Update and Questions

Discussion in 'General Parenting' started by neednewtechnique, Sep 2, 2007.

  1. neednewtechnique

    neednewtechnique New Member

    Well, it has been a while since I have been posting, things have been getting pretty crazy around my house lately.

    For starters, our oldest went to see her p-doctor on Friday, and we have been improving in LEAPS AND BOUNDS since we switched to this woman. She's amazing!!! It totally fascinates her that I frequent this board and that I am so involved with a great group of people working to help our children. She constantly asks me what new things I have been reading and if I came across anything interesting that I would like to discuss with her. Also, she is working VERY hard to get our difficult child functioning the best she can on the LEAST amount of medication possible, and it has been a process of trial and error, but now that difficult child is a bit older, they have been able to determine that she was MIS diagnosed with ADHD, and she is off the stimulants, and off the sleeping pills, and off the anti-depressants, and the ONLY pill she has to take now is the mood stabilizer (Lamictal). She said it isn't recommended for children under 16, but it was the best, so she wanted to try it, but said that instead of increasing the dose every seven days, she wants to increase it a month at a time until we get to where she needs to be.

    She did mention to me something that kind of got my curiosity going, and I am not sure what to do with the information she gave me besides share it with her counselor.... she said that our difficult child is showing Signs of borderline personality disorder. She also mentioned this is NOT diagnosed until adulthood, so she would not say that she IS borderline at this point, but just that she shows a LOT of signs of it. I don't know much about it, but I am wondering if there is an ADOLESCENT disorder that can co-exist with Bipolar that has the same symptoms......she said that we would continue to explore it as she matures, but I was just curious if anyone knew of a connection.

    Also, we have started the process of getting our 5 year old in for evaluations. Her counselor said that she doesn't think she has ADHD, because there is NOTHING wrong with her attention span, but she is very hyperactive and she has some control issues, also she has a few other quirky things that have put up flags for her and she would like to see her have some testing done. The ONLY psychiatrist around that takes children that young, thank our lucky stars, has a GREAT reputation for being reasonable in treatment of young children, but will not accept a referral from her counselor, he is insisting that a referral come from her pediatrician, so we called and he agreed to write the referral as long as he could spend some time with her when he does her school physical on Tuesday, so once we get that referral, we can start setting appointments for the evaluation.

    My other question to you, my youngest daughter, who truly is a easy child is almost 4, and has been completely potty trained (day and overnight)since before she was two. We have NEVER had complications, until a few weeks ago and she started to wet the bed again. Then the last few days, she has been having accidents during the day too.... she doesn't seem to be in pain or irritated so I don't think she has a bladder infection, but is there something that could be going on psychologically that is making this happen??? I know that she is used to her sister being in daycare with her, and now she isn't because she started school, but that is really the only thing that changed, and even before when they WERE in daycare together, it was a preschool and they were in separate classes and didn't really see each other during the day, they even had separate playgrounds because they broke the playgrounds up by age for equipment safety reasons.....

    Just curious!!! If anyone has any thoughts.....

  2. Hound dog

    Hound dog Nana's are Beautiful

    Wow. I think it's great you have such a wonderful psychiatrist! :bravo:

    I just wanted to comment about the borderline personality disorder thing. Nichole was diagnosed with it at 15, and confirmed by two other psychiatrists, along with the BiPolar (BP). So it isn't strictly diagnosed as an adult. Although I think dxing it at 5 would be way early.

    As far as the younger one, has she been drinking more than usual toward bedtime? Sleeping a bit later than usual? If you can find a different reason, I'd still have her checked for a bladder infection. Sometimes they don't have noticable symptoms.

  3. neednewtechnique

    neednewtechnique New Member

    The one showing signs of Borderline is the 13 year old, not the 5 year old. The five year old has not made it in to see her psychiatrist yet, we are finishing working out all the wrinkles with referrals and getting counselor records to them so we can make an appointment. The 13 year old actually came to us through the foster care system in January and was diagnosis'ed ALL WRONG and on ALL KINDS of unnecessary medications that were actually making her WORSE than she really is, instead of better. I did find an article online by a doctor that explains how to diagnosis Borderline as an adolescent, and I will be printing it out and taking it to her next psychiatrist appointment. I think the reason that she can't diagnosis it now is because the diagnosis criteria for adolescents is stricter than that of adults and the timeframe for adolescents is symptoms present for a year, and we have not even had her for a year, so we cannot say for certain whether these signs were there before or not...
  4. Hound dog

    Hound dog Nana's are Beautiful

    Yes, they're going to want that year to judge by, I'd imagine. Especially since she was misdxed before and the medications caused problems.

    I admit to being relieved it's the 13 yr old. whew. I was a bit worried that a psychiatrist would be leaning that way in one so young still. (although some of Nichole's borderline behaviors can be traced back earlier than 5)
  5. smallworld

    smallworld Moderator

    I have two kids on Lamictal; my daughter started at age 11 and my son started at age 12. While it is not FDA approved for the treatment of BiPolar (BP) in children under age 16, it is FDA approved for the treatment of epilepsy in children as young as age 2. So there are plenty of young children who do take Lamictal with good results.

    We have had nothing but positive experiences with Lamictal. It has smoothed out my kids' moods as well as helped with depression. Unfortunately, we got to a point where we couldn't raise the Lamictal any more and they were still depressed so we added a low dose of an AD (Lexapro) at that point. They are doing quite well on this medication combo.

    Since your difficult child has had a lot going on with the foster care system and wrong diagnosis/wrong medications, in your shoes I wouldn't jump to a Borderline diagnosis at this point. I think I'd give the new medications a chance to work and give your difficult child a chance to continue to settle in with living with you. Your difficult child has been through a lot of changes in a short time.

    In terms of your 4-year-old and the new wetting issues, I agree with Lisa that you should have her checked for any signs of infection or medical problem. If there is nothing physical going on, it could be emotional. I'm sure you don't want to hear this, but my youngest daughter started experiencing increased anxiety in reaction to her siblings' issues. Even though yours has always been a easy child and may continue to be a easy child, she has to be affected by the household turmoil caused by having two difficult child siblings. We've been told that it's quite common for siblings of difficult children to need the support of their own therapy. Although she's still young, you may want to look into play therapy for your easy child.

    Good luck. You have a lot on your plate.
  6. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    neednewtechnique, doesn't it get you angry when your poor child is
    misdiagnosed and put on the wrong drugs? I'm still mad about it. Son is still overweight due to the medications.
    My own Psychiatrist (who is not a child psychiatrist) believes that Borderline Personality Disorder (BPD) is part of the bipolar spectrum and told me that many professionals are starting to see it that way--often it is treated with the same medications--mood stabilizers--with good results.
  7. DammitJanet

    DammitJanet Well-Known Member Staff Member


    I have borderline along with bipolar. I am one who has absolutely no doubt they are two totally separate issues.

    I have some links that have links to information about teens with borderline or borderline traits.

  8. AllStressedOut

    AllStressedOut New Member

    We haven't received an official diagnosis yet, but we did see the therapist in the new psychiatrists office last week. My youngest difficult child is only 7 and between his visit Thursday and what we discussed Friday about school, she thinks borderline personality disorder may be one of the diagnosis for him. As I said, nothing is official, we still have to talk to the psychiatrist himself on the 18th. But I guess it's not completely out of the question to diagnosis it this young if you see the signs.

    Is all this stuff new to the 4 year old? Her sister visiting all these docs? If so, this could be bothering her.

    My youngest difficult child refused to potty train when little sis came into the picture. He just wanted some of the old attention back and even if it was bad attention, he'd take whatever he could get. He is very needy, so even if some attention isn't enough. He wants it all if he can get it, good or bad.
  9. Sara PA

    Sara PA New Member

    Lamictal is approved for use by children over the age of 2 for the treatment of seizure disorders. It has always been approved for use of one very serious type of seizure and once it was realized the risk of Stevens-Johnson Syndrome wasn't as severe as first thought, it was approved for other types of seizures including the very common partial seizures. That means it has been tested on children and the side effect profile has been determined.

    I was going to say that it is it is not currently approved for the treatment of bipolar disorder in adults but not in children but however in double checking the prescribing information (rewritten in May, 2007) they no longer state "adult" but "patient" in the bipolar section and now list adverse reactions seen in adults and children being treated for bipolar. The dosage table for children in the epilepsy section is referenced in the bipolar dosage section.

  10. neednewtechnique

    neednewtechnique New Member

    The way the psychiatrist explained the difference between BiPolar (BP) and Borderline Personality Disorder (BPD) to me was that BiPolar (BP) is still considered a disorder that is caused by a "crossed wire" or something that is working improperly in the brain that causes it, and Borderline Personality Disorder (BPD) is developed by the environment that the child grows up in. She said that the abuse and neglect that our difficult child went through when she was a child before she moved in with us would make her VERY HIGH risk for Borderline Personality Disorder (BPD).

    Because she deals with lots of adolescents and adults who developed Borderline Personality Disorder (BPD) because of childhood environment problems, this is the reason that she even recommended that if our 5 year old's counselor belives she may be ADHD, that it is critical we get her evaluated as soon as possible and start treatment. Apparently there is a high risk involved with children who have these types of disorders that are left untreated, because of the stress to these children of getting into trouble in school, having a difficult time in school, and getting into trouble at home and the way parents sometimes react to them. These stressors in their environment at such a young fragile age can set the stage for Borderline Personality Disorder (BPD) later on in life. I did some research on that, and actually came across an article that backs that up completly. (This may warrant it's own completely separate post, as I am sure that many of you will have comments on this, and I would LOVE to hear them!)

    You would not believe this woman and some of the things she has told me. She really is AMAZING. I don't know how we got so lucky as to find such a great psychiatrist, as the HORRIBLE experiences we had with the woman she used to see before she moved in with us, and all the horrible experiences I have heard from others about their child's psychiatristS. I told her that I WISHED she would treat younger children so she could take in our 5 year old too, but I have heard GREAT things from everyone I have asked about the guy we have selected for her (well, didn't really select him, he's the ONLY one in our area that is less than three hours away that sees kids that young).

    When she threw that Borderline Personality Disorder (BPD) thing out there, she told me to go home and research it and see what I thought, and to pinpoint some of the symptoms and risk factors that apply to our 13 year old and then when she comes back in a month, we will discuss it further. I guess that she has also determined that rather than a diagnosis of PTSD, her old psychiatrist SHOULD have called it "Complex PTSD", so I have also been researching the difference between the two and what the different long-term effects can be.
  11. flutterbee

    flutterbee Guest

    The reason they are hesitant to diagnosis Borderline PD in adolescents is because normal adolescent growth and maturity can in some ways mimic Borderline Personality Disorder (BPD), as well as other personality disorders. IOW, it's very common to see traits of these disorders in all adolescents. It's when it interferes with functioning and quality of life, interpersonal relationships, etc., that it becomes a personality disorder. I would definitely keep it on the radar, but I wouldn't jump on the bandwagon just yet. My difficult child shows traits of Borderline Personality Disorder (BPD), too, so it's something I keep on my radar.

    Something you mentioned about your 5 year old caught my attention. Anxiety and ADHD can look a lot alike. It took one therapist 8 months to decide that my difficult child did not have ADHD because of the hyperactivity from the anxiety. I'm not saying your daughter has one or the other or both or none. Just keep in mind that what looks like one thing can really be another.
  12. flutterbee

    flutterbee Guest