3 yr old possible Bipolar?

Discussion in 'General Parenting' started by kkenley, Oct 15, 2009.

  1. kkenley

    kkenley New Member

    I am new here and looking for opinions from others in the trenches.....not my wellmeaning relatives (a great number of whom are medical professionals)

    My 3 1/2 yr old son has been a go-getter from the start....crawled at 4 months and never looked back. Talked early and exceptionally well...his reasoning abilities are amazing....the kiddo is smart and uses it to his advantage. He Has always been strong willed....ready to go to battle over everything...If I tell him not to touch it he will do it to spite me and see how far he can push it. HE is not defiant all the time, but when he doesn't want to do something.....oh my! LOL
    He is my sweet loving imaginative boy.....but we have some issues going that have finally come to a head and led me to seek a diagnosis....so here I go and I may jump around....I'm sleep deprived and depressed myself!!

    He does not sleep....that was our biggest problem. He's always been busy....never sits still, no impulse control, no concern for safety...If he can jump off it he will. He squirms like he's about to wet his pants when he has to sit down. Then the not sleeping got bad...really bad...I put him to bed at 8 and he is still awake at 11, 12, 1am. He is up and down all night and will even go so far as to leave the house and go outside to play at 3 am....that is un-nerving! He gets up and raids the pantry or will wake up his 2 yr old sister in the middle of the night to play.
    He cycles from being calm, quiet loving to running laps around my house jumping off furniture and tackling his sister. Then he will be sullen sitting in the corner and scowling. If we ask him what is wrong he will say "Please leave me alone" and turn his back on us. He will stay like that or even leave the room to sit grumpily by himself in a room on the other side of the house and if we ask why he's upset it is usually "because sister looked at me" Etc, etc. that will last for an hour or so and then he's up and playing like normal. Sometimes he goes off about how an object is dumb or stupid. For example he might say he has the dumbest car seat, he hates his car seat, it's the dumbest seat I want my old seat back. He has imaginary friends that are "his Kids" five of them...two sons and a daughter....not sure what the other two are supposed to be! LOL He one day told me that we was tired of his "old son" and he was going to kill him...he has told me before that I am "the stupidest mommy and he hates me" these horrible, hateful things come out of his mouth and then he's back to my sweet momma's boy. it's heartbreaking and scary at the same time
    Did I mention he does not do change? LOL we got a new dining room table and he cried about it for a week...refused to eat at the new table and wanted the old one back.
    He had normal seperation anxiety when being left at nursery, etc at about 4 months and never out grew it...he crys and throws a fit when ever I leave him somewhere. HE is fine after a bit, but I always have to peel him off me and run for cover!
    Tags on clothing and seams on socks make him crazy....to the point of me having to pull over on the side of the road and take his pants and undies off just to get home in peace because he is having a melt down over the tag on his undies.
    The bad mood and tantrums might be several times a day or might be several times a week. I never know what to expect.
    Some days we can pick up the toys from the floor and clean no problem, some days he informs me "you do it" or "I don't know how...I don't know how long it will take" and he will cry and not do it...I have tried changing my discipline methods....rewards often don't work...he will tell me he doesn't need a cookie or a candy or a sticker, etc punishments and consequences don't work because he will just say "Ok, that's fine"
    I know he's only 3, and 3 year olds are hard and defiant, and hyper....but He is outside of the normal range!
    Pediatrician diagnosed ADHD originally... tried Melatonin for sleep and that worked great for a few weeks then quit all of a sudden. Also ADHD medication....can't think of name right now. He reacted badly to the medications....severe anger and mood swings. So now Dr says he feels it is bipolar (I have a strong family history of depression and my grandfather is manic and so is his mom). He wants to start Rispiridone and I don't yet....I want to try addressing the sleep issue first and seperately to see how that affects him....remove any possible environmental factors and other possibilities and be sure before just jumping in and medicating him.
    We have an appointment with a specialist but not until Dec. 9. I want to at least talk to her first before starting medications...

    So I guess what I am getting at is....am I right in wanting to wait or am I just in denial? OR am I reading too much in to his behavior and trying to make the horrible 3's into something more?? We had a follow up appointment today to see how medications were working and I told the Dr. I had not started them....Dr was a little confused and wanted to know why I did not want to do medications.....I just told him I don't know....just not convinced yet? So we are trying clonodine for the sleeping issues at my request but he feels we will ultimately still end up diagnosed as bipolar...I just want to be sure when we do that we tried to be sure before just medicating?
  2. SRL

    SRL Active Member

    Hi kkenley. Welcome to our forum.

    I would really urge you to get a full multidisciplinary evaluation on your little guy to get a fuller picture of what is going on. It sounds like the professionals you are dealing with are jumping to medications fairly quickly without having done a complete evaluation (at least I'm not seeing any signs of that).

    For instance what looks like ADHD can just as well be something called Sensory Integration Dysfunction. Motion, sensitivity to tags, some mood problems, and sleeping problems can be attibuted to Sensory Integration Disorder (SID). If this article below rings a bell at all then check out the book "The Out of Sync Child" by Carol Kranowitz.

    Does he have trouble with loud sounds, bright lights, crowds, or food textures (ie very picky eater)?

    Sleep issues can also be caused by issues such as Restless Leg Syndrome that can only be diagnosed through a sleep study.

    The sorts of mood swings that you are seeing can be attributed to any number of issues including bipolar, ADHD, Asperger's Syndrome, Tourette's, etc. so it's really important to cover all the evaluation bases and not just jump to medications unless it's severely indicated, such as with safety issues. We do see a lot of undiagnosed Asperger's Syndrome or High Functioning Autism so we suggest that parents always do their research and make sure that is included in the child's assessment. FYI--resistance to change, anxiety, and sensory sensitivity are red flags for Asperger's Syndrome. Doctors often miss it, especially at young ages.

    For an initial round of evaluations, we suggest at minimum speech/language, occuptional therapy for motor skills and sensory issues, and for this age seeing a developmental pediatrician or pediatric neuropsychologist. That combination will yield some initial data to draw some conclusions from. For this age group we generally do not recommend just being seen by a behavioral therapist or child psychiatrist without getting the fuller picture because often there will be missing pieces of the puzzle. I know you're doing what your doctors have guided you to, but I feel really strongly about not medicating kids in this young age group without evaluating them first because medications and medication reactions can make things worse or cloud the picture.

    Are his speech patterns and vocabulary more adult-like than that of a typical 3 year old?
    Does he have any quirky behaviors or unusual interests for his age group?

    Until you know what's really going on here, I'd suggest laying low on discipline. If you can get him to pick up toys, fine, but don't make a big issue out of it. You might want to check out the thread at the top of this board about The Explosive Child.

    Hope this helps.
  3. smallworld

    smallworld Moderator

    Welcome! I'm glad you found us, but sorry you needed to.

    I have a 16-year-old son, who has been under the care of mental health professionals since the age of 10 (and believe me, he was challenging before that), and the jury is still out about whether he has bipolar disorder. We know he has some kind of mood disorder, but we are not certain it is bipolar disorder. It is VERY tricky to nail down the diagnosis in kids because their symptoms change and develop as they change and grow. I can't imagine trying to nail down a bipolar diagnosis in a 3-year-old.

    That's not to say there's nothing going on because it certainly sounds as if there is. What kind of specialist are you seeing on December 9? Have you thought at all about having your son evaluated by a neuropsychologist who can do some intensive testing to give you a better idea about what might be going on?

    I don't think there's anything wrong with addressing the sleep issue first and seeing if your son's days settle down once he gets adequate rest at night. The medications used to treat bipolar disorder are not without side effects and should be used as a last resort, not as your first option.

    Hang in there. Others will be along to give you more ideas about what to pursue.
  4. kkenley

    kkenley New Member

    The specialist we are seeing is a peditrician who specializes in behavioral issues. Not sure of her official title. I've heard very good things about her.
    His speech is very much like an adult... Very good grammar and huge vocabulary. He picks up stuff from other peoples conversation and later will tell me all about it. For example... He was bitten by a rattlesnake earlier this year and had to go to the er. About a week later my mom told him to be careful and watch out for rattlesnakes. He told her " gu, there are snakes that are the same color as a rattle snake but they don't have rattles and they are dangerous. They are called bull snakes. They're good snakes". I have no idea where he heard that.
    He loves cars.... He will spend hours racing them and lining them up on his bed and his "kids" ride in them
    He doesn't seem to have issues with food texture, but his clothes can drive him crazy. And he frequently tells me his car seat is tipping him and it's going to make him fall.
    The sleep medications are helping and I'm seeing a slight improvement in mood. Still very busy and distractable but he is a three year old and my first so not sure how much of that is outside of normal if at all.
    Back when the sleep issues started getting bad he was complaining that his heart hurt (chest pain). The docs did not find any cause and no heart rate increase etc. Not sure if maybe it was anxiety related?
    I just feel like medication should be a last resort. He's not in any physical danger.... The not sleeping is the biggest issue I have. I feel that he needs to sleep to stay healthy.
  5. madregrande

    madregrande New Member

    I do not think you are in denial at all. I believe that all possible actions should be made before medicating a child- especially one so young. My 4 1/2 yr. old son has Sensory Integration Disorder, and your child sounds almost just like him. I think you should have an occupational therapist evaluate him for this. If you read The out of Sync Child, as was suggested in another post, I think it will be very enlightening for you. We began having problems with our child around 2, but in hindsight I can see things even from his infancy that were red flags. My child is also smart and articulate- To the point that I cannot get him any services from the public schools even though his behavior was so disruptive in 3k (jumping off tables, rolling himself inside the carpet square all over the floor istead of sitting still at circle time, etc.) that they would not accept him back for 4k for the following year. We had to enroll him elsewhere. Sleeplessness is one of the symptoms of sensory problems. I have battled this with my son since infancy. He has NEVER napped, and his nighttime sleep has never been great either. As in another post, I too suggest that you not discipline him too much until you figure out what is going on. You may find that he does these things due to a sensory need that his body is trying to fill. If your child does have sensory issues, occupational therapy, along with strategies mentioned in The Out of Sync child, will help with the sleep problems as well. Not completely, but will make a difference. Let us know how things go with that. Good luck!
  6. SRL

    SRL Active Member

    If his clothes are making him crazy and he's having that problem with the car seat I'd recommend picking up a copy of the book The Out of Sync Child by Carol Kranowitz. For clothes, one solution is to find what he can wear comfortably and then buy multiples in the same style, color, etc. Trust me, the boredom of looking at the same thing every day is much better than the daily battles.

    Does he memorize good size chunks of movies, tv shows, or books?
  7. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I would check him out with a neuropsychologist or have the Multi-Disciplanary Evaluation. Sounds like he has some sensory issues, but that is always a big red flag for Autism Spectrum Disorders (ASD) (autistic spectrum disorder/Aspergers/Pervasive Developmental Disorder (PDD)-not otherwise specified) and, since this is often missed in young kids, you really need somebody who understands what to look for. A speech delay or speech problems are often another big sign (although not with Aspergers), plus obsessing over certain things (like the weather or dinosaurs), poor eye contact with strangers, strange toy play or no toy play (lining up toys, dismantling toys, not really using imaginative play) and not relating well to same age peers. And, of course, the sensory stuff.

    Without a total private evaluation, I wouldn't put him on medications. You really aren't sure what you are dealing with yet.

    Good luck, whatever you decide to do.
  8. karif

    karif crazymomof4

    My son has several diagnosis and Bipolar being one of them. Before we knew exaclty what was wrong,( and I still think we have a way to go with that one), the doctor put him on risperdal. We started at an extremely small dose and worked up. He is doing well on this and it was a God send. My son had many, many problems. I am not saying medications are the only answer but keep an open mind. Hugs and blessings on your journey.:D