6 yr. old autistic son recently diagnosed with BP-NOS
Hi. My name is Erin and I am new here. I am the stay-at-home, homeschooling mom to two children DD and DS. I also have a background in psychology and clinical counseling.
DD is 9 years old and is neurotypical.
DS was diagnosed at 19 months of age with Autsim. He is "high functioning," in other words he is able to communicate verbally and lacks some of the more severe symptoms of Autism.
In February 2011 we took him to the local Autism clinic because we were beginning to notice some disturbing behaviors which we related to his Autsim. At that time, the Developmental Nurse Practioner (we have a shortage of developmental/child psych MD's in our area) diagnosed him with Depression and Anxiety, along with Autsim. The initial diagnoses fit very well. (He was showing every DSM-IV sign of classical depression.)
We began him on Celexa, eventually reaching a maximum dosage of 15mg, which is very small (my son is very skinny for his age, although he is of the proper height. Medicating him is difficult because of this). We saw IMMEDIATE results from the Celexa. Within hours he was a different child. I know SSRI's are supposed to take weeks to work, but that was absolutely not the case for our son. We were also given a script for Clonopin (.5mg) to use as needed for severe anxiety and irritability.
After several months on the Celexa, we began to notice more irritablilty, aggression and tantruming/rages. The NP decided to put him on Risperdone (.5 mg, again a very small dose). I researched it and decided it was worth a try. We saw slight improvement, but we never got back to baseline from the introducation of Celexa in February, 2011.
About 4 weeks ago we had an episode where my son wanted something and I couldn't give it to him immediately. From that moment on, for 4 straight days, he was at the lowest point I have ever seen him. He was self-harming, destroying property, attacking me, crying, screaming, not sleeping, not eating and threatening to kill himself. We used the Clonopin more in those 4 days than we had in total all the months prior. We seriously considered taking him to the local children's hospital for admission because it was terrifying for all of us.
I made an emergency appointment with his NP and we went to see them on day 5. That day he was the polar oposite. Giggling, full of energy, happier than I have ever seen him (but not in a scary way), however he started talking in "baby" language and self-soothing (hand flapping, rocking) more than usual.
The euphoria lasted only a little while and now we are in a cycle of up and downs all day every day. I never know what is going to set him off. He is also very tired which is unusual and noncompliant with my requests, again very unusual.
As of this morning at our appointment, the NP and consulting psychiatrists (there were 2) feel that he is exhibiting signs of early-childhood onset bipolar. In some ways I totally agree, and in others I am in doubt. I requested some medical testing to make sure there is nothing else going on (he will have a blood work up and an EEG to rule out silent seizures). The NP has begun weening DS off of the Celexa and beginning tomorrow morning we are increasing his Risperdone.
I can handle the diagnosis and treatment. More than anything I greive his future because I know the struggle that lies ahead. What I am hoping for is that someone here has had a similar experience and can guide me through the decisions I know I will be making in the coming months. I thank you for reading this and for your reply.
Erin
Hi Erin,
While my daughter has bipolar, and my neice is autistic, I personally am not experienced with a child displaying both autistic and bipolar sx's. Finding a support group on this site will be the best way, I think, to find other parents either currently going through - or who have gone through - what lies ahead for you. By posting your description (as you did above) in the indicated area when requesting to join a support group, you will be directed toward the one which best fits your individual needs.
Best wishes to you!
--
Shelle, 49 in So Cal - Celexa 20mg, Xanax 0.5mg rarely as needed
Single Working Mom to Rachel, 12 - BP w/anxiety - Lamictal 200mg am+Seroquel 50mg am/200mg early pm, Therapeutic School/7th Grade
We also have Birdie, the love bird - she bites; and Scarlett, the kitten - she does too
Family Response Team Volunteer, rmadmom@hotmail.com
The Balanced Mind Foundation - Bringing Hope Home
FROM THE BALANCED MIND FOUNDATION: Do not start, stop, or change medication or other treatment 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 judgment of a doctor who knows you or your child.
I too have a son (9 - Asperger's) that was recently diagnosed as bipolar. I think it was the right diagnosis. His anger is out of control and I never know what is going to set him off. The things that irritate an autistic child like noise, bother my son tremendously. Then, the bipolar causes him to not be able to control that anger. It is a dangerous combo if you ask me. We are working with a pediatric psychiatrist that has research experience with bipolar children. We are still trying to find the right mix. He is still on some of the meds from before he was diagnosed with biolar. He is on 54mg of Concerta (for his ADHD), 10 mg of Citalaphram (antidepressant), 300mg Lamictal, Clonzanapam .75mg, .Risperadal .25 x 4 times daily, Claritin 10mg (allergies).
Just a quick look and opinion - thats a LOT of Concerta for a child with a suspected mood disorder. I mention this because to this day I believe it was the switch to Concerta from Metadate that put my DD over the edge into mania last year. Not that she wouldn't have gotten there anyway, but I believe it highly accelerated the process.
Good luck.
--
Karenj
Self: as sane as I can be everyday
A - DD (17yo) well adjusted, high functioning, motivated, successful, waiting patiently to go away to college
M - DD (13yo) Bipolar I (dx 4/2011) ADHD (dx 2nd grade), dumb high IQ, mainstream education with IEP/BIP, Seroquel XR 400mg - morning: Seroquel 50mg evening; Lamictal 150mg - morning
BF - Live in boyfriend of 5 years, supportive and learning more every day
EX - Ex-husband, divorced since 2002, family history of bipolar, unpredictable and sometimes explosive
TONIGHT (Friday January 20th), Great Plains Laboratory is having another FREE Webinar about Autism. Their information highly overlaps with pediatric bipolar Disorder. It might not be too late to register for it. http://www.greatplainslaboratory.com/home/eng/webconferences.asp
Even if you cannot make it to that one, they have many recorded Webinars archived that may help shed light on what is going on, biologically.
My younger daughter had many "associated characteristics" of autism, but NOT autism itself. She did have much of the commonly associated biological problems that go along with autism, too! "Funny" we don't consider autism a "mental illness" but we call bipolar disorder that!
--Jeanie aka "Naomi"
It's Not Mental
Older dd: formerly(?) teen-onset bipolar (morphed into ultradian cycling): "Recovered" after over 13 years - stable off psych meds almost two years. Now fine on just diet changes and higher thyroid levels (after healing - addressing gut issues/Candidal overgrowth while using EMPowerPlus and other supplements). She added a little EMpowerPlus back on as a multivitamin simply because she feels better on it - gets sick less often.
Younger dd: formerly(?) Childhood-onset schizoaffective, TS, OCD, anxiety, PTSD, migraines. After over 15 years, is now "recovered" for almost 5 years after treating endocrine issues, food sensitivities, gut issues, sleep issues, nutritional/mitochondrial needs.
--My son is almost 7, was diagnosed PDD NOS at 21/2 yrs old by a pediatric specialist, and about 3 months ago, it was like someone flipped a switch somewhere, and my son just lost his mind. He started getting in trouble at school, and at home. He acts out 85% of the time...He's defiant, and has trouble sleeping, rages and tantrums, and pings off the walls like a pin ball machine!! He has an appointment with a psychiatrist tomorrow, I've already had a session with her, and she thinks because of my family history of bi-polar disorder, and his symptoms, he may have it as well....It breaks my heart to think I gave this horrible disease to my son...Anyway, that's where I'm at on this journey...I could use any advice regarding meds, cool routine tricks, diet advice, ect...Thanks, Guys...
Mom of N and G
Mom of N and G,
Welcome to TBMF. I would first like to encourage you to go to the "Learn" tab above and click on "Getting Started". It is an excellent introductory article to childhood BP from diagnosis to treatment to school issues. I would also look at giving him as regular a routine as possible, including sleep, activity and meals.
Did your ds have any infection recently? It is possible to have a neuropsychiatric problem develop after having a strep infection, and this would be important to rule out, especially considering the acute onset of his sx. It is always important to look for any possible physical cause for these brain sx.
There are many dietary options, and you can read about these on the CAM Forum. In general though, it's best to limit sweets, feed them regularly, and avoid artificial chemicals.
For info on meds for BP, check out the Expert Treatment Guidelines. I also suggest you start keeping a mood chart of some sort, or at least a daily diary of his behavior and other sx. Research and read as much as you can to educate yourself as you go along in this journey.
Is he on any meds at this time?
--
Brenda,51, TBMF Parent to Parent Volunteer
Mom to A, 17 1/2, BP, Tourette's, OCD, ADHD: Eskalith CR, Lamictal, Cytomel, Allegra
E, 16, BP,AS: Seroquel, Eskalith CR, inositol, Buspar
B, 14 1/2 & H, 11 1/2
Married 18 years to DH, 51
FROM TBMF: 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.