4 year old bipolar????????

  1. so a 4 year old is diagnosed with bipolar by a pediatrician, put on depakote........
    what do you think????
    child is unmanageable with any sort of discipline, will throw tantrums over an hour.......child hits himself and says "mommy hit me" ( right in front of others) child injures pets to the point of pet deformation. several specialists are sought out at this point in time, and the depakote has been upgraded to 250mg/ morning and 125mg night. ( with no change in behavior)
    what do all of you psych nurses think??????? please............
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  2. 29 Comments

  3. by   LolaRN
    I am not a psych nurse but my daughter is being tentatively diagnosed as Manic depressive. She has been being treated for psych problems since she was four. Her doctor thinks that it is very hard to give an actual label at that age, even now at 7, because kids are so neurologically immature. She has worked on treating the symptoms and we have been pretty successful with that. She still has problems definitely but we are not getting bitten, kicked, hit every day. She takes zoloft and risperdal. My heart goes out to you because I understand how hard it is. And if you are anything like us, we have had loads of armchair parents telling us that "if only you....she'd be fine" or "i'd never let my kid get away with that". Until you have dealt with it, it's impossible to understand. One book recommended by our doctor was " The Bipolar Child" by Demitri Papolos and Janice Papolos. Excellent resource. Let me know if I can help.
  4. by   traumaRUs
    I have a son with behavioral issues - go to conductdisorders.com - not just for conduct disorders - they deal with psych issues too. Good luck...
  5. by   NewEnglandRN
    Hi... I'm not an RN (yet!), but my son was diagnosed with depression at age 6. At that time he was placed on Effexor and had an extreme reation requiring hopsitalization in a pedi psych ward. After being there for three week of observation, they diagnosed him with early onsey bipolar disorder.

    That was 7 years ago and many medication changes, specialists, EEGs, MRIs, etc. Do I believe he has bipolar disorder... yes. Was he symptomatic at age four... yes, but I did not feel he needed medication at such a young age.

    Of course every child is different and some very young children need psychiartic drugs to help them.

    Michelle in MA
  6. by   lucianne
    tinynurse, are you asking what psych nurses think about the diagnosis, the meds, the age of the child, or what? I couldn't speak to the diagnosis without knowing the full history. The behavior you describe is similar to the way early onset bipolar disorder can present in children, but I've also seen children with attachment disorder act this way. Was this child separated from his mother at an early age or did he have multiple caregivers or a chaotic family life?

    When being used to treat biploar disorder, it can take some time to get the depakote to a therapeutic level. Also, depakote doesn't work to stabilize moods for every kid. Some need lithium for mood stabilization. Many with severe behavioral problems need an atypical antipsychotic added to the mix to help with the rages and tantrums. ADHD is often comorbid with bipolar disorder.

    If you have more specific questions, I'll try to answer them.
  7. by   jaimealmostRN
    nevermind the kid, get those pets the h*ll out of that house! That information is extremely upsetting to me, I hope that this childs mother finds them new homes or even turns them over to a shelter.....
  8. by   timewood
    I am not a psych nurse but I have a niece who is bipolar and was showing signs in early toddlerhood. Children will also cycle through alternating manic and depressive episodes multiple times throughout the day. The child you are describing does not sound bipolar to me (with that little bit of info). That amt of violence is not typical of bipolar children....how devastating....
  9. by   Tweety
    It makes sense to me. As bipolar is probably a chemical imbalance, or an organic disorder of some sort, why wouldn't it appear at an early age, the behavioral manifestations may be different than adults of course.
  10. by   teeituptom
    Sorry I just cant buy it
    defies belief
    Bipolar 4 yos, not a chance
    more likely What I call PPP skills
  11. by   traumaRUs
    Tom - although childhood-onset bipolar disorder isn't a common diagnosis - it can be very real. Please don't automatically attribute it to PPP (poor parenting skills). Hubby and I have been through some horrid times with our youngest from age 15 to 17 with a major depressive episode. However, we are not poor parents either - married for 24 years, both professionals who are good solid parents. Not every psych diagnosis is related to PPP. (I expected a little better from you!)
  12. by   Tweety
    Quote from teeituptom
    Sorry I just cant buy it
    defies belief
    Bipolar 4 yos, not a chance
    more likely What I call PPP skills
    Sorry I disagree. PPP doesn't come to play in all physch. disorders. That's so old school. Like blaming a domineering mother on someone's homosexuality.

    Good parents raise sick kids.
  13. by   traumaRUs
    Thanks Tweety.
  14. by   teeituptom
    Quote from traumaRUs
    Tom - although childhood-onset bipolar disorder isn't a common diagnosis - it can be very real. Please don't automatically attribute it to PPP (poor parenting skills). Hubby and I have been through some horrid times with our youngest from age 15 to 17 with a major depressive episode. However, we are not poor parents either - married for 24 years, both professionals who are good solid parents. Not every psych diagnosis is related to PPP. (I expected a little better from you!)

    Teenagers are a different story. I know that very well Om on my 7th

    But I will never buy it for 2 and 3 and 4 yo"s

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