Bi-polar dx

iVillage Member
Registered: 08-27-2003
Bi-polar dx
14
Wed, 08-27-2003 - 1:27pm
It has been awhile since I have needed advice from the boards, but it is good to know you are all still here. My son was dx ADHD 8 years ago. We have added over the last 2 years, ODD, anxiety, and depression to his dx. We had him evaled at Children's Hospital of Phila in 2000 which resulted in the new dx. What had sent us for evals to begin with was a therapist that we were seeing had suggested that Nate may be bi-polar. Well,,,, the docs at CHoP wouldn't definitivly dx him with Bi-polar due to his age. We are now 3 years later and alot more frustrated.

Currently, we have wrap-around services that provide at home and school behavorial therapy and support. The therapist that we have now has also made strong suggestion to have evals for bi-polar. She gave me a list of symptoms for bi-polar with 3 columns-most common, common, and somewhat common. Well, Nate, has just about all of the symptoms from all of the columns. And for quite a while, not just recently. We do have a pychiatrist right now that manages our meds, so I sent her the list and a letter stating my concern with Nate being misdiagnosed. We see her this evening. I am worried, scared, confused, angry, you name it!

Can anyone give me any feedback on meds for bi-polar/ADHD combined dx? experiences? I have been doing some research on line and getting more worried. The meds seem so drastic. And the possiblity of scitophrenia (sp?)? It is all so scary and this is my 11 year old son. My exhusband was just dx with ADD and bipolar a few years ago. I dont want Nate to grow up with the difficulties (alcoholism, drugs, etc), but then what if the bi-polar is an incorrect dx also. Should I be pushing for the dx? He has been having trouble in school and at home even with taking Ritalin, Zoloft and Risperadol. So what we are doing now does not seem to be effective.

thanks

Angie

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iVillage Member
Registered: 05-01-2003
In reply to: momdoesitall
Thu, 08-28-2003 - 12:42pm
Well CHOP is one of the best in the area and knowing what the quality and quantity of good docs in the area are like, I cant really give you too much more choices. Yeah I am in PA too in fact in a suburb of Philly so let me know if you are nearby so I can give you some names. If your son has bi-polar he should NOT be taking an antidepressant without a mood stabilizer. It looks as if he is being treated for depression with psychotic features and ADD. There are many doctors that dont want to put the label of Bi-polar on a child and actually treat the symptoms instead of labeling. Personally I think that is just plain stupid and that people get far too hung up on labels. Giving something a name isnt going to make any difference except how ignorant people may see things. I dont really care what others think and would rather know what we were dealing with. Are you using a doctor from the same agency that is providing wrap around services? Is your son also getting a TSS or Mobile Therapist? I run a support group for parents of mentally ill kids in Bucks COunty. If you are nearby, we are meeting tonight. You may get some ideas of docs from there.

Debbie

Avatar for kathy_in_ga
iVillage Member
Registered: 03-26-2003
In reply to: momdoesitall
Thu, 08-28-2003 - 6:20pm
My son had a horrible time his first 4.5 years of his life. We thought we were bad parents, we did everything everyone else said we should do. Nothing worked. We had him evaluated at 4.5 & BP or a mood disorder was mentioned. Hubby & I started looking into our exteneded families history. My mother is BP. We found out hubbys great grandmother was manic depressant & actually died in a psych hospital. We both have "strange" relatives, including hubs brother who is an alcoholic drug user & probably BP.

Our son was put on a mood stabilizer (depakene, a liquid form of depakote) when hwe was 4.5. He had a few outbursts, but it was much better. Then when he went into 2nd grade it all broke loose. We tried several different med combos but nothing really helped. Now this year things are much better. He is currently taking Depakote, a mood stabilizer, Seroquel < an antipsychotic, and Adderall XR for ADHD. We have tried several different mood stabilizers and anti psychotice, but this combo seems to do the best for him. Therapy never helped my son until he was put on the right meds. Your son should also be seeing a child psychiatrist.

If you are unsure of the DX, look into family history. Also read the book "The Bipolar Child" by Demiti Papolose. Here is his web sight which has lots of info. bipolarchild.com

Another good web sight is bpkids.org. Has lots of great info. They have lots of printable material, on the main pg click on "About early-onset bipolar disorder" and you will go to a pg that has all kinds of helpful info.

As far as the right DX, if you are not totally sure start keeping a journal or mood chart. I kept a journal on my computer each day. I would just document what kind of a day my son had, his sleep & eating patterns. I could tell the really bad days by looking for the long entries. This helped us determine if there was a cycle. Now if your son is on medications for ADHD only, then they can also make things worse if taken alone. This is why a mood stabilizer is helpful. You can't tell what a childs reaction to a med will be. Unfortunatly my son has had strong reactions to 3 different meds. 2 of them were ADHD meds. The other one was Risperdal, and anti psychotic, that made my son afrtaid of everything.

I too don't want my son growing up like his uncle, un DX BP I am sure. Now that we have a DX we can work with my son & make sure he grows into a a responsible adult. He will have to know that he can fall into the drug alcohol trap, and that he needs to avoid them but taking his medication. Most of the ones who do fall into that trap are self medicating, trying to slow their brain down during manic phase, or drinking to get rid of the depression. This is the excuse my brother in law uses.

I hope I helped in some way. Sorry this got to be long, but it is important that you educate yourself. Find out all you can.

Kathy

iVillage Member
Registered: 03-27-2003
In reply to: momdoesitall
Fri, 08-29-2003 - 12:38pm
Doctors are split on diagnosing BP in kids - some doctors believe it simply doesn't exist, while other doctors believe the sooner you treat it, the better off your child will be. Given that you have a family history of BP, it would probably be best to have your child evaluated further. In my research I have found that both Zoloft and Ritalin are not recommended for treatment of BP or ADHD w/ BP. Both meds can actually worsen the BP symptoms because of the way they work in the body. Strattera is more recommended for children with BP because it is a non-stimulant medication. I do not know what the problem is with Zoloft (my son takes it, as well) but I was told by more than one doctor that Zoloft is not the anti-depressant of choice with BP.

Schizophrenia and bi-polar are not necessarily related. They are both serious bio-chemical imbalances which cause mental illness, but do not necessarily occur together. Bi-polar is a mood disorder, while schizophrenics basically lose touch with reality. Ask your child's psychiatrist for information regarding both.

iVillage Member
Registered: 07-27-2003
In reply to: momdoesitall
Sun, 08-31-2003 - 2:44pm
My understanding is that IF your ds is bipolar he would go off the wall with the Ritalin and the Zoloft. He would be manic all the time and EXTREMELY manic.
iVillage Member
Registered: 06-20-2003
In reply to: momdoesitall
Mon, 09-01-2003 - 8:52pm
I am in Berks County PA right outside of Reading, Pottstown, Allentown. We just got TSS added to our Behavorial Therapist in wrap around . We had mobile therapy... long story short... Nate did not open up and respond and the therapist took him to a mall arcade and left him there while he went shopping. Needless to say he is no longer employeed with the agency. But we all agreed that Nate might do better with the TSS.

The pychiatrist that we use is not with the wrap around agency but I like her. She is trying to get us connected with a Child Pysch in her group. Just checking on insurance etc. Meanwhile, she did put Nate on a mood med. It is called Gabitrol. It is along the same line as Depakote, and other seizure meds. It is new and does not require blood work. She said that she went to a conference and it was a topic of discussion with alot of positive responses from other docs with regards to mood disorders. So far so good. We have been on it for 5 day. Gradually increasing dose. I just hate giving NaTE a med that is used for treating seizures, but the doc assured me that one of the side effects of the med is a positive effect on mood disorders. so we are giving it a shot. Crossing my fingers.

iVillage Member
Registered: 06-20-2003
In reply to: momdoesitall
Mon, 09-01-2003 - 9:00pm
Thanks so much for the web sites . I am sure they will provide me with alot of info. My son currently takes - Medidate ER for ADHD. Zoloft for depression, Risperadal for agression. The goal of the pysch is to get him regulated on the Gabitrol and then ween him off of the risperadal. The Gabitrol is similar to Depakote.. but somewhat safer. Doesnt require any blood work. There is family history of bi-polar on his bio-dad's side of the family. And depression on my side of the family. Bio-dad is the major case in his own right. I know for sure that he is but he is in denial yet. Again thanks for the info. I am going to go do some reading.
iVillage Member
Registered: 06-20-2003
In reply to: momdoesitall
Mon, 09-01-2003 - 9:05pm
I have not heard much about the Stratara (sp). I have had a few people ask me if Nate is taking it. I am so afraid to change things. The pysch right now said to start with changing to the Gabitrol and once stable on it, we will make some other changes. One thing at a time so we can monitor the effects of each change. Any feed back on the effects and results with Stratara would be greatly appreciated!

THnaks so much

iVillage Member
Registered: 06-20-2003
In reply to: momdoesitall
Mon, 09-01-2003 - 9:10pm
With alot of the research I have been doing recently, I have discovered that alot of the problems of the issues that we have been having with Nate are associated with the manic state. I was associating many of them as part of the depressed state, but quite the opposite. In the last year, things have gotten progressively worse and the moods so much more severe. Hopefully making the changes that we are will yeild some positive results.
iVillage Member
Registered: 08-31-2003
In reply to: momdoesitall
Mon, 09-01-2003 - 11:08pm
Hi ... I just thought you'd like to know that Zoloft is not a recommend for children with Bi-Polar... It may help the depression but creates problems for those with BP. I apologize for not having the source that I read that from but in the last 2 days I have spent countless hrs online trying to find out why my ds is not adjusting well to his meds. He is also on Zoloft and is BP. Needless to say I plan on calling first thing in the AM for Med check appt. If I find the source I will post it.

Tracey
iVillage Member
Registered: 09-02-2003
In reply to: momdoesitall
Tue, 09-02-2003 - 12:24am
I am in a similar boat, except my son is only 4...and it is sooo hard to think of him on all these meds. He has been started on Seroquel, an anti-psychotic, because his psych doctor feels he needs to have his schizoid tendencies controlled before he can be treated for his bi-polar and ADHD...suffice to say, i dont feel real good about things right now!! My ex, my son's father, is Bipolar and ADHD, and was suspected to be schizophrenic, so I also know how awful things can get when its not controlled. the meds out today are much better than years ago, although you are wise to be wary...I am a nurse and i checked all manner of resources before I even let my son take a single tablet...but also, be careful of over -worrying, sometimes too much info can be as bad as not enough!

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