psychosis occurs, which is withdrawn once the episode is over. Our daughter is now 18 and is off meds entirely. In my opinion, she does have both a "mood disorder" and a "thought disorder" and it really is hard to tell whether they coincide or are related or what. For her, psychosis means hearing voices that tell her what to do, getting messages from road signs, feeling special or God-like, etc. However, even when not psychotic, she has some irrational ideas that guide her decisions. At this point, I don't even care about labels...but it can be relevant to treatment choices.
It is scary to read that a psychotic episode affected academic skills. Our daughter got her GED last year, and seems less and less able to read books. I wonder...
One other thing about EEG's. Some people thing there is a lot of overlap between bipolar and temporal lobe epilepsy. If you google temporal lobe epilepsy, you will see that it covers a lot of behaviors and experiences, in our house, including feelings of unreality, disassociation, anxiety, sudden attacks of anger or sadness, difficulty recognizing people, trouble understanding words, babytalk, and periods of wandering with amnesia. It is important to know that EEG's do NOT pick up temporal lobe seizures (also called partial seizures), because the electrical activity is too deep in the brain. They actually sometimes put electrodes inside the brain to catch them, which is pretty far-fetched.
So, a negative EEG does not rule out TLE.
In my family, one child has TLE and one has bp w/psychosis. The one with TLE appears to have no psychiatric problems, but there have been times when she would appear, to someone who is not familiar with TLE, as "crazy."
Thanks for sharing, Windy.
My DD definitely has hallucinations all the time, and there is a history of schizophrenia in her family. But she does have very bipolar traits, too. But that could be the fetal alcohol manifesting. It is all so overlapping....She is still not on any meds, and is doing okay that way for now. I think once we get hre fetal alcohol eval finished we will know what role that plays in all of her issues, and the pdoc will move forward with his diagnosis then. But I am thinking the pdoc that we see is wary of labeling her with anyting as strong as bipolar or schizophrenic.
There seems to be so much that can go wrong in the brain, but they all cause similar symptoms.
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grapevine, 34
DH, 44
stepdaughter, 12 undiagnosed, unmedicated
DS, 4
My 8 yr old was diagnosed ADHD/ADD at about 3,since he was 2 he has been having hallucinations. BiPolar never even crossed my mind untill recently when it was pointed out he maybe and I delved deeper into it. I switched Pdocs and the new one almost immediatly asked for him to have a psych eval. He tried him on a low dos. Adderall,it turned my son into a zombie,so after a week we stopped that.after seeing a psychologist the pdoc put him on Methilin 5 mg at first,then when it didnt do anything 10mg. the second day on 10 he had trouble swallowing and breathing hard, he was taken to our local ER and the Methylin stopped. the psychologist hadnt had time to score the eval but told me just basd on what he saw on the test there is much more going on than ADHD, much more likely to be bipolar and scitzophrenic. He is hallucinating more and more,where when he was younger it was mainly at night,now he has episodes durring the day as well. we go back to the psychollogist at the end of this month,in the mean tiem his Pdoc put him on a med to calm him down(just got it yesterday forget the mane)it isnt an adhd med but more for severe anxiety and mental disorder is what the instructions said.
How do you find out a familly hisotry when u only really know one side of the familly and everything was hushed,and never spoken of? my sons father's familly is out of touch. we have no contact even with him,though mental retardation runs on both sides of our familly,as well as bi polar,adhd,and psosiopathic relatives.how does one find out about stuff that runs in families when there is no one to ask?