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I think he may be reverting?
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<blockquote data-quote="susiestar" data-source="post: 517851" data-attributes="member: 1233"><p>I read this and what you postedd on lanelly's thread. Given the bipolar diagnosis, have you read The Bipolar Child? It is an awesome book, though parts are a bit technical. </p><p></p><p>Your son is only on abilify, an atypical antipsychotic. That probably is NOT going to control his moods, though it may help. In the book there is a medication protocol that is approved by the board of child and adolescent psychiatrists as the best way to treat a bipolar patient. Bipolar is a chemical problem in the brain and all the non-medicine therapies in the world are NOT going to be enough on their own. None of us want to medicate our kids, but this is a physical problem (chemicals not in the right balance) and it needs a physical solution so that the other therapies can have a real chance to work. </p><p></p><p>This medication protocol says to use a mood stabilizer and an antipsychotic together until the moods are stable. It is a LONG process, months not weeks, to know if a medication will work. Most need to be in the blood at the therapeutic level for 6 weeks before you know how well they will work. This is AFTER you titrate up from the starting dose to the therapeutic dose, and it is very hard. But it is also the BEST way to help him. Once the moods are stable, you can then treat any remaining problems. Often other problems like adhd, anxiety, etc... go away when the main problem is resolved. You should NEVER allow a doctor to start an antidepressant or stimulant unless he is already stable mood wise on the mood stab and a/p medications. You may even have to use 2 mood stabs to get the moods to be stable.</p><p></p><p>I have NO idea why, but it seems that MOST psychiatrists do NOT watn to follow this. They want to put a person on ssri antidepressants to treat bipolar and these are PROVEN to cause mood cycling in epople with bipolar AND in some, esp kids, who do not have bipolar. in my opinion it is a crazy choice to start with, and I have yet to have a psychiatrist give me an answer why they would do this. Each time we saw a new psychiatrist with my son (due to insurance changes, schedule problems, etc...), the new doctor would try to diagnosis Wiz with bipolar and put him on just an antidepressant. When I pulled out the book and the medication protocol (I had the book because for a while there was a question of if Wiz was or was not bipolar, settled long before we saw these docs) and said that if we were going with that diagnosis then we had to follow this, each doctor said that on second thought it probably wasn't bipolar. I am NOT saying yoru child isn't bipolar, I am saying that the docs couldn't explain WHY they would go against the medication protocol recommended by the board that certified them that was based on scientific evidence that it worked. </p><p></p><p>What I am saying is to ask the psychiatrist if a mood stabilizer is an option, and why it isn't if he says no. It really is needed if your child is bipolar (it is hard to diagnosis kids and most of us have seen the diagnosis change over the years as our kids grew and new things emerged). At the very least the psychiatrist should be able to tell you why a mood stab is not appropriate at this time. Make sure you have the medication protocol with you when you discuss it, because it makes things easier.</p><p></p><p>On the topic of good days, have you considered that maybe he is better on the strict days because the routine is more set, and he has little change from day to day? Many of our kids do MUCH better with a strict routine and little divergence from it. Not as much fun for the rest of us, and even for them it isn't as "fun" but it doesn't have as much anxiety or as many things that they don't cope wth well. got a LOT of heat from family and other parents and teachers for not having my kids in every activity, for insisting on a set night for family time, on keepng a schedule and not changing it just because some coach had a meeting and wanted to have practice at a different time with no notice. When we changed with all those things, the kids didn't know what to expect and it caused a lot of problems. When i kept to a routine, things just went better. The kids knew what happened when, what the rules were, and t was a lot easier for them. </p><p></p><p>It is just a thought.</p></blockquote><p></p>
[QUOTE="susiestar, post: 517851, member: 1233"] I read this and what you postedd on lanelly's thread. Given the bipolar diagnosis, have you read The Bipolar Child? It is an awesome book, though parts are a bit technical. Your son is only on abilify, an atypical antipsychotic. That probably is NOT going to control his moods, though it may help. In the book there is a medication protocol that is approved by the board of child and adolescent psychiatrists as the best way to treat a bipolar patient. Bipolar is a chemical problem in the brain and all the non-medicine therapies in the world are NOT going to be enough on their own. None of us want to medicate our kids, but this is a physical problem (chemicals not in the right balance) and it needs a physical solution so that the other therapies can have a real chance to work. This medication protocol says to use a mood stabilizer and an antipsychotic together until the moods are stable. It is a LONG process, months not weeks, to know if a medication will work. Most need to be in the blood at the therapeutic level for 6 weeks before you know how well they will work. This is AFTER you titrate up from the starting dose to the therapeutic dose, and it is very hard. But it is also the BEST way to help him. Once the moods are stable, you can then treat any remaining problems. Often other problems like adhd, anxiety, etc... go away when the main problem is resolved. You should NEVER allow a doctor to start an antidepressant or stimulant unless he is already stable mood wise on the mood stab and a/p medications. You may even have to use 2 mood stabs to get the moods to be stable. I have NO idea why, but it seems that MOST psychiatrists do NOT watn to follow this. They want to put a person on ssri antidepressants to treat bipolar and these are PROVEN to cause mood cycling in epople with bipolar AND in some, esp kids, who do not have bipolar. in my opinion it is a crazy choice to start with, and I have yet to have a psychiatrist give me an answer why they would do this. Each time we saw a new psychiatrist with my son (due to insurance changes, schedule problems, etc...), the new doctor would try to diagnosis Wiz with bipolar and put him on just an antidepressant. When I pulled out the book and the medication protocol (I had the book because for a while there was a question of if Wiz was or was not bipolar, settled long before we saw these docs) and said that if we were going with that diagnosis then we had to follow this, each doctor said that on second thought it probably wasn't bipolar. I am NOT saying yoru child isn't bipolar, I am saying that the docs couldn't explain WHY they would go against the medication protocol recommended by the board that certified them that was based on scientific evidence that it worked. What I am saying is to ask the psychiatrist if a mood stabilizer is an option, and why it isn't if he says no. It really is needed if your child is bipolar (it is hard to diagnosis kids and most of us have seen the diagnosis change over the years as our kids grew and new things emerged). At the very least the psychiatrist should be able to tell you why a mood stab is not appropriate at this time. Make sure you have the medication protocol with you when you discuss it, because it makes things easier. On the topic of good days, have you considered that maybe he is better on the strict days because the routine is more set, and he has little change from day to day? Many of our kids do MUCH better with a strict routine and little divergence from it. Not as much fun for the rest of us, and even for them it isn't as "fun" but it doesn't have as much anxiety or as many things that they don't cope wth well. got a LOT of heat from family and other parents and teachers for not having my kids in every activity, for insisting on a set night for family time, on keepng a schedule and not changing it just because some coach had a meeting and wanted to have practice at a different time with no notice. When we changed with all those things, the kids didn't know what to expect and it caused a lot of problems. When i kept to a routine, things just went better. The kids knew what happened when, what the rules were, and t was a lot easier for them. It is just a thought. [/QUOTE]
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