question for experienced parents

Discussion in 'Parent Emeritus' started by klmno, Apr 29, 2007.

  1. klmno

    klmno Active Member

    i hope i'm not posting this in wrong place, but i'd like some input from parents of older difficult child's. my son is 12 and was diagnosed with depression and disruptive conduct not otherwise specified last winter/spring. now psychiatrist says it sounds like he might have some manic episodes so changed medications from prozac to mood stabilizer. i'm trying to get him in for an inpatient evaluation because i'm not sure of anything anymore. does this necessarily mean he's bipolar for the rest of his life? if it is a chemical imbalance causing mood issues, does that necessarily mean bipolar and if the kid is 12, is there a possibility that balance can return naturally after puberty is over? sometimes if a kid ends up with multiple diagnosis, can that mean docs really don't know? i know- i'm grasping at straws to hold onto hope that things won't just get worse for the rest of his life- :smile:
  2. DDD

    DDD Well-Known Member

    Hey! Welcome aboard.

    Perhaps you will get a more definite answer from some other CD
    family membrs. My response is rather generic. Personally I don't worry about which "letters" a difficult child has so long as the difficult child
    can be stabilized and function in society appropriately. on the other hand,
    can things change later on??? Sure can!

    Try not to worry too much about "what ifs". Try to live in the
    current times and use your energy to support your child as he faces life in 2007. I know it is hard but from many many years
    experience, I can promise you that it is best to not waste your
    energy on possibilities....either high or low. Just make sure you have the best psychiatrist for adolescents that you can find. Hugs.
  3. smallworld

    smallworld Moderator

    Welcome! I'm glad you found us.

    My difficult child 1 is not much older than yours -- and I don't usually frequent the PE board -- but your post caught my eye. You've asked the million-dollar question. My difficult child 1, who is primarily anxious and depressed, has had manic reactions to the antidepressants Prozac, Zoloft and Effexor XR and a depressive reaction to the SSRI Celexa. Does that a bipolar diagnosis make? We've consulted a fair number of psychiatrists, and they have not given us a definitive answer because quite frankly, they don't know. difficult child 1 is currently being treated with the mood stabilizer Lamictal (we're in the process of weaning him from the mood stabilizer Depakote because it contained his mania, but also plunged him into depression). He's doing better -- no more raging -- but he's still depressed so we just added a low dose of the SSRI Lexapro and are crossing our fingers that it doesn't send him into mania again. Our psychiatrists have said that anywhere from 30 to 50 percent of kids who initially present with depression actually go on to have bipolar disorder. But one medication reaction cannot definitively make the diagnosis. The child must be observed carefully over the years for signs of both mania and depression, and yes, getting to the other side of puberty will give you more clues about the final diagnosis. Even though difficult child 1 doesn't have the official diagnosis of BiPolar (BP), he is being treated as if he does because we had no other choice given his extreme reaction to antidepressants. I'm guessing that's what's going on in your difficult child's case as well.

    In addition to a good psychiatric evaluation, I'd strongly recommend a neuropsychological evaluation to fully assess your difficult child's congitive and psychological strengths and weaknesses. neuropsychologist testing can guide you in putting the proper interventions (school-based, medication, therapy, etc) into place.

    While it's hard not to worry about the future, I agree with DDD that you should put your energy into getting your difficult child the best help you can at this point. Because ultimately, the more proactive you are now, the better his future prognosis will be.

    For more info on diagnosing BiPolar (BP) in kids, you might want to google Dr. Ellen Leibenluft. She and her colleagues at NIMH in Bethesda, MD, are studying this diagnostic dilemma.

    Again, welcome and good luck.
  4. judi

    judi Active Member

    In the end, as an adult, DDD hit the nail on the head. It doesn't matter what initials you have been diagnosed with, your ability to integrate into society: hold a job, make contributions to society, have a family and/or longstanding relationship. These are the only goals most of us with older kids want anymore. Getting them to go to therapy, be respectful to us are much farther out goals - some achieve them, others do not.

    At this point, my son is almost 22, he has a beautiful son himself (5 1/2 monthts). However, he is minimally involved with this little boy, has no job, lives with folks who are shady at best, etc... My point to this is that we all have had great expectations for our kids, some of these can be met, some can't.
  5. Suz

    Suz (the future) MRS. GERE

    I agree with everyone who posted before me. There is so much wisdom there.

    If your son has been on medication for over a year already then his challenges didn't start with puberty and I'd be amazed if they ended once puberty was done.

    I'd suggest that you also look around your family tree. It's uncommon for mental illness to suddenly pop up without any forewarning in a family. Look at the older generations and sideways at his peer generation for your family and his father's. Even if nothing was officially diagnosed, are there any alcoholics/drug abusers/self medicators lurking? Does "eccentric" or "quirky" describe his ancestors? There is so much to be learned from looking around.

    Then, treat the symptoms. If it is BiPolar (BP), your best defense is a good mood stabilizer, then add things for other symptoms afterwards. Like the others, I stopped worrying so much about the alphabet soup that was always changing with Rob's diagnosis's and only worried about competency NOW.

    And post often. It saved my sanity during those terrible years knowing that I wasn't alone.