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General Parenting
In BiPolar (BP) diagnosis, do you have to have sleep issues?
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<blockquote data-quote="rlsnights" data-source="post: 320456" data-attributes="member: 7948"><p>You need to get your hands on the book <u>Survival Strategies for Parenting Children with Bipolar Disorder</u> by George Lynn. You can order through the CD website (see bookstore) which links to Amazon. Or see if it's at your library.</p><p></p><p>He thoroughly discusses what it looks like (in his experience) when a child has stand-alone BiPolar (BP), BiPolar (BP) with Autism Spectrum Disorders (ASD) and BiPolar (BP) with Tourettes.</p><p></p><p>After you've read this you will be much clearer about whether your kiddo is experiencing anxiety related to the Autism Spectrum Disorders (ASD) or the added issues of BiPolar (BP). There is a high percentage of dual diagnosis of Autism Spectrum Disorders (ASD) and BiPolar (BP) so you may be right about your child's mood swings.</p><p></p><p>I would also strongly suggest that you start a mood chart/diary. I have my own Excel chart tailored to the things that are issues with my son. You could do the same or you can find lots of them online. If your son does stimming or has rituals, etc you could put them in instead of suicidal behavior/speech for example. If you do your own chart it's a good idea to keep everything either Y/N or on the same scale. I picked 6 just because it felt right to me. Gave me enough room to show differences in mood without giving to wide a range from top to bottom.</p><p></p><p>I chart the following things daily:</p><p>Upper mood limit (on a 6 pt plus scale)</p><p>Lower mood limit (on a 6 pt minus scale)</p><p>irritability (6 pt scale)</p><p>anxiety (6 pt scale)</p><p>impulsivity (6 pt scale)</p><p># hours sleep per night</p><p>suicidal thoughts or actions (Y/N)</p><p># hours sleep during day</p><p>attended school (Y/N)</p><p>Sick (Y/N)</p><p>medications - I list each medication he usually takes and the dose plus Benadryl which we sometimes use to help him sleep. I code each day's medications as X if he took it, R if he refused, and X2 if he took 2 doses in one day because he was catching up after refusing the day before. If the dose changes I put the new dose in the cell so that I know the date that we changed the dose. I add new medications as they come along.</p><p></p><p>I chart both up and down moods daily since my son often has mixed moods with both the activation of hypomania and the agitation of hopeless depression together. </p><p></p><p>I also keep a narrative diary with special emphasis on changes in behavior and unusual stuff like illnesses, stressors like deaths or health problems in friends/family, big changes to his routine. When he is having a bad streak with big rages, etc. I make very detailed notes if I have the time. You can make it really short too and you don't have to write every day as long as you at least do the numbers and note the medications.</p><p></p><p>For my purposes, the numbers on the mood scale represent:</p><p></p><p> +6 Activated severe; unable to work; hospitalized</p><p> +5 Act mod/severe impairment </p><p> +4 Act Mod sig impairment/able to work</p><p> +3 Act mild/mod impairment</p><p> +2 Act mild no sig impairment</p><p> +1 Upper normal</p><p> 0 Normal</p><p> -1 Low normal</p><p> -2 Dep mild no sig impairment</p><p> -3 Dep mild/mod impairment</p><p> -4 Dep mod sig impairment </p><p> -5 Dep mod/severe impairment</p><p> -6 Depressed severe; unable to work; hospitalized</p><p></p><p>My son rarely shows "traditional" signs of mania. Instead he gets what I call activated - intense, hyperfocused (mission mode), agitated, angry, anxious.</p><p></p><p>I will tell you that difficult child 2's therapist, psychiatrist and I have all really found this helpful. It keeps the professionals up to date quickly and easily since I can send them the info electronically. They can print it out for his records if they want it. I can take the data and put it into a graph and show his mood shifts over the course of weeks and months if I want to.</p><p></p><p>My difficult child 2 almost always sleeps easily and hard except for talking in his sleep a lot. I didn't think there was any real variation in his sleep patterns until I started religiously charting his sleep. Now I know that when he's trending manic he only sleeps 8 to 9 hours a night. When he's trending depressed he sleeps 11 to 12 hours (if his school schedule permits). That amounts to a change of up to 4 hours a day in the amount of sleep. It's not the same as in adults where there can be a very big reduction in sleep but it's still a significant difference from the psychiatrist's perspective.</p><p></p><p>That's one of the things that a really experienced child psychiatrist knows - early onset BiPolar (BP) does NOT look like adult onset BiPolar (BP). Getting yourself more familiar with the features of early onset BiPolar (BP) will help you get a handle on whether your child is showing signs of BiPolar (BP) or not.</p><p></p><p>If you get the book I suggested it will give you a good start on getting the info you need about BiPolar (BP). There are many other good ones but I would start with this one if it were me.</p></blockquote><p></p>
[QUOTE="rlsnights, post: 320456, member: 7948"] You need to get your hands on the book [U]Survival Strategies for Parenting Children with Bipolar Disorder[/U] by George Lynn. You can order through the CD website (see bookstore) which links to Amazon. Or see if it's at your library. He thoroughly discusses what it looks like (in his experience) when a child has stand-alone BiPolar (BP), BiPolar (BP) with Autism Spectrum Disorders (ASD) and BiPolar (BP) with Tourettes. After you've read this you will be much clearer about whether your kiddo is experiencing anxiety related to the Autism Spectrum Disorders (ASD) or the added issues of BiPolar (BP). There is a high percentage of dual diagnosis of Autism Spectrum Disorders (ASD) and BiPolar (BP) so you may be right about your child's mood swings. I would also strongly suggest that you start a mood chart/diary. I have my own Excel chart tailored to the things that are issues with my son. You could do the same or you can find lots of them online. If your son does stimming or has rituals, etc you could put them in instead of suicidal behavior/speech for example. If you do your own chart it's a good idea to keep everything either Y/N or on the same scale. I picked 6 just because it felt right to me. Gave me enough room to show differences in mood without giving to wide a range from top to bottom. I chart the following things daily: Upper mood limit (on a 6 pt plus scale) Lower mood limit (on a 6 pt minus scale) irritability (6 pt scale) anxiety (6 pt scale) impulsivity (6 pt scale) # hours sleep per night suicidal thoughts or actions (Y/N) # hours sleep during day attended school (Y/N) Sick (Y/N) medications - I list each medication he usually takes and the dose plus Benadryl which we sometimes use to help him sleep. I code each day's medications as X if he took it, R if he refused, and X2 if he took 2 doses in one day because he was catching up after refusing the day before. If the dose changes I put the new dose in the cell so that I know the date that we changed the dose. I add new medications as they come along. I chart both up and down moods daily since my son often has mixed moods with both the activation of hypomania and the agitation of hopeless depression together. I also keep a narrative diary with special emphasis on changes in behavior and unusual stuff like illnesses, stressors like deaths or health problems in friends/family, big changes to his routine. When he is having a bad streak with big rages, etc. I make very detailed notes if I have the time. You can make it really short too and you don't have to write every day as long as you at least do the numbers and note the medications. For my purposes, the numbers on the mood scale represent: +6 Activated severe; unable to work; hospitalized +5 Act mod/severe impairment +4 Act Mod sig impairment/able to work +3 Act mild/mod impairment +2 Act mild no sig impairment +1 Upper normal 0 Normal -1 Low normal -2 Dep mild no sig impairment -3 Dep mild/mod impairment -4 Dep mod sig impairment -5 Dep mod/severe impairment -6 Depressed severe; unable to work; hospitalized My son rarely shows "traditional" signs of mania. Instead he gets what I call activated - intense, hyperfocused (mission mode), agitated, angry, anxious. I will tell you that difficult child 2's therapist, psychiatrist and I have all really found this helpful. It keeps the professionals up to date quickly and easily since I can send them the info electronically. They can print it out for his records if they want it. I can take the data and put it into a graph and show his mood shifts over the course of weeks and months if I want to. My difficult child 2 almost always sleeps easily and hard except for talking in his sleep a lot. I didn't think there was any real variation in his sleep patterns until I started religiously charting his sleep. Now I know that when he's trending manic he only sleeps 8 to 9 hours a night. When he's trending depressed he sleeps 11 to 12 hours (if his school schedule permits). That amounts to a change of up to 4 hours a day in the amount of sleep. It's not the same as in adults where there can be a very big reduction in sleep but it's still a significant difference from the psychiatrist's perspective. That's one of the things that a really experienced child psychiatrist knows - early onset BiPolar (BP) does NOT look like adult onset BiPolar (BP). Getting yourself more familiar with the features of early onset BiPolar (BP) will help you get a handle on whether your child is showing signs of BiPolar (BP) or not. If you get the book I suggested it will give you a good start on getting the info you need about BiPolar (BP). There are many other good ones but I would start with this one if it were me. [/QUOTE]
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In BiPolar (BP) diagnosis, do you have to have sleep issues?
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