BiPolar, Mood Disorder, or what?

[eaccae]

Reg - I agree - at the very least I would find a new psychiatrist. Again - I have heard nothing but wonderful things about the AMEN clinic. If I could afford it and it were near enough for me to visit - I would be there in a hearbeat. But the idea of waiting and seeing what a new psychiatrist has to say is a good idea too! Sometimes though - you have to folow your gut! When I was younger my parents took me to several different psychiatrists (due to depression and other things) - it took 5 for us to find one that worked. Everyone of them pointed to my being adopted as the root of my problems. Well - my being adopted - good Lord - we all forgot I was adopted in my family - this was a non issue for us - but all the psychiatrists could see was that I was adopted (except one). (By the way my being adopted had NOTHING to do with any of my issues). I guess my point is that just because they are a psychiatrist doesn't make them right! Anyway - good luck and let us know what you have decided!

[reg]

Ohmama, Ansmom and Eaccae, thank you all for your advice and hug, I really needed both

Ohmama, I do think that the Amen clinic would truly be what is best for my son. I'm just not sure how to come up with the money and how to get through 4+ days with him unmedicated and having to travel. I should also mention that I also have an 11 year old son with ADHD who is doing pretty well at the moment, but he had a rough school year last year. I would feel guilty taking one child to the Amen Clinic and not taking them both. Did I read that your son is on Depakote now? If Depakote helps with ADHD behavior and Bipolar disorder, I am wondering why patients that have some symptoms that could be attributed to ADHD &/or Bipolar not be treated with Depakote?

I think I will wait for the results of the EEG first. Maybe that will help to give us some idea of what is very going on.

I hope you all have a nice peaceful weekend!

[ohmama]

It is always difficult to make these decisions. With my twins, I could not afford to take both of them to the clinic. I took the one who needed it most. The other will have a crack at it in another year or so when my credit card is paid off from the first visit. I'm glad I have really good credit and can get a deal with no interest for a year!

Depakote is used for mood disorders to stabilize the temporal lobes. It is also used often for seizure activity as in epilepsy. There are so many meds out there so it all depends on what your doctor is most familiar with. I found that many of them will focus on the adhd and not on the overlapping conditions such as temper and mood disturbances. To some extent the mood and temper goes hand and hand with the adhd and the current check lists that are used don't seperate this as another disorder. One that requires treatment first with something like a mood stabilizer. It wasn't untill I read Dr. Amens books that I realized why you needed to do this.

With our family there is a history of bipolar and temporal lobe difficulty that goes back 3 generations. Once I saw on his scans how inflamed that area of the brain was I understood that this needed to be taken care of before the adhd could be addressed. Even though I am not the bio mother I am in the family and lucky that I knew this background information. It was part of the puzzle that could not be missing if we were to get the right treatment.

I was very impressed with the diagnosis process at the clinic. There were hours spent just on taking the history of the family. This was gone over carefully with me by the historian after I filled out many pages of questions in advance. There were computer tests they gave my boy along with personal interviews for him and me. Then the scans and finally the results and final meeting with the chief of psychiatry on the 3rd day. It felt like I was given royal treatment. My wild "fire boy" loved all the attention. He was the star! I was amazed at how good he behaved but I guess it's not hard when you are being given all that attention.

Yesterday I went with my sister to see her kids doctor. These are the twin siblings of my boys. Hers are 12 yrs old and very adhd with many overlapping disorders. We are certain they also are afflicted with temporal lobe disorders, even more apparent than mine are. They are very violent and explosive.

The psychiatrist just called it adhd after a 15 min look at the check list. This is a new doctor, 1st visit. She had the chart in front of her from the previous doctor who was on the right track and had prescribed the Depakote. This good doctor left the area and the new one took over. These children are already on Depakote but their blood level is only at 73. A blood level of 80 or 90 is more appropriate for therapeutic treatment of what they are dealing with. The new doctor did not address that. She wanted them to take Strattera. When my sister told her they already tried this she wanted them to do it again.

When I questioned her judgement on the benefit of using this med a second time since they had an obvious temporal lobe history she became very hostile. She had to put it off for another appointment in two weeks when she had more time to go over the family history with us. She really didn't like it that my sister and I questioned her. She was someone who I thought needed a psychiatrist and medication herself.

[reg]

Don't you just hate it when Doctors won't listen to you? Afterall, we live with these children and know their behavior better than they ever possibly could. A good Doctor is one that understands that we have been paying attention to the subtle changes in our kids since they were born. They need to give us credit for reading up on the conditions and knowing what we are talking about. I try to read everything I can on the subject, each time hoping that I will find something new that will "fix" all their difficulties. Maybe someday!

[reg]

Ohmama,
I was just wondering what your child's official dx was? Is he considered ADHD with Bipolar disorder? I'm wondering since the Concerta has always been really effective for my son, but the Strattera seems to also help with the rest of the day and evening when the Concerta has worn off, he is much more even on both meds. Maybe Depakote with the Concerta might be even more effective. Do you know if these two meds are ever prescribed together? While I still don't believe my son has Bipolar, I can see that there are a couple of his behaviors that would cause concern. He can come off as a "know it all" at times, and he has really curly hair that he keeps pretty long(looks a little like Justin's for American Idol a couple of years ago, note--some of the girls have told him they like it), his counsellor used his hair as another reason he suspected bipolar. A lot of his friends also have their own behavior problems and my son worries about them and tries help them. Maybe he gets too involved. I was just wondering if Depakote would even help these kind of problems.

From our earlier posts--I understand what you said about helping the child first that needs it the most as far as the Amen Clinic goes .But my youngest ADHD child is almost twelve and can be a little jealous of the older brother and I want to be very careful that he doesn't get the idea we care more about the older. Our credit is good also, but our insurance is not. We have to pay 50% of all medications and insurance only pays $20.00 each time either boy goes to the Neurologist or for Counselling. It adds up to over$500.00 a month that we must pay out of pocket, plus they keep raising the amount we must pay each month for the insurance itself, currently $250.00 a month out of my pay. Sorry I did not mean to whine, just explain.

[ohmama]

My boys dx was Ring of Fire adhd. That also includes an anxiety disorder. Ring of Fire, to sum it all up means he has early onset bipolar, specifically what is affected is the temporal lobe area that is responsible for the mood and temper outbursts along with adhd, anxiety and a few more overlapping problems.

He should be able to take a small dose of a stim once we get his next Depakote blood level checked in 2 weeks. Maybe Concerta? The blood level tells us where he is at therapeutically so this can be added without him getting manic.

I think you should look at www.bpkids.com to get an idea of the symptoms of bipolar disorder. That counselor is nuts if he thinks he can attribute curly hair with a credible suspicion of having bipolar?? Very odd summation on his part!!

Your son sounds like a wonderful boy. The fact that he cares about others and wants to get involved shows he has great compassion. This is a rare and fine quality in a young person.

I don't think he has bipolar. I think he needs a new counselor as well as a new psychiatrist. Maybe he comes off as a know it all because he is in touch with his feelings and needs someone to recognize it?

Don't worry about the 12 yr old younger brother being jealous, it's very normal. He will get over it as he grows up and realizes some maturity. As you know you need to give each child the individual attention they need and not think too much about what the other one will think. They will take their signals from you.

[Amsmom]

reg,
Please get a new psychiatrist. I'm not a dr, but anyone who would describe a child's hair preference (no matter how wild or unruly) as bipolar, is frighteningly misinformed. Please check the site ohmama referred you to. I think you will see that your child does not meet the criteria.

[reg]

Hello Ohmama and Ansmom,

I did check out the BP site that Ohmama referred me to and I took the Parent Version of the Young Mania Rating Scale, the score I came up with is-0. The instructions said to base answers on his PRESENT behavior, he is actually doing better now than ever before, but even if it had been based on his behavior when he was having more problems-it would have been a 12 at that point. The instructions said anything beyond 13 could be a potential case for mania or hypomania, but I also don't think this test takes into account a patient that is ADHD. So I'm going to hold out until after the EEG to see what those results show us.

This counsellor was the first one to ever suspect that my son has BP. I have told him from the very start that I do not agree with this dx. Whatever he said to the Neurologist is what caused him to want my son to have another evaluation. The Neurologist said that maybe it is a mild case or it is just starting. My opinion that his behavior is the same as it has always been, if not improved. I questioned the counsellor about this dx for about 30 minutes during my son's last session. He said that my son has rapid speech with "flight of ideas", grandiose behavior "know it all", "wild hair" and has some risk taking behavior, (getting himself involved in problem situations) I explained that I tend to speak rapidly and that my son knows that his sessions are only an hour long. My son wants to cover everything while he is there. Plus I think my son generally likes talking his problems out with this counsellor. The counsellor is young and I think my son feels comfortable talking to him. I am afraid if I ask to switch to someone new, my son might not respond well. The hair is just his way of saying I am going to be what I am and if people don't like it--too bad. He does not feel a great deal of peer pressure to be like everyone else, he likes being different. This relieves me. His risk taking behavior is generally from speaking his mind-no matter what, he has gotten involved in fights because of this, he has also gone as far as to call the parent of a girl he thought was in danger of hurting herself to let the parent know what this girl was doing. I guess that is my main concern right now, a few of his friends have serious problems and they call him and tell him about them. He then feels like he is responsible for helping them. This scares me. I think his counsellor feels that this is an example of grandiose behavior-in thinking he can always help them. He doesn't have a great many friends, so I think he truly treasures the ones that he does have. Sorry to ramble on, I just wanted to be more complete in my description of my son. I REALLY appreciate all of your help with this. I hope things are going well for you both. ;D

[lisle]

Hi, Reg:
I am trying to figure out this confusing diagnosis also. One thing said to me by the author of the BP Child is that oversexualized behavior, including excessive cursing, provocative posturing, talking about sex a lot, inappropriate touching, etc is not part of adhd and is part of bpolar kids. That and grandiosity are the hallmarks that distinguish the two dx's. However 80 percent of kids with bipolar have adhd, so go figure.
Still if they are not bp they don't have grandiosity and hypersexuality. I find grandiosity hard to grasp unless it's really psycho like thinking you are able to fly. I read in an article that a child who thinks he can teach the class better than the teacher and tells her what she should do is grandiose or one who calls the prinicpal and says the teacher should be fired is grandiose. These kids don't look at their status as kids as any different from the status of adults. They think they know just as much and can tell adults what to do. Does that help? lisle

[reg]

Thanks Lisle, what you write helps somewhat. My son does not curse alot. I don't think that he talks or acts on sexual matters any more than any other teenage boy, (or at least not what I see, and he is actually very open with me most of the time). As for the grandiose behavior, he does not think he has super powers. But one thing that might apply to him is the fact that he acts the same way around authority figures as he does around his peers. There have been times in past years when he thought that the teacher gave "stupid" homework assignments and just refused to do them. It was not that he thought he could teach the class or anything. He just decided certain assignments were not teaching him anything, and if he knew the material, he should not have to do the homework, and the truth was that he would generally get A's on the tests. The failure to do homework was what brought his grades down. I think part of what is coming off as grandiose behavior may just be his way of protecting his self-esteem. He has been teased and thought of as wierd by many kids due to his behavior in the past. We have always tried to build him up by talking about his strengths, his intelligence and other talents. My question is even if he did have some of these symptoms of hypersexuality and grandiose behavior, would the dx of BP and BP meds stop these behaviors?

I hope things go well for you and your child. I really appreciate your taking the time to help me.

[Sorka]

Reg,
Hey if he drives ya crazy send him over to my place! I'll give you a break!!

As far as psyc's go.. there is one in Akron that does an adult add support group. I don't know if he works with teens but it might be worth a shot. Let me know and I will send his name and number.

Being local to you mabye we can come up with some sources to help you out.

Also there is a CHADD chapter starting in Stark County it looks like there is going to be a meeting in Sept.

Good to see you back!
Denise

[reg]

Hello Denise.

Thank you ;D for your offer to help. I am just taking things slowly at this point. Maybe the EEG on Thursday will give us some idea. He is actually doing great right now. Exercise helps him a great deal and he is getting plenty because Marching Band, football and soccer have all started for him. It is a juggling act to get him and his younger brother where they need to be, but I'm glad to do it if it helps them.

I hope things are going well for you and your family. Have a great weekend!

[Sorka]

Ok you know things are looking pretty grim ..heheheh.. you have two boys.. and all that soccer, and football an marching banc etc... I have THREE boys and a girl!!! WHat was I Thinking!!!!!!!! hehehehe

Hey mabye I can borrow your boys some time to help me with 'gym' class for our homeschooling!!!! I think I am going to get together some soccer dates with a couple of other families.

I hope that EEG goes well, Do you take him to Children's?
Denise

[lisle]

Hi, Reg:
How are things going? Yes, bp meds should help with those symptoms. The trick is finding the right mix, as always and avoiding side effects. We have tried a few and had many bad effects, unfortunately. I think that your son's attitude towards his teacher's assignments is a bit grandiose. My son is exactly the same. He thinks he has the right to control his own life completely and haates school because he feels so "controlled." In fact, he had an explosive episode yesterday relating to that.
He will ask us for permission to do things and eventually accept consequences for his behavior but at the same time he feels we don't have the right to tell him what to do or what he can't do, that he can do what he wants and "nobody cares." That's one of his favorite comments
I don't think he has a clue how people perceive him, actually. He acts kind of thingyy and has a hard time admitting he doesn't know something. How about your son?
lisle

[reg]

Just an update on the question of the BP dx for my son. He had his EEG last month, no seizures were found. He is actually doing very well right now. He is keeping up with his homework and his grades are pretty good right now--so far. One thing that is helping is the fact that he has what they call block classes--each class lasts 2 periods a day but is only a semester long instead of the full school year. This means instead of 7 or 8 classes to remember the details of the assignments-he only has 4. This is MUCH better for him, especially since he has so much going on right now with football, soccer and band. As luck would have it, the counsellor he was seeing needed to change his appointment to another night--just not possible with my son's schedule--so we have not been back there for a few weeks. I think it is for the best to end the counselling--at least with this particular one. His neurologist did not insist on my son getting another opinion either at this point, but did give me a name of a psychiatrist that he trusts in case we need it. I know what to look for, and if I see he is getting depressed and more grandiose in the future, I will make the appointment. I really appreciate all of the advise that you all have given me. It really helped alot---thank you all SO MUCH