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............
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
And you've spent how many years working child psych, Tom? Saying a 4-year old can't have bipolar disorder is like saying a 4-year old can't be diabetic.
I'll grant that it's very difficult to differentiate "normal" 2-year-old behavior from problematic behavior due to mental illness, but that doesn't mean it doesn't exist. When I first started working in child psych, I probably would have agreed that most of kids' problems stem from poor parenting. I would do an admission and hear the parents describe their child's behavior, all the time thinking about what I would discuss with them concerning discipline issues when they came to visit...then they'd start telling me how they tried to manage the behaviors and lo and behold, they'd be doing everything "right." It wasn't only talk, I could see how they interacted with the child during visits. It didn't take long for me to lose that assumption that these kids would be OK if only their parents were better parents.
Yeah, I've seen lots and lots of cases where the parenting skills left a lot to be desired and probably exacerbated the problems even if not the cause. Abuse and neglect certainly screw kids up, not to mention maternal drug/alcohol use during pregnancy, but sometimes kids just have screwed up brain chemistry and there really isn't a minimum age for it.
Oh, OK. I thought when you said you'd "never buy it for 2, 3, and 4 year olds" you were saying you didn't believe that children could have bipolar disorder. I'm still confused about who "they" are who claim that the rates are...what? and who "they" are who want to pump their drugs into kids.
I'll admit I've got a biased viewpoint because the kids I see are the ones who's behaviors are bad enough that they are admitted to a locked acute unit, but there are certainly kids out there who aren't going to be able to grow and develop normally without some kind of help. Some of them do need meds because they can't even control their own behavior long enough to learn how to control their own behavior. These kids don't have any friends. Many times their own extended families don't want to have anything to do with them. These little guys are sad and miserable and can't understand why they keep failing at everything they try to do. There are worse things than being labelled (and of course, the enlightened health care professional doesn't label his or her patient as "the bipolar kid" or the schizophrenic, right?). There's having a totally crappy childhood and then a totally crappy life because your brain chemistry is messed up and your parents were more concerned about the stigma of a "label" than your well-being.
In every situation we weigh the benefits vs the risks of medication, and for some kids the benefits of using meds to help them outweighs the risks.
Why do the rates of mental illness in kids seem to be rising? It could be because people are beginning to admit that they can't manage their children's behavior. Can you imagine a parent in the 1950's admitting that their 8 year old child beats them up and injures them or threatens them with a knife? Everyone would have told them the kid needed more discipline...in the form of spanking, of course. Which would have made situation much worse.
It could be because adults with bipolar disorder and other psych illnesses are being better managed through medication and are more functional, working, marrying, and...having kids who will have the genetic material to predispose them to a psych illness.
It could be because children are exposed to untold environmental toxins--both chemical and sociological. A recent report found that children who are exposed to television before the age of 3 have a 20% greater incidence of ADHD than kids who don't watch TV at an early age. As for chemical toxins, no one really knows what we're all being exposed to and what effect they could have on children's development.
That said, a) I don't trust drug companies when it comes to marketing their products and b) I know there are lots of parents (and teachers) who want a "quick fix" for their kids' behaviors. I would only advocate medication for behaviors that have a severely detrimental effect on a child's quality of life--risk vs. benefit.
luci
PS: Don't forget that it hasn't been that long ago that it was believed that autism was caused by having a cold, distant mother--more PPP. I don't think anyone really believes that one anymore.
This thread has really hurt my feelings. My son, now 13, was diagnosed with depression at age 6. He comes from a stable home, in an affluent community and is raised by both parents. For years I felt guilty because I thought it was something I did or did not do. I educated myself about mental illness, joined and worked for the National Alliance for the Mentally Ill and took my child to the best Doctors and therapists available.
Depression and bipolar are neurobiological brain disorders. My son's mental illness was not caused by PPP and I take great offense to that assumption. I have worked hard to get my own family (with a history of depression on both sides) to accept my son's diagnosis. I do not feel he is a labeled child because of his diagnosis.
What frightens me is that there are professionals working who do not understand the pain a family goes through dealing with this. Mental illness affects 1 in 5 people. I do not know why the incidence of mental illness and PDD in children has grown so much in the past 10 years. I do believe environmental toxins & genetics are partially responsible.
Sorry to go on... I guess I am in the 1% of the population who is NOT to blame for my child's psychiatric disorder (BTW I think that number is way off! ) I KNOW I am not responsible for his diagnosis (unless you include genetics into the mix.) No parent should be made to feel guilty for that.
I'm sorry your feelings were hurt Michelle. It's all a matter of educating people and trying to erase the stigma of illnesses that are expressed via behavioral problems, mood problems, hallucinations, psychosis and other equally scarey (for people not used to dealing with them) manifestations. Remember that there was a time when people thought physical illness was a result of sin or offending the gods (and is still thought of that way in some cultures).
Not a nurse here, just a mom who could use a nursing degree at this point with one bp teen, one 'normal' (yuh) & one just not dg yet.
Tom, from my point of view the best aspect of getting this diagnosed as early as possible is to avoid meds that start kids cycling. Or make them worse. Even OTC cold meds can do it, & so easy to avoid if you just had an idea what you were dealing with. Not saying let pdoc community pump them full of meds either!! (CAP convention Miami 10/2003: they practically admit they're routingely msdg it as add, adhd, depression-- & mstxg it.)
Also keep in mind: an unmedicated kid in a mania, a depression, or more likely rapid cycling already has a brain flooded with out-of-whack chemicals & his development is continually interrupted & regressed. A small regular dose of an atypical antipsychotic he can tolerate will at least give him regular periods of sleep which can help stop the cycling for a while.
tjjs: am so worried about you letting them give your 7yrold Zoloft. Pls pls read "The Bipolar Child" again. Better yet: sign up for an online support group with CABF (child & adolescent bipolar foundation)-- the associated parent group communicates regularly w/Papolos' & their peers. Read more & read widely. If you just follow along & let pdoc give her AD's, &/or stims, for yrs (as, god forgive me, I did), when the hormones start surging you will almost certainly have an out-of-control situation which takes yrs of med tinkering to stabilize. Papolos himself says: when a child has been on AD's for yrs I cannot predict how long stabilization will take.
tinynurse My understanding: usual treatment for a little one is small dose of atypical antipsychotic. Is the child in hospital?... maybe they have already tried all the AP's? maybe take a peek at the medication threads on CABF forum... (depkt for a 4yo??)
Did you know that 50% of people with bipolar disorder have a parent or grandparent with the disorder as well? Probably not. Out of three children, my niece (2nd child) looks exactly like her mother and, you guessed it, bipolar runs in her mother's side of the family. Even at less than one year old it was obvious that this child was being hijacked by her brain. She is also precocious, gifted, loving and thoughtful (so are the other 2). No, I do not think it has helped her behaviors to be around the adult family members who also have bipolar disorder but, the other two have been around it as well and are unmoved.
I am saddened by your ignorance...please research before forming an opinion.
Specializes in LTC,Hospice/palliative care,acute care.
Honey,don't take it to heart...Consider the source is an ignorant bigot and move on...My own brother- in- law told me there is no such thing as ADD and ADHD "It's all bad parenting" These people are judgemental and very rigid in their thinking and they won't change....
until they pop out a challenging child-then their tune will change fast...
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.....
I agree. It is criminal to subject animals to be tortured by this child.
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.....
This made my blood boil. What the hec are those parents thinking? What a message to give the kid by leaving animals in the house for him to maim.
teeituptom, BSN, RN
4,283 Posts
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