Bipolar disorder - kids/teens
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Anonymous
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If your child was diagnosed with bipolar disorder, what were some of their symptoms as teenagers? Did they show any signs in childhood?
We've cycled through various possible diagnoses for my DD and the latest we are thinking about is bipolar. We've also considered autism, ADHD, anxiety and depression, personality disorders. She has some traits of all of those and may of course have multiple diagnoses. What seems unexplained by anything we've investigated is the intensity and frequent changes of her moods. Sometimes she is irritable and angry, sometimes near-catatonically withdrawn to the point of having difficulty forming speech, and sometimes cheerful, energetic, and talking a mile a minute (more like hypomania than mania, though - she's pleasant and fun to be around when she's like this). She was very high-strung and anxious as a child but was mostly well-adjusted and did not have these fluctuating moods at all. They came on somewhat suddenly at about 13. She has a close-in-age sister who is unusually even-tempered, so sometimes I wonder if I do not have a correct baseline for what is normal moodiness in teen girls. Moods are quite unpredictable and do not seem connected to her menstrual cycle. |
Anonymous
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My sister tried to commit suicide as a freshman in college she was diagnosed then with bi polar disorder.
When she was 13 they knew she needed help they never got her any. She is now 51 and never got help. She has created a life for herself but I will have zero contact with her. She's even an associate professor at a very well known college and married. |
Anonymous
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Would having this diagnosis change anything in her treatment?
How old is she? Some teen girls are extremely moody and grow out of it. |
Anonymous
She's in her late teens. It would mainly make a difference to her meds (we've already tried a lot but none of the main meds used to treat bipolar). It might also provide insight into some of her behavior. |
Anonymous
I’m not at all sure but if she is late teens I really suggest setting some parameters before she goes to college. Including a hipaa and ferpa waiver. And an expectation of FaceTime check ins at least once per weeks. Keeping location sharing on. Etc. the schools will not share even a smidge of information with you if you do not have waivers. Also really think about whether she can find a college that is close enough for you to do an occasional drop in. Try to meet her roommate, take them both out to dinner and give the roommate your cell number just in case there’s ever an emergency (or give it to the roommates mom if you meet them at move in). I had a roommate who had a schizophrenic break and it was really challenging. |
Anonymous
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One flag for my kid who later had schizophrenia was intolerance of ADHD stimulants. We tried them one time at a young age and had immediate overwhelming crying. It was terrible and he never took stimulants again. Other than that a pretty typical mix of ADHD, anxiety, autism stuff.
Bipolar patients have similar poor reactions to stimulants. |
Anonymous
That is pathetic of you as a sister by the way - it's your parents fault. Not hers |
Anonymous
Have you done a full neuropsychological evaluation? And are you sure her catatonic withdrawn stages isn't that she's just high. Very easy to keep a cart in her room to smoke. Or maybe she just gets extremely overstimulated and shuts down. The other two moods seem pretty consistent with teen girl behavior (irritable and pleasant) |
Anonymous
Mine is diagnosed with bipolar II which seems to fit well. Nothing as a child would have med me to think this was a possibility. Symptoms obviously included mood swings. The depression was so unbelievably dark with him not being able to move for days. The manic involved not sleeping and doing impulsive things like spending money (after stealing credit cards), leaving the house and going who knows where. It was intoxicating sometimes and sometimes it wasn’t particularly pleasant. He also developed extreme anxiety which led to school refusal. There were suicide attempts, violence, property destruction. |
Anonymous
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OP, I’m so sorry you’re dealing with this. Whatever it is, it sounds like a cognition problem (at least somewhat outside of her control), rather than a character problem (completely within her control). Your instincts are right; she’ll probably need extra help and support to optimize her emotional control. If you aren’t already in a waitlist for a complete neuropsych, I’d start there. You’ll want everything. It will cost thousands.
The good news is that you’re dealing with this in the golden age of neuroscience. There are so many new therapies out there that aren’t mainstream yet, but are being studied. If it were my child, I’d take the time spent waiting for a neuropsych to start reading any new book related to the brain. You might consider scheduling neurofeedback to start right after you get the testing results, with the caveat that it’s an art and the skill of the practitioner matters. Keep in mind that you’ll lose the legal authority to talk to her clinicians in just a few short years. You need to really push the timeline and be open to doing multiple therapies at once, especially during the summers. Do you have local friends or family who can drive her to appointments if you work? |
Anonymous
Neurofeedback isn't an appropriate therapy for mental health disorders like bipolar, depression, or schizophrenia. OP, if you are working with a psychiatrist, it is reasonable to ask about a bipolar diagnosis. Hypomanic would be bipolar 2 while florid mania (thinking completely irrational kind of mania) would be bipolar 1. My exH and his Mom were both bipolar 2, which can be hard to diagnose because the hypomania is often normalized as a reaction to a situation. FWIW, his mom used to have depression with catatonia as an aspect of her bipolar, but not everyone with bipolar does. One of her family members once explained to see that the catatonia was considered a form of psychosis, which I didn't know, and anti-psychotics are sometimes prescribed for bipolar patients. What is your interaction with her psychiatrist? Do all of you -- parents and kids get to report on mood? What often happens with bipolar patients is that they are unable to recognize their own mood states and accurately report on them to the prescriber. So, a psychiatrist will often miss the mania, especially hypomania, because it is reported as a normal state when the patient is "fine" or "at their best". NAMI runs a good class called NAMI Basics for family members with a child who has mental illness, and they also run good support groups, which is a good way to compare notes with similarly situated parents. |
Anonymous
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Honestly save the thousands on a neuropsychiatric profile. That’s for getting an IEP or testing accommodations. Mental health diagnoses are a bunch of symptoms and can change all the time with youth. Plus you’ll need funds for future mental health interventions.
A lot of youth special needs is a sunny happy ending of the right treatment leading to normal life. The serious mental illnesses, which this could be, are a long adult struggle. Treatments are primitive and have low efficacy. By all means try and avoid drug abuse—itll exacerbate mental illness. |
Anonymous
Agree with this. Stay grounded and help her develop actual strategies now for managing her fluctuating moods. How can she communicate how she is feeling? How does she know when it’s time to reach out for help? The clinical definition matters less, and may even be a detriment because there’s so much stigma and assumptions that create unnecessary barriers. I would also make sure she is tracking her cycle and managing her stress. Those play a huge role in managing symptoms of any disorder. |
Anonymous
| I'm sorry you are going through this...we have a child with a similar profile (whom some Drs. have noted may be BPII) and while we continue to have many challenges Dialectic Behavior Therapy (DBT) has been game changing for my kid. Highly recommend the DBT center in Bethesda (and they even take some insurance). DBT is a different type of therapy and geared towards skill building. |
Anonymous
As the ex spouse of a person with bipolar, I would encourage you to have a little more empathy PP. You don't know what the poster went through. Also, while her parents should have helped her sister and her, many people don't know what to do for mental illness. I firmly believe that when we become adults, we are responsible for getting our own health, and her sister, if employed, likely has access to health insurance and thus treatment. Bipolar, especially when unmedicated, can lead the person with bipolar to do things that would be considered abusive. Sometimes this abuse or manipulation goes away when medicated, but sometimes it does not. I navigate a very complicated situation with my kids (now young adults). We love dad, but to various degrees we have all had to set boundaries. Because of the type of abuse I endured and the long period of abuse, my boundaries are much firmer than the ones my kids have set. I basically no longer speak to my ex-husband unless there is an emergency regarding one of the children. When I speak to him or of him, of course, I strive to be polite and kind but also limited. I tell him nothing about my life or the kids' lives. I will do nothing for him. I will not socialize with him at all. If I had not had kids with him, I would be zero contact with him. While I can understand that some of his actions toward me were driven by illness, other behaviors were not driven by illness or continued when medicated. He has also made a choice at various times to not medicate, and while I understand that is his choice, because that choice impacts his behavior toward us, his choices have consequences in terms of whether or not we feel it is safe and enjoyable for us to spend time with him. He has also never chosen to recognize the consequences of his actions and make amends. A person's bipolar doesn't mean that friends and family member must remain in contact and subject to their abuse. I would feel quite differently about level of contact if my ex-husband had been medication compliant and diligent about seeing his psychiatrist and therapist regularly and interacting with them (and me) honestly. But, the truth is that part of bipolar is that people often have anosognosia (inability to understand they are ill) or are otherwise in denial or dishonest about their illness, and bipolar patients often refuse medication (which I view differently than going on/off or otherwise changing medications at the direction of a psychiatrist). OP, while I have directed my comments to PP, I hope I haven't scared you. Bipolar can be highly treatable. Regardless of the diagnosis your kid ultimately has, you have time, while they are under 18, to model and guide them to collaborate with their doctors, be honest about feelings and impact of medication, use other adjuncts like accommodations at school, and get them to sign paperwork (healthcare power and HIPAA waiver) so that you can still help them when they are over 18. I know many socially and professionally successful people with bipolar. |