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.
Aug 29, '02
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