medications? Diagnosis? how can I know if its right?

weaselqt

New Member
We have battled ADHD since difficult child was a baby - he wasn't diagnosed until 5 years old - but I knew before that. When he was 7 he got angry with me and chewed through the cord plugged in to the wall to his radio. No, he wasnt hurt - but that REALLY bothered me! Our pediatrician. sent us to counseling - we've been so many times - and nothing has ever seemed to work for us.

One couselor we went to was great - to begin with. but it seems that difficult child manipulates counselors too. I got tired of paying all the $$ for what I called a joke. This particular counselor used difficult child favorite tv show Dukes of Hazzard and difficult child said that Bo Duke was good guy and everytime he was good and acted like Bo Duke - we would put chips in a jar. Fill the jar for special treat from counselor. Well, after a couple of days - difficult child says he is tired of acting like Bo Duke and being good. Then, go back to counselor and would not listen to him. Then we go in as family and difficult child is playing with hot wheels car and wouldn't put it down and then walked over to counselor and drove it in to his CROTCH!! Well, that was it for me. difficult child giggled and tried to do it again and I just got up and took him and left. We have not been to counseling since - that was 6 years ago (and the 5th counselor). I felt I could manage my difficult child with my motherly love - BOY AM I WRONG!!!

difficult child was not diagnosed BiPolar (BP) until he was 13 - adn facing school expulsion. psyc put him on risperdal immediatley and it did make a huge difference. But I don't think it works anymmore - really do not. As for ADHD - he is hyper with or without it - but his school behavior is absolutely wonderful last year and so good so far this year. He had only one referral last year and that is because he wore an unofficial jacket to school (rule is you wear certain color and he didn't follow - but he didn't do it again). It is when he gets around the house or around his family - he is horrible and extremely EXCITED!!! Geez - i just don't know what to think anymore.

I just don't know what to know. What do I ask? I've kept everything covered up and don't want my difficult child to fall off the wagon because I thought I was supermom, etc., etc.

i'm trying to get help - but don't know where to go. jWhat is in Shreveport, Louisiana? - any help is welcome.
 

smallworld

Moderator
Do you live within driving distance of a large city with either a children's hospital or a university teaching hospital? If so, these hospitals generally have neuropsychologists on staff who do intensive testing (anywhere from 6 to 12 hours) to figure out dxes and come up with an appropriate plan of interventions. It sounds as if you should consider this step because the medications aren't working and symptoms of the various childhod disorders tend to overlap (what may look like ADHD/BiPolar (BP) may in fact be another disorder altogether).

For what it's worth, Risperdal is not a medication that is used for the long-term treatment of bipolar disorder (which is why it might seem to have petered out). Mood stabilizers are the preferred treatment; these include Lithium, Depakote, Lamictal, Trileptal and Tegretol. Furthermore, stimulants like Metadate can make kids with BiPolar (BP) far worse, particularly if used without a mood stabilizer on board.

Good luck.
 

Janna

New Member
I think in children, there is no real way to know if the diagnosis is right. The psychiatrist goes with an "optimistic" diagnosis, medicating based on behaviors, reports from parents, schools, etc, and hoping for the best.

I have had 8 psychiatrists, working on #9 now, look at my son, Dylan. All M.D.'s, no psychologists or therapists, psychiatrists. One says ADHD. One says Mood Disorder. One says Intermittent Explosive Disorder. Within the last 2 years, our psychiatrist says "Bipolar for sure" and weeks later the neurospych says "Pervasive Developmental Disorder (PDD)-not otherwise specified, I don't know what to say about the Bipolar". LOL! We just say he has both.

There have been alot of medications that have made Dylan worse. Risperdal was indeed one. He hallucinated, was more manic, talked non stop. He was on this drug for some reason 3 times over several years, the psychiatrists just kept going back to it. But every time, it stimulated or activated him.

And he cannot handle any stimulants at all. Tried Metadate. Ritalin, Concerta, and down the line. All stimulated him.

I wouldn't categorize and say ALL Bipolar kids can't handle a certain drug. I think alot of it has to do with chemistry. Alot of medications that should absolutely work on my son, do not. Things that should calm ~ stimulate. Things that should regulate mania ~ make him hallucinate.

I, myself, took Effexor for a while. Hated it. I felt like I was standing outside of myself looking in. Ate like a hog, too. Took it for depression, lasted about 3 weeks, and I stopped.

I think the only way to know if your difficult child has Bipolar is to continue with someone, preferably a psychiatrist, that can monitor your difficult child.

Dylan can honeymoon/maintain for a good 6 months at a time. Eventually, he always caves.
 

Sara PA

New Member
Re what Janna said about "Dylan can honeymoon/maintain for a good 6 months at a time. Eventually, he always caves."

Bipolar is a cyclical disorder. "Rapid cycling" is more than 4 mood swings within one year. (Yes, just four times in one year. Hard to believe if you are use to mixed states or the ultra or ultra ultra rapid cycling some children display.) Mood stabilizers, generally speaking, reduce the number of mood swings. For some people, that might mean it eliminates mood swings -- total stability; for others it might mean it reduces them to one every six months or two years or 10 years.
 

BusynMember

Well-Known Member
I really have to agree with Janna. There is no way to know for sure--if the medications work, you can sort of see that you are on the right track. As an adult, I am diagnosed wtih bipolar/anxiety disorder/panic disorder/mild Obsessive Compulsive Disorder (OCD). I'm not even sure it's right and I'm OLD. I don't know if I'm really bipolar or just have crazy moodswings--an antidepressant works for me and antidepressants are supposed to be bad for bipolar. I take what helps and sort of forget the label. I also have always had neurological symptoms--possibly Aspergers, but who knows? Some kids are clear cut, but few are. Same with adults. There are no blood tests. If ADHD medications don't work or make a kid worse, in my opinion don't give them to the child, even if he's hyper. There are more than one reason for hyperness. If mood stabilizers work, give them to the child. If the child displays autistic traits, treat them--that requires interventions rather than medications. If you want a better picture of your child, go to a neuropsychologist. in my opinion you will get closer to a true diagnosis., but psychiatry is an inexact science. At times I felt as if me and my son were guinea pigs. I've learned to take labels with a grain of salt, and just do what works. And if one professional isn't helping, I move on. in my opinion and unfortunately vast experience both for myself and my son, counselors/talk therapists are poor diagnosticians. I REALLY take what THEY say with a grain of salt. I've had much better luck with more educated professionals. Not trying to sound like a snob, but for me and my son even regular psychologists totally missed the boat. The maddening thing was so many were so sure they were right. I could go to another therapist, or take my son to another therapist, and get another firm diagnosis the next day. It's not easy. (((hugs)))
 

busywend

Well-Known Member
Sorry to say it is a trial and error method that seems to be the norm around here. I wish there were better ways to know what results would be probable.

It can be time consuming and stressful to get the right medication or medication combo.
 
M

ML

Guest
Honey you are sure preaching to the choir here. I haven't been in the game as long as you, and the supermom halo fell long ago here. Now I'm shooting for "good enough mom".

My son had issues from birth. He cried a lot. I took him into the pediatrician several times only to be sent away with looks of "boy she's a nut". They could never find anything wrong. But by 6 months he was diagnosed with reflux and then came the ear infections and asthma by a year.

The behavior was erratic all along. He could be sweet and charming sometimes and I'd wonder if it was all in my head. Maybe I wasn't prepared for this mother thing and I needed to work on *me*. Hmmm... in daycare they would see a different child. He would be lethargic and introverted, not an aggressive bone in his body. At home he was climbing on furniture and acting out.

We have been through several evaluations within our budget and those that we could get by begging. Currently we have an adhd and anxiety diagnosis but I know there is more to it. Maybe spectrum, maybe bipolar, maybe all of it. But for now, he's just shy and inattentive at school. He saves the meltdowns for home. I suppose that's better than the alternative.

I am president of the worst mother of the world club which membership must be accompanied by daily doses of "the I hate you's" thrown in for good measure.

Know that you aren't alone.

Hugs,

MicheleL
 
K

Kjs

Guest
I must agree with BW-- trial and error. We have tried several and it is so hard. You get your hopes up, and you start out slow..by the time you are at the level suggested difficult child is either doing well or just the opposite. Then it is the comming off period, and starting over. But, once you find the medication that works it is well worth it.
 

Janna

New Member
Bipolar is a cyclical disorder. "Rapid cycling" is more than 4 mood swings within one year. (Yes, just four times in one year. Hard to believe if you are use to mixed states or the ultra or ultra ultra rapid cycling some children display.) Mood stabilizers, generally speaking, reduce the number of mood swings. For some people, that might mean it eliminates mood swings -- total stability; for others it might mean it reduces them to one every six months or two years or 10 years.

REALLY, Sara???????????????? I honestly did not know that. I must have missed that somehow.

Four times in a YEAR?

Learn something new every day. Thanks ~ :smile:
 

BusynMember

Well-Known Member
Kids can cycle four times a DAY. Or four times an hour. Many times they get stuck in a "mixed state" which is mania and depression combined. It looks like severe ADHD--lots of screaming (the anger and frustration of depression with the ENERGY of mania). That's when most bipolars commit suicide, in a mixed state.
 

weaselqt

New Member
I'm taking him to a new counselor soon (getting it worked out) but we are close to Louisiana State University Health Science center (LSUHSC) in Shreveport. I've seen commercials about studies on teens that are ADHD or BiPolar or Both - but have never checked into them. Kinda weird - my sis-in-law works at a prison (social worker) and today she told me that she would rather work with 5 schizophrenics than one bipolar anyday. She thinks we need to get my difficult child in sooner and pressure the psyc. Problem about trying new ones is that none of them that my insurance covers are taking new patients. I wonder if I can just walk in to LSUHSC in Shreveport? Hmmmmm - maybe referral from pediatrician? Thanks for everyone's input - I guess I'm just now realizing I'm not handling as well as I should have - not even close - hard cookie to bite.

I do have to say that a mom of a difficult child who is 10 at my school is going through tough time right now. She told me she thought that I (ME!!!) was very patient with her son in class and how she appreciated how I dealt with him and how non of the teachers could deal with him, etc., etc. Honestly - I'm shocked because that child grates my nerves too - but he TOTALLY reminds me of my own precious difficult child!!! The sp. ed. teacher told me I had good patience with him - but I certainly don't feel that way. So, now I look at my parenting and feel I'm treating someone else's difficult child better than my own??? Am I??? I jsut don't understand and I do feel down about it. I don't know.

Anyway - sorry to make all of this so long - I'm just so overwhelmed at the moment!! {{sigh}}
 

totoro

Mom? What's a difficult child?
Janna-That was why they termed K an Ultra-Ultra-Rapid-Cycler!!! I couldn't believe it either when I first had read that!!!
Shoot, I meet that criteria!!! I always thought I was not!!! LOL :rofl:
 
M

ML

Guest
Mine has mood cycles at least every day. Some of them are even predictible like waking up is about 80 percent to be a bad scene. When I pick him up from school or daycare he's always happy and chattery. We have one blowout at least three times a week.
 

Janna

New Member
Yeah, I had no idea. I figured Dylan was a rapid cycler. The thing that makes it hard is because he's soooooooooo hyper as it is. Then some of the Pervasive Developmental Disorder (PDD) stuff stimulates him. So sometimes it's hard to tell if he's manic, or overstimulated LOL! I'm starting, just recently, to be able to see the differences now that he's not on any real good medications, but some days it's hard.

I see some very extreme behaviors on the manic end, but they are inconsistent. LOL! I dunno, but I know it's way more than 4 times a year :smile:
 
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