Children w/ Bipolar

  1. My neighbor's son has been dx with bipolar at the age of 7. She has been told that he is a rapid cycler and now he has a comorbid dx of oppositional defiant disorder which I question because he seems like such a sweet kid. He is defiant with the docs and his parents, not around other families or at school. Have any of you seen this young of a bipolar pt? What can you tell me about being dx so young? Is it a poor prospect? She said he has already been suicidal early last year but they recently had to admit him and taper off current meds and start others. She said when they brought him in once and he was throwing a fit having to return after his counselor/doc visit the nuses/aides like took over and put him in the padded room when what she wanted was to calm him down in his room. She said she feels like she gives up all control when she enters that floor. She fears what his exposure to this ward is doing to him as well. Any thoughts on that? It sounds as if no one is communicating to her about why they do what they do (policy) so I told her to talk to the nsg supervisor on the unit and maybe she could explain things to her but she said all communication has to go thru the social worker. So I thought that was kinda weird. Also, she can only visit from like 6-730pm. He is a kid. Why cant she be there to help take care of him? He took a cold shower b/c he didnt knowif you turned it a little further it would get warm!( What can I tell this mom? She is a really great mom.
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  2. 18 Comments

  3. by   Loray
    I do not nurse children however it appears from what you have said things get pretty confused for her and her child. In my experience family therapy sometimes can be helpful. The question is where will this child be in 10yrs if he is not recieving the right help. Mum getting some support should help the child.
  4. by   BjOnrs
    I have a child that was diagnosed as bipolar at the age of two. Also has OD syndrome. She needs all the [rpfessional guidence she can get and it will still not be enough. Some of the newer medications may be appropriate for her child but it is just a try this and see situation. Good luck with the school situation. Depending upon your district it can be a good or horrible experience. I unfortunately had both.
  5. by   Orca
    I cannot imagine anyone diagnosing a two-year-old as being bipolar. Many things seen in children as part of the normal development process would be considered pathological if seen in the same degree in adults. One cannot apply the same diagnostic standards to both groups. In the case of the seven-year-old, there is some definite pathology there. However, to just throw a diagnosis of bipolar disorder at it seems irresponsible. About the only way to determine bipolar disorder conclusively is to try antimanic drugs and see if they reduce symptoms.

    One psychiatrist I worked with said that the earliest age of onset of bipolar disorder was 18-19 years of age, and that it is inappropriate to apply the diagnosis to younger patients. Indeed, there is a huge debate in the psychiatric community about this. Although you can find reference books on "child onset bipolar disorder", there is no such diagnosis in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Revision), which is considered the "bible" of psychiatric diagnosis.

    I cannot imagine sticking a seven-year-old (let alone a two-year-old) on Lithium or Depakote. I would get a second opinion, pronto.
    Last edit by Orca on Aug 29, '02
  6. by   Rhon1991
    Originally posted by Orca
    I cannot imagine anyone diagnosing a two-year-old as being bipolar. Many things seen in children as part of the normal development process would be considered pathological if seen in the same degree in adults. One cannot apply the same diagnostic standards to both groups. In the case of the seven-year-old, there is some definite pathology there. However, to just throw a diagnosis of bipolar disorder at it seems irresponsible. About the only way to determine bipolar disorder conclusively is to try antimanic drugs and see if they reduce symptoms.

    One psychiatrist I worked with said that the earliest age of onset of bipolar disorder was 18-19 years of age, and that it is inappropriate to apply the diagnosis to younger patients. Indeed, there is a huge debate in the psychiatric community about this. Although you can find reference books on "child onset bipolar disorder", there is no such diagnosis in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Revision), which is considered the "bible" of psychiatric diagnosis.

    I cannot imagine sticking a seven-year-old (let alone a two-year-old) on Lithium or Depakote. I would get a second opinion, pronto.
    Her son is not well. Whatever it is, bipolar or whatever, he is not who he was and needed help. They said it was such a huge change. If my son were suicidal and defiant and a so called expert px him lithium after a year of other drugs and a hospital admission, I think I would be willing to try it. Thanks for your opinion though, looks like I might not get many of them!
  7. by   BjOnrs
    Thanks Rhon1991, I was relating my story about my son when he was two, however: that same son is now 23 almost 24 years old. They were right on the money with their diagnosis.
    When things are not right a parent knows and while the initial shock of a diagnosis may seem harsh , but it confirms that something IS wrong and you need help. Where you go from there may be varied but each step is toward a light at the end of what is a very dark tunnel. I appreciate your support and I know your neighbor/friend is appreciative of the support you lend to her. Thanks from us both.
  8. by   kiwideb
    From what you've said, it sounds like the mother isn't really 'in the loop' as such regarding the care of her son, and hasn't and isn't being informed of how they are managing him.... which doesn't really sound right, especially considering his age... I'm from new zealand thus am unsure of the protocols and services offered but i imagine you would still have advocacy services in place for consumers such as the mother you have described. This type of service can inform her of her rights and she perhaps needs that extra support especially since everything has to go thru her social worker... i agree it seems a bit bizzaire... but there should definately be something in the community to help her out here, it's just a matter of finding out what's available and how to access them... often the hardest part!
    I find it rather sad that a child that age can be labeled with bi polar let alone a 2 year old! I question the assessment process of the whole thing too....
    And yeah, whatever the diagnosis, the boy sounded like he needed professional help, which he is now getting....
    good luck to you and the mother and her son anyway
    deb
  9. by   sanakruz
    There is another thread on this subject entitled" how on earth...." I strongly suggest you go there.
  10. by   chicory
    My now 17yr old daughter was diagnosed bipolar at age 12. She later was rediagnosed as Schizoaffective. We have been through years of hell. She has been uncontrollable and violent through most of these years..w/ups and downs..she would have periods of near normalcy followed by more bizarre and violent behavior. She now lives in an Independant Living shelter and I am sooooo thankful. It's so peaceful at home now, and my little boy will not have to witness her antics anymore. She will never be welcome in my home again. Even though she is mentally ill, her actions can be controlled by herself to an extent. She was always able to control herself outside of the home. People would always tell me what a smart great kid she is. Meanwhile she's be hitting me behind closed doors. Therapy, meds, you name it...nothing really helped for very long. She is a mean unhappy person, and will never change. I grieve for my lost little girl who once was happy and loving. It's as if the mental illness changed her irrevocably..almost like a possession.
    Some kids really can seem fine to strangers. Don't judge the mom when you don't know what goes on at home. I spent years protecting her,not wanting her to go into the juvenile system, making excuses. She really put me through alot of humiliation in front of people who had no clue.
  11. by   Rhon1991
    psychnurse, I read all the posts there and am clear as to where all of you stand on the issue. I agree with many things such as the pharm commercials and maybe too many kids on meds these days. What I didnt find helpful was the thought that these kids have these problems due to bad parenting. Since that is what YOU all see in your line of work, I can understand that. But this mother I know has got to be one of the best moms I have ever met. No, I dont live with her. But I see her outside playing with her children more than other moms, I see how she talks to them and they intelligently and lovingly talk back to her. She has a graduate degree, her husband a doctor. So I doubt bad parenting is the case here (because of the interactions I see). Like I said, Im sure she is someone who would have ruled out diet, allergies, sleep problems, ect. This kid is also very smart, the way he is curious as to how things work and enjoys explaining to someone how things work. She thought he would grow up to be an engineer.
    Anyway, its still sad. He is in school and is on some sort of independent study plan. So they arent 'just drugging him'. In fact, his counselor this summer refused to see him anymore until his drugs were more effective so that he could talk about things! So the mother was caught back by that...
    I am really taken aback to everyones exposure to kids in the mental health system, it does scare me!

    Chicory - wow, you sound a little like my friend. she is doing her best to make him better and protect him and she tells me they have quite the physical fights at home, too. you all would not imagine this if you saw this mother and son. there is apparent genuine love there. she grieves for the son she had before all this too. Sounds like you did your best and making the right decisions. My heart goes out to you.
  12. by   chicory
    Rhon, thanks..it means alot to recieve support. In cases like this the parent's guilty feelings and shame can be enormous. When we see normal kids and their families, we can feel jealous and sad. The loss is like a death, in that you have to come to a realization that yes, your child will never be okay. Please continue to give your neighbor your support and friendship..sounds like she needs it. She's got a long road ahead of her. Oh I do have sympathy for the kids too, don't get me wrong. It's a sad situation all around.
  13. by   RNGranny
    Since mental health issues have been covered under Medicaid/Medicare over the last 2 or 3 decades, we have suddenly developed an entire multi-billion dollar industry of being to apply a psych diagnosis to everyone. What will happen when 90% of our children become adults and fall under the Americans with Disabilities Act because they have been diagnosed with a mental disorders. I think it is impossible to make all these diagnoses on very young children. Many children who act out have had little or no consistent parenting or discipline. I was appalled at what passed as good medicine when I worked Ped psych. Some of the doctors had the ethics of a turd, excuse my French. And that goes for the proliferation of ADHD diagnoses. We have a generation of latch-key kids and kids who are stuck in day care or apartments. Mom and Dad come home from work exhausted and the cooped up kid wants to vent some energy. Parents can't handle the normal demands, seek help, child put on meds. Tragic!
  14. by   CliveUK
    Could it be possible that this kid hasn't got anything wrong with him, but actually has something very right with him. Kids with very high IQs often display difficult behaviour thanks to boredom, frustration and so on. It was Rhon saying how curious he was about how things work &c. I find it sad that Rhon then said "She thought he might grow up to be an engineer' - he still could!

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