My daughter was diagnosed at age six with Early Onset Bipolar Disorder. Such a big diagnosis for such a little girl. It was frightening, and I found out soon enough that there really isn't a lot of information available at this time on Bipolar Disorders in young people.
Before the diagnosis, I'd read books on ADD, ADHD, Oppositional Defiant Disorder, and many other illnesses associated with children who are "difficult". Some of the characteristics fit, but there was always something that DIDN'T fit. I knew, and those around her knew, that she wasn't your "typical" child. Even in infancy, she was a "high maintenance" baby. Of course, she was my first child and I didn't have anyone to compare her to, so I tried to brush aside worries with "every kid is different".
At age three, she started attending a daycare program. Before that time, she'd had little contact with other children. I was a stay at home mother until that time, during which I was going through a divorce from her father (who is bipolar) and had to get a job. I knew things would be difficult for her...change always seemed hard. But, I didn't expect to hear the reports back from the daycare that I heard. She was very aggressive, seemed not to understand and recognize the feelings of others, and was easily agitated. Again, in my ignorance and my sense of protectiveness, I chalked it all up to outside happenings in her life at that time.
Things only got worse with her age. I seemed to be apologizing and making excuses for her more and more. One day at her new daycare, she was hugging a boy. The problem is that she was standing, he was sitting, and she was hugging him from behind around the neck. This boy was turning colors and struggling to get away, but she simply didn't "read" the signals from him.
I talked to other parents, who gave me lots of great advice on how to disipline, how to let her know what our expectations were, etc. Unfortunately, what works on "normal" children doesn't always work on children with mental illness. She began to internalize all of the feedback she was getting from her caretaker, from me, from our family. She came to believe that SHE was a bad person. We tried to explain that while her behavior was not acceptable, we still loved her.
Emily is now in the first grade. At age six, she's operating on the academic level of a 4th grader. Unfortunately, the strides she has made academically cannot correct the social behaviors she continues to struggle with. At first, we had her tested for ADD. Many times the symptoms of ADD can mimic those of EOBP. However, if it is a task of her choosing, she can stay focused for literally HOURS on end. ADD kids don't generally have that ability to focus. Still, before Christmas of 2000 we tried a double blind study for Ritalin. In a double blind study, no one knows which week is the low dose, the medium dose, or the placebo until the last pill is taken. The Ritalin took away her mania, and she fell into a deep depression. Symptoms of depression in children can be different from that of adults. She was very irritable, quick to cry, quick to temper. In short, she was a miserable little girl.
In early January of 2001, we finally got the diagnosis of EOBP. And, truly, we aren't even sure if in the end this will be the diagnosis that "sticks". She is in counseling and is currently on Depakene. In February she was put on a low dose of Zoloft, which I was not entirely comfortable with. I'd talked to other parents of BP kids who warned that anti-depressants can often trigger psychotic episodes, but I felt that I needed to trust our doctor's judgement (which I still do, for the record). Unfortunately, it turns out that Emily is one of those children who can't tolerate Zoloft. It took away the depression, and left her with extreme mania.
At the time of this writing, we are getting ready to try a day treatment program at a nearby psychiatric hospital. The hours are similar to that of going to school, and she will be home each night. Insurance will only pay for 14 days of this program. Insurance is a whole other issue! The program will involve things such as group therapy with other children near her age and anger management. In addition, the doctors will be monitoring her progress and adjusting medications as needed. Our hope is that this program will arm her with the social skills she needs to use if she is to stay in school, as well as level out medications so she can function as a part of her class.
Emily just started grade 4 and is doing very well on Depakote, Risperdal and Concerta. She continues to have a few social problems now and then, but overall we have seen huge strides in her behavior and her sense of self. She enjoys Girl Scouting and has aspirations to be everything from an artist to an astronaut. Emily wants to learn all about foreign languages, sciences and history. She's becoming more skilled at making friends and keeping them. I'm very proud of her, and grateful for all the progress she's made so far.
It's very frustrating to see so much ignorance and prejudice regarding mental health issues. While things do seem to be getting better, they aren't happening fast enough. My child is bright and can be so sweet and loving. It's hard to have to explain to people that she really can't help the way she behaves sometimes. I get tired of the looks that seem to say "you're a bad mother" or "she's just a spoiled brat". Those people don't know what a struggle it is to live in our family.
Eventually I intend to put up some of the links regarding Bipolar, especially as it relates to children. I don't want other parents to have to feel that they must face this alone.