Bipolar disorder anxiety and hallucinations

Discussion in 'General Parenting' started by Flutterb, Nov 14, 2011.

  1. Flutterb

    Flutterb New Member

    Hi. I'm new here but not new to parenting special needs kids. I have four children three of which have either complex psychiatric or medical issues. Last week I hospitalized my eleven year old son after he told me he was having command hallucinations to harm himself. He has a diagnosis of bipolar disorder and anxiety not otherwise specified. The psychiatrists feels these are non psychotic hallucinations and started him on an antidepressant ; stopping his mood stabilizer. My son is home , seems upbeat but is still hallucinating. Has anyone encountered this? Also, if so how did you help your child navigate school?
  2. buddy

    buddy New Member

    Hi and welcome. I do not have any experience with this but wanted to just welcome such an experienced parent to the group. I am so sorry your son is suffering from this. (the only experience I have is seeing a child who is in hospital with my son, my son told me that he has imaginary friends and that is why he is talking all of the time, broke my heart)

    I am sure there are parents of kids who have some forms of hallucinations here, so hang tight, I am sure you will get some responses.

    I can relate to having a child with very unique school problems. My son is unable to control what he says in public (and what he does at times too) and explaining that to other students, worse...explaining that to administration who just dont get just awful. We are going to do a classroom education program for the kids who are in class with him. (guess we need to do it for the principal too, sigh) That may help others not to tease and hurt his feelings, but what to do to help him??? does he respond to adults who redirect his thoughts? Would an aide be appropriate for him?
  3. Flutterb

    Flutterb New Member

    Thank you for taking time to reply. I am lucky to be in a supportive district thus far. Tomorrow will be his first day back and I met with both principals, the social worker, his guidance counselor and team teachers today. We pulled him out of his largest , most chaotic class and he has some key people to check in with when he is struggling. My biggest question is how to manage his class work and keep him engaged in learning when he's actively hallucinating. They don't have a problem developing an IEP with him but I have no idea what to ask for .
  4. buddy

    buddy New Member

    oh I see, wasn't sure what the school issues were. How wonderful they are working well with you. Development of an IEP ( one difference from a 504) is not done alone. Luckily you would sit with the Special Education. team (I assume the EBD teacher, mainstream teacher, administrative staff who support him, etc.) and you would all first identify areas of need. Using those areas of need you will write what the present level of performance is. The team will then decide on goals to address the areas of need. You decide who can help him reach those areas and if any related services or adaptations (transportation, Occupational Therapist (OT), speech and language, pt, an aide, etc.....) will be needed to meet those goals. Does he need a break space if things get to overwhelming? Can he have a private study place in the school for short times if he needs to be away from kids? Does he need help navigating socially when he is hallucinating? what helps reduce this? can he take scheduled breaks to do a relaxation program or listen to music to help keep things down (as an example IF that was an issue)
    This is a very generalized view of the process... again you would not have to think of all of the goals and ideas alone. that is why it is a team approach.

    The following is just to share, if it isn't helpful, no problem...
    These are parts of handouts for school and they are general...still they can be used as suggestions for accommodations and then of course what you feel will work for your individual son can be added or adapted from these...

    This is regarding schizophrenia, but I copied it because it addressed hallucinations:

    Instructional Strategies and Classroom Accommodations
    • Reduce stress by going slowly when introducing new situations.
    • Help students set realistic goals for academic achievement and extra-curricular
    • Obtaining educational and cognitive testing can be helpful in determining
    if the student has specific strengths that can be capitalized upon to enhance
    • Establish regular meetings with the family for feedback on health and
    • Because the disorder is so complex and often debilitating, it will be necessary
    to meet with the family, with mental health providers, and with the
    medical professionals who are treating the student. These individuals can
    provide the information you will need to understand the student’s behaviors,
    the effects of the psychotropic medication and how to develop a learning
    • Often it is helpful to have a “Team Meeting” to discuss the various aspects
    of the child’s education and development.
    • Encourage other students to be kind and to extend their friendship
    —From “Schizophrenia: Youth’s Greatest Disabler,” produced by the British
    Columbia Schizophrenia Society.

    And this on bipolar:
    Educational Implications
    Students may experience fluctuations in mood,
    energy, and motivation. These fluctuations may
    occur hourly, daily, in specific cycles, or seasonally.
    As a result, a student with bipolar disorder
    may have difficulty concentrating and remembering
    assignments, understanding assignments
    with complex directions, or reading and
    comprehending long, written passages of text.
    Students may experience episodes of overwhelming
    emotion such as sadness, embarrassment,
    or rage. They may also have poor social
    skills and have difficulty getting along with
    their peers.
    Instructional Strategies
    and Classroom
    • Provide the student with recorded books as an
    alternative to self-reading when the student’s
    concentration is low.
    • Break assigned reading into manageable segments
    and monitor the student’s progress,
    checking comprehension periodically.
    • Devise a flexible curriculum that accommodates
    the sometimes rapid changes in the student’s
    ability to perform consistently in
    • When energy is low, reduce academic
    demands; when energy is high, increase
    opportunities for achievement.
    • Identify a place where the student can go for
    privacy until he or she regains self-control.
    —These suggestions are from the Child and
    Adolescent Bipolar Foundation. For more suggestions,
    consult the Foundation web site at Home | The Balanced Mind Foundation.
    This site is a rich resource for teachers.
  5. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    HI there and welcome to the board, but very sorry you have to be here.

    I was wondering: Are there any psychiatric issues on either side of his genetic family tree? Any medications in particular that are working for them? I was told that medications that work for one member of the family tend to work for other members too. I am wondering...what is a non-psychotic hallucination? I never heard of that before. What was his early history like? The more you tell us, the more we can try to give support and suggestions.
  6. Flutterb

    Flutterb New Member

    He was very outgoing as a young child but from time to time spoke of what he called his spirit guides; as early as 3 ...he stopped talking about them when he entered school but apparently the voices never went away. Last week he told us a very long elaborate delusion. It was incongruent and he was so convinced it was real. I am bipolar but have never had hallucinations. I have no idea really what an nonpsychotic hallucination is.
  7. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Why are they giving him an antidepressant rather than an antipsychotic? I think I'd probably want to get a second opinion. Command hallucinations can be serious and can get is best to get rid of them as soon as possible. I have a friend who adopted two children whose birthmother had bipolar, and one of the children has always hallucinated and has been in the hospital many times. He is taking antipsychotics.

    Hugs to you and I'd see that second psychiatrist ASAP. Keep us posted.
  8. AnnieO

    AnnieO Shooting from the Hip

    :hugs: and welcome... My daughter has been diagnosis'd bipolar... And her worst hallucinations happened while she was still relatively medication-compliant and on antidepressants. Some AD's can actually activate mania in bipolar... I'd be looking for a second opinion, too.

    More :hugs:
  9. flutterby

    flutterby Fly away!

    An AD without a mood stabilizer in a patient with bipolar is a bad idea. Given the hallucinations - non-psychotic or not - I don't understand why they didn't put him on an AP. My daughter has auditory hallucinations (non-psychotic, which I take to mean that she realizes that they aren't real) and risperdal has taken care of that.
  10. Liahona

    Liahona Guest

    difficult child 1 hallucinates. Most of his are formless visual or murmuring auditory. They started at school at age 5. I think they are anxiety induced. He is just beginning to understand that he sees and hears things others don't. The last one at school though was of him hurting other kids. He still believes that was real. And he did hurt another kid since he thought he was getting away with it already. He learned a difference between hallucinations and real behavior is his aides reaction to it.

    I keep on the look out for command hallucinations but he hasn't had any yet (that I know of).

    When he has hallucinations all other expectations get put on hold for awhile to make sure everyone is safe. He is still in school, still has homework and we don't tell him the expectations are lowered. He is watched very closely and if something (like an assembly or certain homework assignment) is just to much for him he doesn't have to do it. There is an assembly on Thursday that difficult child 1 will probably miss because his anxiety is creeping up.

    I also think you should get another opinion about the medications.

    Welcome to the board!
  11. Bunny

    Bunny Guest

    I have no experience with what you and your son are experiencing, but I just wanted to add my welcome as well. This is a very knowedgable group of parents here.
  12. Flutterb

    Flutterb New Member

    He was at his therapists office today and he is indeed totally manic at this point. The hospital psychiatric docs were so far off base. I knew this , complained and was over ruled. His primary psychiatrist sees him Friday and is inboard with what's happening but does not want to start new medications until he can see my son. So we are hanging on tight. He , of course, has an underlying psychosis which I tried to explain to the hospitalist but he is green and needless to say we will not go back there. Our other option for inpatient or intensive outpatient is an hour away ;but as I am sure most of us would, I would take him to the end of the earth to get him help. Thanks for all of your replies. I'll update Friday.

    In retrospect this all makes so much sense and explains so many odd behaviors. It's so disheartening to see him Decline cognitively and emotionally but hopefully an antipsychotic will be added Friday and the atypicals are great for mania too.

    Again thanks for your support. Our local nami branch has no support groups for parents.
  13. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Hey, I noticed you're from Wisconsin so I sent you a private message.