When did you know it was BiPolar (BP)

[Dara]

When Did you know your child had BiPolar (BP). Sammy is turning 3 in June and his therapist and I were talking about his patterns of behavior. He said off the record that it sounds like he is having manic episodes. I totally agree. We have suspected BiPolar (BP) for a long while. We have said that we would not be surprised of this was his diagnosis or some kind of mood disorder even ADHD. Really, I just want your thoughts on the early signs you guys noticed. Really what can they do with a 3 year old?
Thanks for your thoughts and wisdom!

 

[mightymouse]

Great question Dara. My son is almost 4 and I suspect BiPolar (BP) as well. I started to suspect it after finding this site and have also read some of The Bipolar Child and the description fits him to a tee. We're in the process of having him evaluated, but I am not impressed with what's been done so far so I'm sure we'll go to someone else. I'm very curious as to what other's have to say about this topic.

 

[BusynMember]

From my long, tiring experience, it takes a long time to get the right diagnosis. My son was diagnosed ADHD/ODD at three. Then he was diagnosed bipolar at seven. He had symptoms of both, but they were both wrong diagnoses because all of the childhood disorders have similar symptoms, BUT each disorder has a different treatment. My son is Pervasive Developmental Disorder (PDD)-not otherwise specified, which is often mistaken as bipolar. He was on at least ten drugs for ADHD and bipolar that he didn't need. He's finally doing great, but he was 11 before getting the right diagnosis. He no longer is medicated nor does he appear to have moodswings. He needed school interventions badly, not medications.

 

[Dara]

We are really just starting out with the whole diagnosis process. I have suspected BiPolar (BP) or some kind of mood disorder for a long time. His behavior definatly goes in cycles. Unfortunatly, his yucky behavior stays a lot longer and is more frequent than the good behavior. Mind you that most of these issues are left only for Daddy and mommy. He is perfect angel for everyone else. He is high anxiety. He is very overwhelmed or sensory overload in public places. He is able to take in a room and notice every tiny detail in seconds. He has developmental delays including language. He has random explosions that cannot be explained by "triggers" I have never seen anything like it it a young child and I have taught preschool for a long time! I dont really want an answer but I do so I can take educate myself and take care of Sammy in the best way. I am so afraid of BiPolar (BP). My roommate in college had it and it was the scariest things I have ever seen. I read all of these horror stories and I am terrified for my sons future and our future. I love Sammy so much. I just wish I understood what he is thinking and what is going on in that cute little head of his.

 

[SRL]

Your little guy has a lot going on here so you will want to have him seen by someone highly qualified and who will do a thorough evaluation. Expect this to be like putting pieces of a puzzle together.

Something to keep in mind as you do your homework is that undiagnosed Autism often looks like bipolar as well.

 

[flutterbee]

So many symptoms overlap it can be hard to tell. Especially in a young child not able to articulate what they are feeling.

I suspected BiPolar (BP) in my daughter for quite a while which is why I refused to medicate just the symptoms as so many wanted me to do - namely the school. I refused to medicate symptoms until we had a solid diagnosis. And that took a long time. (She's not BiPolar (BP), by the way.) At a continuing education class I attended, they said that statistically it takes 10 years for a child with bipolar to be correctly diagnosis'd. That is devastating. Unfortunately, there are vast shortages of child psychiatrists and neuropsychs, even in a metropolitan area such as mine, which just further complicates things.

Because of that and the long waiting lists, psychiatrists around here required a referral from either a therapist or a pediatrician. (I've noticed that Children's website has been changed to read that parents can self refer now, but this wasn't the case 2 years ago.) The psychiatrists at our children's hospital (The Behavioral Health Centers) don't diagnosis, from what I was told at the intake meeting. :surprise: I couldn't believe it. They depend on the therapists to send them the information and they just prescribe the medications. (I think that is because they anticipate that all of their patients will be seeing therapists that work for Children's as well. That is just not the case.) I found another psychiatrist at a child and adolescent psychiatric hospital and had to wait 6 months for the appointment. They only have 2 child psychiatrists at that particular facility. (And I just got a letter this week that our psychiatrist is leaving and going to Children's. So, we'll have to wait again.)

While difficult child's neuropsychologist said to keep bipolar on our radar with her, it's her anxiety right now that is the issue. And we go through some periods where it looks a lot like what I read about with childhood bipolar. And when she was younger her anxiety looked like ADHD. It probably still does to a lot of people, I just can recognize the difference now.

I'm just trying to stress, through this long winded spiel, how important it is to get the right professionals involved as soon as you can. When I started this process with my difficult child, I didn't have the benefit of this board. I had never even heard of a neuropsychologist until difficult child's therapist referred us to one. Had I had the insight and experience of others who have gone before me, I don't think it would have taken nearly as long to get the right diagnosis for my difficult child and get the right medications and therapies in place for her. She would have benefited greatly from earlier intervention.

 

[SRL]

wynter'sgrace, thanks for taking the time to explain what you have been through in terms of getting a correct diagnosis. I agree, it's extremely important to get the right people involved.

BiPolar (BP) is trickier to diagnose at younger ages than many of the other disorders we commonly see here. Because BiPolar (BP) virtually always points towards medications and medications can make changes in speech, language processing, behaviors such as obsessions, tics, etc, even if the medication isn't targeting that area, it's important to identify or rule out those other possibilities. BiPolar (BP) can also run comorbid with most of the disorders we see here. Our developmental pediatrician wanted to prescribe Prozac at our first appointment and I refused because most of the evaluations ahead of us. Sure enough a year later when we made the decision to trial an SSRI it had a huge impact (positively) on my son's language processing and would have clouded the speech/language results.

When my difficult child with Autistic tendencies went unstable due to very serious anxiety, he looked very much BiPolar (BP). I started to see manic phases where previously we hadn't seen any and his other behaviors in many way paralleled BiPolar (BP), in addition to an increase in the Autism. Had I gone looking for my first answers at that point in time I would have given serious consideration to BiPolar (BP) when it really isn't a factor at all. Manic looking episodes can stem from anxiety, ADHD, sensory, Tourette's, etc so be sure and look at the big picture before narrowing it down to a specific cause.

If BiPolar (BP) is part of your child's neurological makeup, you certainly will want to identify that. Just be sure to cover all the bases.

 

[Dara]

I have no desire to medicate him at this point. I want to know what we ar medicating before we even think about it. Unfortunatly, the only neuropsychologist I found in our area was a complete quack! We are visiting the develpmtl pediatrician. on the 30th so maybe he will point us in the right direction. Sammy definatly has high anxiety. I really just wish I knew what was going on in his head.
Thank you for all of the info you guys have. I do really appreciate it. THis is such a confusing time. Trying to figure everything out!!

 

[jal]

I am still having a hard time accepting the BiPolar (BP) diagnosis. Two dr's, a psychologist and his current psychiatrist have diagnosis'd BiPolar (BP). We have just begun the process with the neuropsychologist. I have been aware that it could be BiPolar (BP) since last August when he was first diagnosis'd and read everything I could on it. He fits the Bipolar Child almost to a tee. The psychiatrist said he was going with an evolving diagnosis of BiPolar (BP) and last week he confirmed it when he saw difficult child in a semi-manic state. It was (is) hard to swallow. The hardest thing I had to do was to place him on Lithium. An almost 5 yr old! It broke my heart. :crying: We have chosen to medicate because physically he is a danger to himself. He is also a flight risk at home and in school (which is why he has been given a break from preschool). He is so wound in a constant manic state he cannot absorb the environment around him.

I pray that this BiPolar (BP) diagnosis is wrong, but I don't think it is.

Oh and to boot the psychiatrist thinks ADHD too. That's the worst mix to have. :frown:

 

[Lothlorien]

I took my difficult child to a neurodevelopmental psychologist when she was three and she told me that she was just having temper tantrums and she made me feel like this horrible mother that was looking for something that wasn't there. I knew something wasn't right with my kid, but her reaction to me made me stop pushing further. I didn't really suspect bipolar until the last 6 or seven months or so. She was just diagnosis'd about 2 months ago.

Honestly, with his young age, it could be a number of things. Autism spectrum comes to mind. Have you taken him for evaluation at your local children's hospital? I would thing that there would be your best start.

You may want to check into some of the natural treatments...such as Gluten/Caesin Free or The Feingold diet. Since he is so young, it would be fairly easy to get him on one of those programs. I started my difficult child on Feingold at 3 1/2. Now we just restrict the food coloring and corn syrups, which are HUGE triggers for her.

 

[SRL]

Ugh, that's sure what you need when you finally take the plunge to have your child evaluated.

If I had a child with ADHD tendencies, I'd be looking into omega fish oils. I've recently seen several studies that suggest they are as effective as medications. I don't know how reliable the studies were, or whether they've been reviewed and published so as always don't take everything you read as gospel. I think the other study was recent and out of the UK.

http://www.smh.com.au/news/National/Fish...0701561387.html

Guess granny wasn't so far off with the cod liver oil.

 

[Dara]

Sammy has been evaluated by many neurologists and is in ABA therapy which specializes in Autism. Everyone there agrees that he is not Autistic. THey are not ruling out Pervasive Developmental Disorder (PDD) yet. Where can I get info on those diets. It might be difficult because Sammy eats only 4 things so... Our next appointment is a highly reccomended devp pediatrician. Like I Said the neuropsychologist was less than helpful. In fact, I think we all lost some brain activity due to this man! Hopefully we will soon have a better idea of where we are.
Thank you guys again! Have a good rest of the night!

 

[smallworld]

Dara, I'm confused. If the ABA folks don't think Sammy is "autistic," what do they mean when they say they're not ruling out Pervasive Developmental Disorder (PDD)? According to the DSM-IV, the pervasive developmental disorders (PDDs) are a series of five diagnoses: Autistic Disorder, Asperger's Syndrome, Pervasive Developmental Disorder (PDD)-not otherwise specified (not otherwise specified), Rett's disorder (which only affects girls) and childhood disintegrative disorder.

 

[Dara]

They are saying Not full blown autism. Pervasive Developmental Disorder (PDD) is high functioning which he barely was on the chart for so they arent sure there. he does posses some tendencies but mostly it seems like BiPolar (BP) or someother mood or behavioral disorder. I really think we are far from answers but who knows..

 

[smallworld]

You should be aware that autism is a spectrum disorder, which means it can range from mild to severe symptoms. Pervasive Developmental Disorder (PDD) is technically an overlying category for a group of individual diagnoses as listed in my post above. All the PDDs lie on the autism spectrum. Pervasive Developmental Disorder (PDD)-not otherwise specified means non-verbal language problems not meeting strict criteria for other Pervasive Developmental Disorder (PDD) disorders.

 

[SRL]

Diagnostically, since Sammy has or has had issues that fall in the realms of speech, language, sensory, anxiety, motor, with possibly ADHD and ODD, hopefully the developmental pediatrician will be able to see a primary diagnosis that will account for all of those symptoms. BiPolar (BP) doesn't even come close to doing that, although sometimes it is a comorbid diagnosis or sometimes parents report that children with that cluster of symptoms have mood disorder tendencies.

 

[smallworld]

SRL is right. My kids have mood disorders that tend toward bipolar disorder and are being treated as if they have bipolar disorder (FWIW, we've been told by several psychiatrists it can take about 5 years of observing a child to definitely make a diagnosis of bipolar disorder). My kids have had extensive neuropsychological and psychiatric evaluations. They have no motor issues, no speech issues, no language issues and no learning disabilies. They have mild sensory issues, inattention, significant anxiety and depression. The professionals who have evaluated my kids say their inattention is tied to their mood issues.

 

[Dara]

I know that it is going to be a long road to figure out what we are dealing with here. In the past 2 years things have changed drastically to the direction we thought we would be going in. In the begininng we all thought the developing stages of autism. I dont know if working with each behavior as it came about really stopped it from really developing or that he never had it at all...we will never know but now, he is definatly moving away from the autistic route. THe real problem is, Sammy had seizures at 11 days old. He had 8 seizures in a 24 hour period 2 of which lasted 3-5 minutes. They did every test under the sun and have no idea what caused the seizures. It was a one time thing really. We also are not entirely sure what damage the seizures caused. THe current theory going here is that whatever caused the seizures caused all of the issues we are having including emotional issues. We were optimistically hoping that with maturaty these problems would ease. I hate to jinx myself but he has been on a good pattern lately. (I probably shouldnt have said that because my husband is out of town and if he starts in again...) Again, I am hoping that the dev. pediatrician. will have some idea of the direction we need to go. It all seems that the pattern starts, no sleep, no eating and extreme tantrum and raging...and when he gets in these raging moods the sparkle from his eyes are gone.

 

[BusynMember]

Dara, the more you describe your son, the more he sounds like he could be on the autism spectrum--these kids can and do rage with the bipolar kids, and are often confused with them. However, speech delays and finicky eating are more an Autism Spectrum Disorders (ASD) issue than bipolar. In fact, many bipolar kids start speaking VERY early. They also tend to crave carbohydrates. You can't rule out autism/Pervasive Developmental Disorder (PDD) as young as your child. It was ruled out with Lucas too, but he has it. He's too young to rule in or out anything, really, unless it is blatantly obvious. I would get him into school early interventions and not worry about the label right now. If he has speech problems, I'd make sure he gets speech. If he has trouble expressing himself completely, I'd try to get ABA. If he needs PT or Occupational Therapist (OT) I'd get it. Social skills? I'd get it. My son couldn't get his Pervasive Developmental Disorder (PDD)-not otherwise specified label until he was 11, but he was in Autism Spectrum Disorders (ASD) early interventions before he turned a year old. I can't tell you how good this was for him. At fourteen he is functioning at a high level, no longer raging, and is a happy teenager, albeit "quirky." He used to tantrum, rage, hit himself, bite himself, etc. thus he got a bipolar diagnosis, but he was just frustrated in a world he didn't understand. Once he got help, he became almost mellow! He is my sweetest child by far right now, BUT we were proactive from the beginning. He was adopted at age two, and was already in early interventions before that, diagnosed with "severe ADHD." Well, we knew it was more. He didn't speak on time, yet he learned all his numbers, letters, colors etc. He was a really strange kid. His tantrums were scary. Once he learned to talk clearly (age 4 1/2), his tantrums disappeared, but they don't disappear in all Autism Spectrum Disorders (ASD) kids. Some need medications, like Risperdal. 50% of all kids on the Spectrum are on medication. But I think you're smart not to rush into a diagnosis or medications. No matter what you're told right now, it is likely to change as your child gets older. I personally like NeuroPsychs the best for evaluating. Psychiatrists completely missed the Autism Spectrum Disorders (ASD) in my son, even though I asked about it a lot, and gave my kid medications up to the wazoo. The neuropsychologist took twelve hours of testing, pinpointed his deficits and problems, and nailed him right. Good luck and don't focus on bipolar yet. Lots of things can cause tantrumming.

 

[SRL]

MM, this child has been in ABA from a very young age which is why Dara mentions the possibility that if it is/was Autism the effects could have been minimized due to intense early intervention. Between the seizures and the intervention, it clouds the diagnostic picture which is why she's needing to get input from those outside of the ABA therapists who work with him. He's had plenty of therapy, now what they need are answers and recommendations on the next steps to take (ie early intervention preschool).