question about bipolar

[Kjs]

My son has never actually been diagnosed from any testing. He see's a board certified child psychiatrist. As I said in other posts, he see's it as a waste of money for a neuropsychologist test or others. He wrote bipolar not otherwise specified/ ODD when I asked for a diagnosis for school. He has said on visits that we are treating him for bipolar. We are treating him for mood disorder. He says he see's some depression / anxiety. WELL I see A LOT of anxiety, more than anything else. yes..his moods are up and down, all depends on how the day went. Lamictal has definately helped his moods, but sometimes he is just so defiant and yelling and arguing having outbursts, saying mean things. But he is not violent, never has been. Just very, very defiant. Most of what I read tells me bipolar kids are violent. Are they? Does it mean he will become violent as he grows older?
I was told by a teacher last year that difficult child has a conscience. If he has an outburst in his room (science), difficult child will always come back and apologize. (not to all people/teachers). After a difficult encounter at school or home, difficult child will seek out someone to speak to. I have friends across the street, with two easy child's about same age. difficult child will seek her and her husband out to just talk to if things are going bad. He will also call the old counselor from elementary school. She is sill very much in touch with him.
so, what is the real difference between mood disorder / bipolar / ODD ?? He does meet every single criteria for ODD. also has sooo much anxiety.

 

[BusynMember]

I was a bipolar kid and would go long times without raging and was not violent. I DID have violent thoughts and my rages were NOT fun for the family, or for me, but I didn't hurt anybody. I would throw things and sometimes break things, but didn't hit people. I was more apt to act out on myself as I got older, and was still undiagnosed/not medicated. I also managed to hold things together at school and outside the house until I got into my teens. Then I acted out as an angry teen.
I don't think you have bipolar without a lot of anxiety. I believe they go hand in hand. I was also very phobic and a nervous basketcase. The medications helped everything a real lot. He's getting help young and that's great.
ODD is just a part of bipolar. I'd say every person with bipolar is probably also ODD. In my layperson's opinion, but also that of my psychiatrist, ODD is part of the bipolar spectrum, and often an "ODD" child suddenly improves remarkably once they are put on a mood stabilizer. I think we'll see the day when the stand alone diagnosis of ODD no longer exists. Again, this is my opinion and that of my shrink. :smile:

 

[smallworld]

Kjs, there is a lot of controversy among the psychiatric community over what constitutes childhood bipolar disorder. For all intents and purposes, only a board-certified child psychiatrist can diagnose bipolar disorder in a child. However, neuropsychological testing can shed light on the diagnosis -- for example, whether the child has co-morbid learning disabilities, ADHD, executive dysfunction, autistic spectrum disorders, etc. In addition, the neuropsychologist who evaluated my son last December administered psychological testing, which determined that my son has chronic severe depression at the core of his mood issues. by the way, I have a hard time believing a psychiatrist thinks neuropsychologist testing is a waste of money. My son's psychiatrist was the one who recommended it, and we found the results helpful in guiding interventions.

My son is currently being treated by his psychiatrist for bipolar diosrder with mood stabilizers (and a low dose of an SSRI for depression). But his psychiatrist tells us that we will not know for certain whether my son has bipolar disorder until he has gone through puberty and becomes an older teen. We know for certain that my son has mood issues -- anxiety and depression (with a good smattering of oppositional behavior thrown in, which I see as a result of being anxious and depressed, not a disorder unto itself). The only reason a question of bipolar disorder even entered the picture is that my son became manic on three antidepressants (Prozac, Zoloft and Effexor XR), but medication reactions are not enough to make the diagnosis. We've been told that bipolar disorder is typically a diagnosis made after observing the child for five or more years (but that doesn't mean you ignore and not treat the symptoms while observing).

I hope that sheds a little light on this diagnostic dilemma.

 

[klmno]

Based on the things my psychiatrist has said, i will second smallword's reply above. my psychiatrist has used the terms depression and manic (mostly depression) and anxiety in discussing my son and has switched him to lamictal. we discussed the fact that this is not an exact science at our last visit.

one thing i will point out- my son was tested by the pschologist in the psychiatrist's office last year because erratic behavior had just started a few months earlier and i had to have some idea of what was going on with him- the testing was also suggested because i was told it would be helpful for use at school. and, i was told that if the school did the testing, it usually was a little skewed to the teachers' perspective, at least in this area. the results include recommendations that can be used at school.

the testing did help but, it has left us in the same place you are already anyway. and, the diagnosis came back as depression and disruptive behavior disorder, not otherwise specified. As I mentioned, it now looks like the disruptive behavior might be mania and i'm not sure the therapist we saw last year approached it as anything other than "a spoiled kid with a bad mom". i'm sure that's the way the school has treated us. anyway, now i am shooting for having another extensive evaluation done this year by someone else. it might not be any more definitive, but there is another year of "history" to take into account.

 

[Big Bad Kitty]

Kjs,

I don't have any advice on bipolar for you. I just want you to know that I have been praying real hard for you. You've been having a hard time lately, according to your posts, and I just feel bad. Big hugs.

 

[Kjs]

regarding mood stabalizer, difficult child has been on Lamictal for about 1.5 years. He did so well, seemed like a whole different kid. Until I switched jobs in February. They were not use to having me home, I have stricter rules than Dad..difficult child is home alone in the mornings to get ready for school and get a ride, he says he is fine with that, but I think it bothers him. (3 days a week), in July it will be 2 days a week that I will not be home in the morning. That is my theory. He is defiant, (we were told ODD when he was TWO!!) He is so anxious and nervous I feel sorry for him at times. psychiatrist tried to add lexapro..was a disaster. Then he added remerom which was really a disaster. i just wish he had a support system at school, that would help remind him he is ok, everything will be fine.

 

[smallworld]

Kjs, I'm not saying your son can definitely tolerate antidepressants, but your psychiatrist started at too high a dose to know if it would be helpful. Our psychiatrist started at 2.5 mg Lexapro and moved up to 5 mg after 3 weeks (we may need to go higher, but slow and steady is the best method with these medication-reactive kids). In addition, Lamictal sometimes is dosed at higher than 200 mg for kids. There may be circumstances exacerbating what's going on with your difficult child, but I do think he may need more careful attention paid to his medications.

 

[Kjs]

psychiatrist said he didn't want to go any higher with Lamictal because he weighs 90 pounds and he thought that was good for his weight.
I think I am more afraid now of new medications since he was just so different when we tried to add. It was scarey.

 

[totoro]

I don't know how my Mom's BiPolar (BP) manifested itself, she died when I was 9, but my moods were a lot like Midwest Mom's. My Brother is very violent and a bad drug addict, he started very young both of us did... around 12 yo. We had lots of violence and rages, but I was able to keep it together at school also. I was the calmer one, with more anxiety.

Now my difficult child 1, had horrible rages, premeds. Very violent, she was very remorseful after. She is the most caring empathetic little girl, until she starts cycling up to a manic episode or a rage.

Now on Abilify she has mostly anxiety and depression, with decreased anger/violence. She stills cycles like craze but without the violence and rages.

Good luck and hang in there. I am glad we did the nuero-psychiatric testing! I realized difficult child 1 is really smart but has a hard time accessing those areas at times, due to the chaos in her head. I wish we had support at school also, especially for the anxiety. To let her know it is OK!