New...Child with mood disorder (Bipolar)
I am new to this website. Looking for answers advice and etc. I have 3 children 15, 8, 2,. I have been going crazy for 4 years with my son. He is 8. The pediatrician said he was strong willed. It never got better. He is immature for his age. We held him back in Kindergarten. He just wanted to play. The teachers said, he was just being a boy. At age 7, we have had enough. We were exhausted. His pediatrician, said he had ADHD. Medication will help. I am not big on medicating my child. But, we needed help. We did adderall all summer. It was a disaster, it made everything worse. At the beginning of school we started Ritalin. It seemed to help. For awhile. Then we were still stuck. We blamed ourselves for our parenting. Although our 15 year old is fine and happy and healthy. We thought we just spoiled him. That is what it seemed like. The doctor gave us a name of a couselor. We went there. After an hour with us, she said she could not help us. We had already tried rewarding good behavior, timeouts and etc. Nothing would work. She sent us to a psyciatrist. I was scared and shocked. So far, he has put us on Ambilify with the Ritalin. 3-months later, not any better. We did have a good month. Only having rages after school for about an hour or two. Then got bad again. So, he decided to do the Ambilify 2.5 mg. in the morning with the Ritalin and his 5 mg in the evening of Ambilify. Well, that was a disaster. After 2 weeks of increased rages I stopped the 2.5 in the morning. I don't think it works well with the Ritalin. I wanted to quit the Ritalin all together. Just do the Ambilify fornow. The doctor said, I can't just stop the Ritalin. That we have to go slow and not make alot of changes at once. I think the Ambilify would work better without the Ritalin. But, I am no doctor. So, now the holidays are here and we are medicating that is not working. The mornings are awful, he gets up all hyper and wanting to irritate everyone, laughing, running, just causing trouble. Refusing to get dressed, brush teeth or eat breakfast. He does ok. at school. His grades are c's. I talked with the school. They want help unless he is failing. He is really smart and can do better. I don't understand why you have to fail to get help. I thought it was our goal to help kids do better. If he can have A's with help why not , help him? After school he is rough, kicking the car seat. Yelling at me, some days are worse, some days there is cursing and laughing, it is a mess. My other 2 children get ignored in the afternoon. It is always about Connor. Making sure he does not hurt the baby , by being all hyper and crazy. Always saying don't do that, I have tried hugging him and talking when he has a episode. But, then I get tired and frustrated and then I yell. It is crazy up and down everyday. You don't know what you are going to get...
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Danielle
Hi Danielle,
Welcome to CABF, I'm glad you found us!
First, I recommend finding and working with a highly qualified and educated child and adolescent psychiatrist, one whom successfully treats pediatric bipolar disorder, who can properly diagnose your daughter. If you follow this link - http://www.bpkids.org/connect/find you can search by city and state for a wide variety of resources including physicians and therapists. You can also search at the American Academy of Child and Adolescent Psychiatrist here - http://www.aacap.org/cs/root/child_and_adolescent_psychiatrist_finder/child_and_adolescent_psychiatrist_finder. This link will take you to a great article about questions to ask your doctor - http://www.bpkids.org/learn/library/the-doctors-visit-parent-checklist-of-questions.
This link will take you to a great article about pediatric bipolar disorder - http://www.bpkids.org/learn/library/about-pediatric-bipolar-disorder. And this link will take you to an article about how a bipolar diagnosis is made - http://www.bpkids.org/learn/library/how-is-a-bp-diagnosis-made.
This is a must read article - Bipolar Disorder, Co-occuring Conditions and the Extreme Need for Caution Before Initating Drug Treatment. Another is What's the Difference Between ADHD and Bipolar Disorder.
Your son's reaction to Adderall and Ritilan is common with kiddos who have bipolar disorder. Mania is often misdiagnosed as ADHD and this can be a costly mistake. Stimulants like Ritilan, used to treat ADHD, as well as antidepressants, can and more often than not worsen and activate the bipolar condition. The result can be activation/mania, raging, suicidal thoughts, even psychosis. A general rule is to stabilize the mood first, then see what is left over to treat. The standard treatment for bipolar disorder includes at least one first line mood stabilizer, like Lamictal, Lithium, Depakote, Trileptal or Tegretol. Treatment usually also includes an atypical antipsychotic like Risperdal, Seroquel, Zyprexa, Geodon, Abilify, Invega, Saphris, or Fanapt. Some kiddos require two first line mood stabilizers and even two antipsychotics in their medication mix to stabilize. Most of the antipsychotics also have mood stabilizing qualities to them. Antipsychotics are great at treating mania, rage and aggression, along with any psychotic symptoms that maybe present. It is important to slowly titrate the dosages of medication in an effort to reduce side effects, and to find the right dose for your child. It is also very important to max out the dose of a medication before moving on, unless of course there are unwanted side effects. It is very important for you to educated yourself on the recommended medications used to treat bipolar disorder. Follow this link to the current expert recommended treatment guidelines from the Journal of the Academy of Child & Adolescent Psychiatry - http://www.bpkids.org/learn/library/treatment-guidelines-for-children-and-adolescents-with-bipolar-disorder. Many parents have found it helpful to print these guidelines and take them with them when they meet with their doctor to discuss treatment options for their child. Like so many other families here, we have found it imperative to follow these guidelines.
One of the best things you can do is to chart and/or journal your daughter's moods and behaviors as this will become valuable information for the psychiatrist. Sample mood charts can be found here - http://www.bpkids.org/learn/library/mood-charts-list-of-several.
Your son does not need to be failing to get help from school! Whom ever told you that is wrong! It is very common that children with bipolar disorder are smart enough to do well in school, but many have difficulty with planning, organization, and the execution of homework when they are feeling stressed or overwhelmed. The public schools do have an obligation to work with children who have emotional issues. There is an information booklet available through our website that you can give to the school to help them understand what accommodations might be most beneficial. The link to that pamphlet is - http://www.bpkids.org/learn/library/educating-the-child-with-bipolar-disorder and this one An Educator's Guide to Pediatric Bipolar Disorder . This is also a good article - Become an Effective Educational Advocate. Additional resouces can be found under the "learn" tab at the top of the page and then click on "education corner". Additional resources can be found at: www.bpchildren.org, www.wrightslaw.com, and www.starfishadvocacy.org.
I'd like to suggest to you two books which I personally, along with many other parents, in our shoes have found helpful. The first is The Explosive Child by Dr. Ross Greene. The second is Love and Logic by Jim Fay. I have found the behavioral techniques basket system as outlined in The Explosive Child to work best during times of instability and then using the techniques outlined in Love and Logic to work best during times of stability. Both of these books can be found in our bookstore section here - http://www.bpkids.org/learn/bookstore. In addition our bookstore has a comprehensive collection of books organized into different sections (Parents, Children and Teens, Professionals) and easy to search subcategories. Each listing includes a description about each book and most offer an online sneak peek at some of the content. You can order through our links to Amazon (CABF gets a portion of the proceeds) or you can find these books in local bookstores or get them through your public library.
Here is my suggestions on how to handle the raging -
In an attempt to avoid rage, identify his/her triggers and try to re-direct the child before he/she goes off. Remove and reduce all stimuli and stressors to avoid escalation of rage. Don't argue or force compliance. Don't threaten with ultimatums. Calmly tell the child what you expect of him/her, walk away, and allow him/her to process the information.
If the child ends up raging talk in a low, calm voice (hard I know!). Avoid using his/her name...in fact, if at all possible avoid talking at all. The use of a PRN maybe needed. Physical restraint may also be needed - learn how to do a therapeutic hold. Make sure the child goes to a safe place. Offer a pillow, other soft object, or punching bag to the child. If you have other children in the home, make sure that there is a safety plan in place.
Practice the use of Low Expressed Emotion (LEE). LEE is using little or no emotion when dealing with or reacting to an unstable child in crisis. Avoid raising your voice. Do not give commands. Do not speak in a condescending manner or criticize the child. Offer reassurances that everything will be all right and that the crisis will soon be over. Avoid being over enthusiastic as well since some children cannot handle the over stimulation of too much exuberance. Think before you speak. In fact, avoid speaking at all if you can. Ignore the cussing. Think of it as verbal vomit.
Remain in close contact with your pdoc. If rage and aggression are worsening don't hesitate to contact your pdoc.
Lastly, read this article - 24: A Day In The Life. This will give you a lot of insight.
Know that with the right medications on board things will get a lot better! Know that we are here for you, and that you are not alone!
Hugs,
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Jackie aka mom2one
Forums moderator, Family Response Team Member
Mom to Mr. 18 (dx'd at age 4), Schizoaffective, bipolar subtype, Anxiety Disorder, PDD, Cognitive Disorder
Meds: Clozaril 75 mg., Seroquel 900 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!
If CABF has helped you, please consider a donation! https://www.bpkids.org/donate?campaign=forums2010
this is my son exactly has he been diagnosed with bp yet?
Lost, you can try to backchannel a member by clicking on the highlighted name- a window will open and a blind email will be sent to which they can reply. Also check out the support groups- you can join an online one that will connect you to other parents.
A "PRN" is a med to be used as require; here it is generally either a fast melt risperdal tablet or zyprexa, both anitpsychotics.
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Darryl - parent volunteer, dad to
Levi, 11, 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.
WHAT IS A prn
PRN means "as needed". Like you would take Tylenol PRN for a HA (headache).
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Brenda,50, CABF Parent to Parent Volunteer
Mom to A, 16, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel
E, 14, BP,AS, mild hypothyroidism: Seroquel, Eskalith CR, inositol
B, 13 & H, 10
Married 17 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.
Jackie,
Your reply helped me. That article seemed as though they were writing about my typical day. I am new here and I am so glad I am not alone. If you read my signature you can see how I can relate to the article, my son was abandoned by his father because of mental illness. I will never walk away from him <3
THANK YOU!!!!
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Jenn 31 in Mass.
undiagnosed bipolar until ag 24 currently stable. In the middle of a brutal custody battle with my youngests sons father.
DS 10 (abandoned by his father because of his mental health issues and need to be medicated) nonverbal learning disability, anxiety disorder, ADHD, and a mood disorder likely early onset bipolar 300mg tripletal 2x daily and .10mg of clonidine
DS 7 no diagnosis, extremely angry, irritable, mood swings, trouble in school. Hoping some answers soon.
DH 33 (stepfather to my sons) brave enough to take us all on and love us through it all.
Hiya folks! My sincerest apologies for interjecting so late, but I want to give an enthusiastic thank you to you all for the stories! I seriously thought I was the only one going through what I was going through. Now, this isn't my child that I'm speaking of, but my nephew (whom I consider like a son). My sister has been having so much trouble containing her son's behavior and these stories make everything seem so clear now. When we were told my nephew had bipolar disorder, we looked at each other cross-eyed. We didn't think it was possible! However, after reading these stories (together), we found out just how accurate they all were. This isn't to say we didn't trust the psychiatric specialists but it's just shocking. Now that we know this is real, we can move forward to alleviate the problem.