His fits arent just like a normal childs fits he threatens to kill me or himself ... trys to stab me with knives/scissors etc. (I have hidden all of them now) he thows plates, vases, pictures  just anything and everything!! He has bitten me so hard he has drawn blood... i've ended up with bruises after these fits and the house is destroyed.... i dont understand why its so hard to find a doctor who understands... we just cant live like this ..

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Mary Alexis Boxx

Hi Mary- I'm glad you found TBMF. It's a place where parents understand and get the day to day turmoil. On our worst day, I remember restraining my son for 8 out of the 24 hours, he was that out of control. Today, someone meeting him would not suspect what his history was.

 The choice of meds trialled so far  is unfortunate, and more sad, it's not uncommon while figuring out how to address the symptoms our kids show.  Antidepressants and stimulants generally make mood conditions worse, especially without the aid of a mood stabilizing med. Because there isn't a lot of clinical studies of treating young children,  Drs don't like to prescribe meds to young kids. Plus, from a parent view, it's a difficult decision to start as well. My son's symptoms became so acute that his behaviors were preventing him from participating with kids his age- getting kicked out of daycare, limited participation in school... We had to be vigilanteven when hugging him when he was an infant, not knowing if it would be tenderness returned or a head-butt.  At times, 'feral' is all that described his behavior, that it would take multiple adults to restrain. His bite marks still imprint a leather coat I wore to protect myself.  We began trying to get help for several years before finally getting finding a dr to treat my son when he was 3 1/2.  We came home with a prescription for luvox (an antidepressant), mainly to address his OCD and anxiety. With a dx and meds, I started researching and came upon this site (at that time it was called The Child and Adolescent Bipolar Foundation). One of the first things I was told was to beware of using AD's. At our next pdoc appt, our pdoc wanted to raise the luvox, and continue on monotherapy. I reiterated all the mood issues we originally discussed, and my concerns. Instead of more AD, we added a mood stabilizer.  Several years later, in 2005,  some treatment guidelines were published http://www.thebalancedmind.org/learn/library/treatment-guidelines-for-children-and-adolescents-with-bipolar-disorder  giving a protocol  that hopefully avoids aggravating the condition.  Charting moods , keeping a journal, and having a health journal can help treatment choices. 

There's an article here http://www.thebalancedmind.org/learn/library/parenting-an-unstable-child-with-bipolar-disorder  that I found helpful when I started. It's helps to understand that the behavior is an effect of illness, and not an inherent personal flaw. If the illness is addressed, your real child can shine.  I was amazed when we finally got to a therapeutic level of meds that the social skills I tried to teach my child were there, but he couldn't access the ability  when a situation signalled for it, at least not consistently.  Our only consistent was nothing was or worked consistently.   

 What's so difficult in trying to figure out what to do is trying to understand what this illness is. As you've already noticed, there are many diverse symptoms, and a dx develops as the severity of those symptoms increase. We struggled for several years before my son was dx'd, and even then, we saw multiple drs to make sure we were  doing what we could. What I have come to realize is that his dx wasn't static. His dx was something that gave us a direction to help him. How we helped him evolved as we learned more about his illness and how he reacted to therapies. To get him stable took a 5 med combo- a mood stabilizer, 2 antipsychotics, an AD, and a stimulant, along with a lot of tweaking. (statistically, clinical reviews indicate 2-3 meds are required to address symptoms ).

  Starting out, it's not just dealing with the everyday behavior. It's also digesting how this changes life expectations. The stress of that grief has a toll too.  In the thick of it, we were struggling day to day, and it wasn't until we got a little relief that it began to sink in.  The online support groups here are helpful for having a place to vent and learn.

 Given that the meds he took did have positive effects on his behavior, I assumed they were necessary. Thinking that we were entering a maintenance role, and that he'd need meds for life, I became more focused on how to limit the risk of being on the meds.  My goal was to optimize his metabolism, and involved using nutritional therapies. The supps I hoped would help keep the side effects in check and enable us to reduce meds. As it turned out, we found issues affecting his absorption and level of nutrients ( some environmental, some due to a genetic variation) that once adjusted for,did allow reductions. While it was not my expectation, continued nutrient therapy allowed the complete elimination of meds over the course of a year. Since June of 2007 he's been med free, and more stable than we achieved with traditional med therapies. These topics are discussed on our Complementary Therapies (CAM) forum. 

A question I had from the beginning, and always nagged me, was how the body dealt with the meds, especially during the growing age. Meds use a target approach to treat the symptoms, but our bodies are a complex community of cells, each with a place and function in the supply chain. A good share of the cells efforts go into allowing the brain to function. While meds can regulate the functioning by manipulating what's sent to the brain, they don't create  the supply chain. Essentially, we backed up to the beginning- regulating the intake, using probiotics and digestive enzymes to improve absorption. We used metabolic testing to gain clues about specific pathways- basicly, the tests measure markers to show if cellular needs are being fulfilled, as well as genetic tests that identified process efficiency of enzymes the cells produce. Those are all cofactors in the process of producing the neurtransmitters, and all upstream of where the meds act.  Therefore, changing nutrition can affect the use or need of the meds. 

Downstream is another issue- nutrition also plays a role in the breakdown and elimination of foreign molecules ingested or absorbed, including from medications. Genetic variations are being discovered that indicate some people have trouble eliminating these things fast enough. It was an issue with my son that we could work around with extra nutritional support and by minimizing the intake of some substances, like dyes, preservatives, flavor enhancers.... Those were compounding factors and contributed to cell damage thru oxidative stress. Reducing oxidative stress is a mechanism of many of the psych meds, but keeping it in check thru diet changes may be a systemic approach that allows all the organs to benefit.  We found thru genetic testing that he is slower at clearing toxins from his body.

A third area affected by nutrition is optimizing energy production, transport and utilization.  Guided nutrition can improve cellular health and cell replication. We also discovered immune system problems which drain energy away from executive functions.

This is link to a post I did a year ago-  http://www.thebalancedmind.org/connect/forums/newly-diagnosed/new-and-overwhelmed-beware-this-is-really-long-and-it-ends-with-me-cr   It's critical for the brain to  have and be able to use the energy we produce.  The insults to my son's physical health impaired his ability to perform the expected brain functions, resulting in the display of symptoms that got classified as 'mental illness'.

There is a practioner finder on the site, and also, you may want to post here, or thru a support group, (which I recommend signing up for) for a pdoc reference.

Lastly, it's important to remember that parents typically come to and post on these boards when at desperate limits. Once past crisis, most move on. You can go to the  Stories of Hope  forum to see that happens  http://www.thebalancedmind.org/connect/forums/748

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Darryl - parent volunteer, dad to
Levi, 13, stable using supps and diet exclusively since June 07. Previously treated and stable with med combo inc. lithium, 900mg seroquel, and small amounts of risperdal, luvox and focalin after being dx'd at age 3 1/2.

Thank You for all the helpful info. We are still struggling but I'm taking it one day at a time... His doctor has now taken him off of the Kapvay and Vivance and he is now taking Abilify 2mg in the morning. We just started the new meds today and he was off of everything for 7 days. His fits are at their worst..he will hit me and then grab his arm and say " arm stop hitting mommy" then continue to hit and say he just cant help it because the men on his shoulders are telling him to do  the bad things... its exhausting

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Mary Alexis Boxx

WOW! Sounds like my son has a twin!  Hes 4.5 and wow.  Thats all I can say. Youre the only other person Ive met whos had to restrain their son. I just joined here on Friday and have already found so much help, its amazing.  I hate that youre struggling like I am, but its nice to hear Im not alone.  My son has been on Abilify since April and its made a HUGE difference. Of course, when he has his fits and really bad days I question whether its working at all.  We had him off meds for 9 days recently.  I almost ended up in the psych ward for me.  Literally.  Hes back on his Abilify and stable now.  We got our second opion Friday, which said 'mood disorder', but they said they were pretty sure its bipolar.  We're waiting on an appt for further psych and neuro testing.  In the meantime I plan to have his blood tested for all of these nutrition things everyone keeps talking about.  Im still trying to figure it out...Im kinda lost as to where to go :(  Id suggest the same for you...it cant hurt, right?!

Darryl, thank you!  That was amazing!!

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Just Keep Swimming...