Early Onset Bipolar Disorder in Children

[Anonymous]

I just want to write to say I'm sorry you're dealing with this issue, OP. You know your child best and should go with your gut. You are right to be concerned, given the family history and of course you want the best for your child.

Maybe it's time for a new pediatrician? At the very least, I would consult with a specialist for a more precise mental health evaluation. I hope you will get some answers and guidance on what steps to take. Peace to you.

[Anonymous]

Some resources on this website:

http://www.hbo.com/events/boyinterrupted/

[Anonymous]

Hi, licensed psychologist and Mom here...I just took this class for CEU's and thought it was excellent, and quite current. Perhaps it will be helpful to you (it's for practicioners, but the info is quite accessible):

http://www.crosscountryeducation.com/cce/product/showAudioDetails.do?expressCode=3048&productType=A&seminarCode=3048

"Cyclothymia" is considered a mild Bi-Polar Disorder (the up's aren't so up and the down's aren't so down, but it's more than the normal range).

Honest answer: If the genetics are going to unfold, there is nothing from a parenting perspective that can make it completely go away. But there is much you can do to lessen the impact.

With family hx of Bi-Polar, one of the best things you can do at age 7 is instill excellent, healthy SLEEP habits. Getting that neurology (the neurology of sleep) routinized will significantly lessen the behavioral impact (if it's coming). you cannot start early enough on this point, so start now.

Diet: Typical ADD type recommendations: watch the caffeine, sugar...make sure proteins are part of the day for sustained energy....in the teen years, careful that undiagnosed adolescent is not self-medicating the swings with booze/drugs. This is something you can prevent from happening.

Cardio-vascular exercise: Studies show that is one of the most effective behvioral way to slow the racing mind.

Seven ISs too young for a conclusive diagnosis. But seven is not too young to meet a great provider who can monitor, watch and be part of the team. Best time to start that is now, begin to develop that relationship in case you need it, and also nip things early.

Find a team that will not "pathologize" giftedeness (remember, hyperfocus and racing thoughts is also associated with high intelligence,not necessarily a symptom of Bi-Polar).

Hope this helps, and I wish you and your family great, good health always,

[Anonymous]

My aunt was bipolar and my dad I believe has low-level bipolar. When my aunt was not on her medication, it would be obvious to anyone that there was something wrong - she was depressive or manic with very little inbetween.

Neither of my aunt's two children are bipolar, so it is not inevitable. I believe that if you're looking for symptoms, you'll find them in some of your child's behavior - every child has those periods when they are more difficult, more manic, more introverted - but I agree with your doctor that the symptoms would probably be more ongoing and obvious. I would assume that everything is fine unless your child is in more obvious distress.

[Anonymous]

I skimmed the responses and I'm not sure if someone posted this already, but the PBS show Frontline did a facinating show on the topic of bipolar disorder and child, and the medications prescribed for it. It was facinating and if it had been two hours longer I would have watched it.


ttp://www.pbs.org/wgbh/pages/frontline/medicatedchild/

[Anonymous]

First of all, let me tell you how sorry I am that you have to go through this. You're really doing a great job in reaching out and trying to learn and do as much as you can. You're DS is lucky to have you. I've got three kids under the age of 8 with ADHD and SPD - all diagnosed within the last year. It's been quite a learning curve but what has really helped is learning as much as possible about the disorders and particularly how it manifests in my kids. We've got therapists and medical providers which have been great. What's also been helpful are the studies we've participated at through NIH and NIMH - at no cost to us. I did a quick look at the NIMH website and found the following which might be helpful

Studies of Brain Function and Course of Illness in Pediatric Bipolar Disorder (Location: Bethesda)
http://www.clinicaltrials.gov/show/NCT00025935

In order to conduct their study, NIMH must assess each participant which means you'll have a group of professionals skilled at making this type of diagnosis looking at your child. The studies that we've participated in have really helped us learn more about our kids. Typically, the administer a variety of tests and assessments in order to arrive at the most accurate diagnosis. Their goal when doing the evaluations is to screen for the type of subject their looking for. They want the results to be as accurate as possible so their results of their research are valid. In every case, we were provided a written report with results of individual tests, interpretation of the results and recommendations. They've also been fantastic resources and have helped us find neurodevelopmental pediatricians, psychologists and areas to target therapy. They've also worked really well with our kids.

Good luck, OP.

[Anonymous]

Thank you so much everyone! I can't tell you how much better I feel having all these resources to look into!

[Anonymous]

Anonymous wrote:

Anonymous wrote:
I guess I look at BP in kids like a learning disability in a way, maybe like ADD. The degree will vary and thus the need for medication, but the child will also benefit by explicit adaptations in terms of behavior/social/personal management (like you mentioned learning to defuse the tantrums). Note, I don't mean to suggest by this outlook that therapy or parental management can serve as a substitute for medication for many kids with BP, I'm just trying to say that when they're young, and the dysfunction isn't so bad that maybe meds should be a later resort.

I don't think it would ever hurt to consult a pdoc who has extensive experience treating BP in kids and who is open to prescribing meds AND therapy, to see how your kids are doing, how your family is doing, and what might make things go better. Family-focused therapy and Interpersonal Social Rhythm therapy are two therapies for BP that have been clinically shown to improve outcomes, and I think probably offer some concepts that apply to mitigating risk (learn to deal with conflict calmly, keep regular social rhythms, maintain sleep patterns/quantity, etc.)

good luck.

Thanks PP -- I think a lot like you do! I had never heard of Interpersonal Social Rhythm therapy.

You can google both Family-Focused Therapy (FFT) which was developed by David Miklowitz at the University of Colorado at Boulder. Also read about IPSRT which was pioneered by Ellen Frank at the University of Pittsburgh. Each of them has written books which cover their theories. Although neither is an easy read, I found they both offered good food for thought about interpersonal aspects of my relationship with by bipolar ex and our family dynamics.

[Anonymous]

OP again.

THis is the kind of thing that just has me wondering:

Last night around bed it was sooo hard for my son to fall asleep. He usually goes to bed at 8 but last night he just coudln't fall asleep. He was talking a lot, about everything, and kept saying he just wasn't tired. OK, that's normal, kids go through these things. So I sat on his bed with him, rubbed his back a little, and asked him what he was thinking about.

He said, It's like my brain has one of those TVs that is split into four screens and there's a picture in each corner. And they are moving, I can watch them all at the same time.

??

He finally fell asleep, around 9:30. He didn't seem to bugged about having 4 different movie - thoughts going at the same time.

It's not that I think not being able to fall asleep until 9:30 is some pathological sign of anything -- it just seems a bit... weird... to describe your thoughts as being 4 different movies that are all running ... simultaneously....

[Anonymous]

well, maybe your son is just particularly perceptive and articulate? i am not suggesting that there is not something going on with him. but when they say things like that, i can't help but wonder if they aren't just describing consciousness or cognition in a way that adults don't because it has been normed for us.

i should say that i have a very very challenging 4 yo and after two years of competing opinions (ADHD, SPD, no diagnosis) i am starting to wonder if her behvarior, since it cannot generate consensus among many well qualified experts, is what mental illness looks like in a child.

[Anonymous]

Anonymous wrote:OP again.

THis is the kind of thing that just has me wondering:

Last night around bed it was sooo hard for my son to fall asleep. He usually goes to bed at 8 but last night he just coudln't fall asleep. He was talking a lot, about everything, and kept saying he just wasn't tired. OK, that's normal, kids go through these things. So I sat on his bed with him, rubbed his back a little, and asked him what he was thinking about.

He said, It's like my brain has one of those TVs that is split into four screens and there's a picture in each corner. And they are moving, I can watch them all at the same time.

??

He finally fell asleep, around 9:30. He didn't seem to bugged about having 4 different movie - thoughts going at the same time.

It's not that I think not being able to fall asleep until 9:30 is some pathological sign of anything -- it just seems a bit... weird... to describe your thoughts as being 4 different movies that are all running ... simultaneously....

Having trouble falling asleep is a classic bipolar symptom at any age, although it can be a symptom of other things as well. Of course, I don't mean just once or difficulty falling asleep in the evening because the child had an accidental nap in the afternoon, etc. Also the description of different tracks going at once in the head is something I've heard my own bipolar ex-husband use to describe his own hypomania. He describes always hearing music in the background.

If I were you, I'd start by keeping a journal of "symptoms" so that if you decide that things warrant seeing a psychiatrist you have a concrete record of what's been going on over a period of time, while at the same time focusing on stabilizing bed time routines, and improving routines to maximize good sleep, etc. You can get some ideas of what to track by looking a book called the "bipolar disorder survival guide" by David Miklowitz on managing adult bipolar symptoms (sleep, mood, irritability, physical restlessness, meds taken, etc.) Also, have you read "the bipolar child" by papadapolos? It's a classic in the field and very readable.

[Anonymous]

Hi, My son is almost 14 and we had started having issues with him since he was about 18 mos.. We looked back at this once he started pre- K and I had asked the teacher to evaluate him to see if she saw any areas of concern. She had 14 yrs. experience in that field. Within a week, she she called me in and gave me the name of a MSW with Smart Start(another program that the government cut. At 5 he started to see a psychiatrist. After much thought and research he was started on meds. Thus started a 10 yr. trial and error with a combination that we still haven't found. My son does have violent and explosive episodes primarily toward me, his mom. We have seen psychiatrist after psychiatrist. Several years ago he was diagnosed with bi-polar along with the diagnosis of ADHD and ODD that he's had since the beginning. I'm a Peds. nurse also, and after living with him, I totally agree with the Drs. on the Bi-Polar diagnosis. He is such a wonderful, smart,caring and funny child until that switch goes on and then life can be hell. I have been bitten, hit kicked. Have had scissors and knifes held up toward me. then after he calms down he just cries and cries because of what he has done. I have so many letters he has written telling me how sorry he is and how much he loves me. I take every chance to tell how much I love him, too and I do love him more than I could ever explain like most of you but it got to the point that after 5 hospitalizations, we realised that he needed much more. The school system that we are in went above and beyond to help him but in the end they told us that they were unable to meet his needs. He was too disruptive in all the classes he was in even with the whole staff working to make it possible. He has spent the last two yrs. in a therapeutic wilderness camp and graduated this July. He spent 3 and 1/2 weeks at home on 3 world wind vacations and did fairly well. Then he started a transitional school the end of August and because of his disruptive and violent behavior, is going to be dispelled from this school probably this coming Tuesday. We were so thankfully that his grandparents are well off because the wilderness camp was around 65,000 a YEAR! This new school is 20,000/yr but with NO refund so if he is released they will spend all that money for 1 and 1/2 months. We have a school consultant who has worked with us the whole time but even she is running out of options for us. We have no idea where to go from here. I am trying to find a specialist here in North Carolina that deals specifically with kids that have early-onset bi-polar. Most of the doctors I have checked on, aren't taking new patients and it may be a 4-6 month wait or longer. We have a crisis now so what do? I have no idea! After the grandparents have spent so much money so far they are all tapped out. I'm on disability and his dad is self-employed. What do parents that don't have the funds do when they need this kind of help for their children? We all know that there is enough population of these children that need more extreme help than anyone has to offer. It's a shame that there is not more help for parents and children in our situation! After 10 years of therapy for the 3 of us that we are in a more difficult situation now then we ever were. Thanks for the names of some of the specialists but, if any one knows of someone closer to us, we would greatly appreciate your help!