BP or does my 7yr old need more discipline?
I just don't know what to do anymore! My son has always been hyper and a "typical boy", so I thought, until he started Kindergarten. The 1st week of school we were in a confrence with the principal, counselor and teacher discussing his behavior issues, hitting, talking back, attitude and he had already gotten kicked off the bus! I took him to a psychiatrist and he was diagnosed with ADHD at age 5 and was put on Vyvanse, after a year being on it, his 1st grade teacher and I noticed that he seemed to over concentrate, so he was put on Adderall. He just started 2nd grade at a new school (we moved), the 2nd week into school, he had a few conduct issues and in a district wide test, he was reading at a 1st grade level! I made an appointment with a new doctor and was informed that my son HAS BP and ADHD, September 2011!
How can he be diagnosed with BP after one test? I have had told only a few people about this and some were not suprised and some said I should get a 2nd opinion. He is now taking Equetro 200mg at night and Adderall XR 20mg every morning for a week now, it doesn't seem to be helping with his attention problems at home/school, he is still getting angry and throwing things when he is asked to do something he doesn't want to do! I AM FRUSTRATED, EXHAUSTED AND FEEL HELPESS! Should I get a 2nd opinion, does he need to be disciplined more? I just don't know how to handle his little attitude and defiance anymore, discipline only seems to piss him off more and makes things worse! HELP!!!!
Thank you for any advice!
Tonya
Welcome to CABF. I think it would definitely be a good idea to get a second opinion. It would also be very beneficial to have neuro-psych and educational testing done. This would give the pdoc much more information to work with. Also, it is a good idea to start keeping a mood chart and bring it with you to the pdoc appts. Here is a link to the Expert Treatment Guidelines and the AACAP med Guide so you have a better idea of the usual treatments for BP.
There are several good books in the Book Store on this site. I also recommend "The Explosive Child" by Ross Greene for learning techniques for avoiding and managing meltdowns and rages.
Gotta go now, but that should get you started.
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Brenda,51, CABF Parent to Parent Volunteer
Mom to A, 17, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel, Allegra
E, 15 1/2, BP,AS: Seroquel, Eskalith CR, inositol, Buspar
B, 14 & H, 11
Married 18 years to DH, 50
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.
Thank you, Brenda for your advice! I looked at the mood charts last night, but I will print some out tonight for sure, my son has been saying things he normally wouldn't say today (bad language)! Thanks again!
Tonya
Hi Tanya, my daughter was also initially diagnosed with ADHD at age 6, and then with bipolar at age 11. It's still a good idea to get the second opinion and the testing that Brenda mentioned - it is all really helpful in coming to understand where your son needs help the most. I am familiar with all of the behaviors you spoke of that seemed to emerge and escalate during those years between each of the diagnoses. Is the new doctor a pediatrician or a child psychiatrist? Has s/he suggested any medication changes?
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Shelle, 49 in So Cal - Celexa 20mg, Xanax 0.5mg rarely as needed
Family Response Team member and CABF Support 11
rmadmom@hotmail.com
Single Mom to Rachel, 12 - BP, anxiety, ADHD (or maybe not) - Lamictal 200mg am+Seroquel 50mg am/200mg early pm, Therapeutic School
We also have Birdie, the love bird - she bites; and Scarlett, the kitten - she does too
FROM CABF: 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 judgement of a doctor who knows you or your child.
Thanks Shelle! His new dr is a psychiatrist, I also go to him for my anxiety and ADHD......thinking about asking him if I may also be BP at the next visit! The old dr had my son on 60 mg on regular adderall/day (too much), this new dr reduced the dosage to 20mg of Adderall XR/1x in AM and added Equetro 200mg/1x PM. The educational testing, is that done at places like Sylvan Learning Centers and similar places? Is that what testing you are talking about?
The reduction in Adderall should help - we actually eliminated all ADHD medication for Rachel. Stimulant medication is often responsible for exacerbating some of the behaviors you are seeing right now. Getting the mood stabilizer on board is a good place to start if it is BP. The general guideline is 1) mood stabilizer; 2) atypical antipsychotic; and then if ADHD still requires treatment, that is addressed last. You will see this in the treatment guidelines and medication guide that Brenda posted. In addition, take a look at http://www.bpkids.org/learn/getting-started. It contains a lot of descriptive information which will help you to weigh in on the diagnosis by comparing some of the information to your own observations.
The educational testing was done as part of her IEP, which I would suggest you request at your son's school - it will help with the accommodations he might need, especially in addition to the transition (Rachel actually went to 3 different schools for 6th grade and it really made things worse in the short term). It is not something you will have to pay for.
She also had a psych evaluation done at school as well as by the Dept. of Mental Health (California has something called AB3632 that's conducted between the schools and the DMH - you might as your son's school if there is any similar arrangement in Texas). This is also something you should not have to pay for.
Neuropsych testing would be done in a medical setting. Here, I would go to UCLA which has a program. If there is a teaching hospital near you, that would be the place I would start to look for that. This testing would be at a cost, but could potentially be covered by your insurance. You might check with your insurance provider also.
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Shelle, 49 in So Cal - Celexa 20mg, Xanax 0.5mg rarely as needed
Family Response Team member and CABF Support 11
rmadmom@hotmail.com
Single Mom to Rachel, 12 - BP, anxiety, ADHD (or maybe not) - Lamictal 200mg am+Seroquel 50mg am/200mg early pm, Therapeutic School
We also have Birdie, the love bird - she bites; and Scarlett, the kitten - she does too
FROM CABF: 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 judgement of a doctor who knows you or your child.
Hi Tonya,
I realize this is an old post, but your post really struck a nerve. Traditional discipline does not work in our house. Not a time out, not taking the offending toy, and certainly not a swat on the pants. Although sometimes, we would put her in time out as a safe place until she de-escalates.
For us, we can control our actions, but not hers. If you do XXX, then WE will YYY. We try and let the consequences from be what they are. An easy example is that when you are hitting your brother, we won’t take you to the school bus stop. For a fight is over meds---it is your responsibility to keep your mood stable---If you don’t take your meds and supplements, that is your choice. If necessary, we are prepared to take you back to the hospital. (we then walk away and it works every time). It is your choice not to do your homework, but you have missed a lot of school and you may get behind the rest of the class.
We try to work in something fun every time we go out. It could be we will stop at the park for good behavior. If you continue this tantrum and we can’t leave in time, then we won’t have time to stop at the park before the doctor’s appointment. After you eat your dinner, we will go to the store and buy soy ice cream.
It gets more difficult as the violence escalates. If you continue hitting your brother, then he will get to go spend time alone at Grandma house (shhh… it’s for his safety). If you don’t stop trying to hurt us right now, then we will have to call 911 for an ambulance back to the hospital (this one also works every time).
Good luck,
Brian--
BK Daughter 7 BP/violent rages. Unsuccessful with multiple meds. Now reasonably stable for last 2 Months on Intuniv + Restrictive diet + True Hope's EMPowerPlus & AminoPowerplus + low dose lithium. Still working towards getting endocrine and metabolic testing.