About our Daughter

I am mother to four wonderful daughters, ages 17, 19, 21, and 23, and wife to the greatest husband on earth. God has given us a special child to raise one who was diagnosed with early-onset bipolar disorder at the age of seven, though she showed signs of it from the age of fifteen months. She also has ADHD, Sensory Integration Disorder (sensory seeking), Dyslexia, and Non-Verbal Learning Disorder-NOS, all typical comorbidities for a bipolar child. In spite of the trials, she enjoys lacrosse, running (finished her first marathon in October of 2014!), and reading and writing her own books. I will share with you the many joys and sorrows we have faced and will face in the future with the hope that you may find better understanding about this mental illness caused by both chemical and structural abnormalities in the brain. I desire that you will be encouraged by this blog if you are also dealing with a bipolar child. Thank you for reading and sharing in our journey.

How Did You Know She Was Bipolar So Young?

I wrote a long explanation of how we came to this bipolar diagnosis in a child so young under my post of March 19th of 2009. If your child or a child you know bears similarities, please seek out a good psychiatrist and don't wait for "things to get better." Often they will simply get worse, and the longer a child is unmedicated, the more damage their brain can accrue. Early diagnoses and treatment are key to providing these children with a chance at a successful life later as a teen and an adult.
Never change, start or stop a medication without the approval of your child's physician!

Tuesday, May 11, 2010

Handling the Rages

One of the worst parts of dealing with a bipolar child is handling the many rages. These are not your typical temper tantrums. One of my children can still throw a major tantrum, but nothing like what we have seen in the past with Caroline. When she was very young, three or four, I was so bewildered and defeated by her rages that I would frequently call my husband at work and beg him to come home to help with her. He was able to do that then (only in big emergencies now) which was a lifesaver. Bipolar rages are more akin to seizures than to fits of anger. They are triggered by seemingly nothing, and the power behind them makes little ones look like the Incredible Hulk. I can still see her face distorted, red, eyes in this weird glaze, screaming, clawing, kicking, biting, physically trying to hurt me or one of her sisters. Awful. Really awful.

I have been asked how you handle these incidents. Honestly, we tried so many things. We tried spanking her, which no matter how "correctly" we did it, produced only greater anger. (she thought we were inviting battle.) We tried time-outs, loss of privileges, holding her, yelling at her (never works), throwing her in the car and driving around (actually the best calming tool) and in the worst of scenarios we took her to the hospital. If she was a danger to her sisters, we took her to the hospital. If she became a danger to herself, we took her to the hospital. If she was raging but it didn't become dangerous, we would let her rage in her room. Nothing strikes at your heart more than when you have an angry, out of control child who is scaring her siblings and you, and you feel helpless to solve the problem.

She has outgrown most of this, we think, or the meds she was put on at Meridell have solved this problem. She hasn't raged like that in a very long time. We are very thankful for the passing of this mixed-state behavior.

13 comments:

Adrienne said...

Of all the terrifying aspects of pediatric bipolar, only suicidality scares me more than the rages. And a raging, suicidal child is something one has to see to believe. The seizure metaphor is apt; almost every parent of a bipolar child that I've ever met (IRL or online) has described them the same way.

I'm glad to hear that you haven't seen those mixed states in your daughter in awhile. It gives me hope.

Anna said...

Megan,

I would love to consult with Caroline's psychiatrist. Could you email me telling me his or her phone number and hospital affiliation. I am at www.letgohangon@aol.com

I have repeatedly asked for lithium for Beth. No one yet has prescribed it. We are planning to go to U of P soon.

Amy said...

We have learned the best way to handle the rages for McKenzie is to move out of the way and ignore her unless she becomes dangerous. We have gone as far as locking her out of the house in the backyard until she gets control-that eventually worked. I only recommend this if the weather permits it and you can still keep an eye on them. Sometimes I think that if they have an audience and reaction it just fuels the fire. I know it does with Kenzie. We have also left her here at the house alone and driven around the block. That is only if we know she is just hysterical and not being dangerous to herself. This is mainly for our sanity and Tori's, our other child. I am not sure if it is the safest idea for them. Once we left her and when I came home she had destroyed my bronzer powder all over my bathroom along with throwing everything everywhere. Of course our daughter is 13 and can be left alone. I know that you cannot do this with younger children. Again looking back I am not sure it was the best idea. But we were lucky and nothing horrible happened while we were gone. We haven't had to do that in quite awhile. It seems to be that if we ignore her behavior and get away from it, she eventually settles down. But if she becomes physical we then have to physically remove her and put her in her room. We have never taken her to the hospital. I have always been afraid of what might happen to her there. I think there were a few times that we should have probably. But things are better now and hopefully they will stay that way. Hope this helps someone.

Heather said...

Megan-- I only come in contact on the web with a couple folks using Amantadine... if you remember, we started it, good results, the crashed hard -- did the holiday, upped the dose (per doc friend at Meridell) and upped Trileptal. 2-3 weeks later, it starts again- these rages like we haven't seen in a year. He seems just miserable. We are off it for 48 hours. How can a med do so good, and then turn so bad...I am perplexed. The good is great - normal-- you really allow yourself to feel normal, but then boom - new holes in the wall, running after every shreiking child, oh, it's so hard to be teased into this safety zone and then watch it fall apart. Anyone out there have thoughts?
Whe you went to Meridell, was it 100% all bad, or just not getting better over time. We have good times, but REALLY bad times.
Thanks-- hard time of year, with school etc.
Heather

Accidental Expert said...

Oh, we know these rages all too well. I wish I could say that mine have outgrown them, but no such luck yet.

Lauren said...

Thank you for this post, Megan. It is so encouraging to hear that Caroline hasn't had the rages in awhile. Before we really started research into bipolar we were often encouraged by others in our church to keep spanking and "break his will." But no matter how calm we tried to be, it would only cause his anger to escalate, and it just seemed cruel to spank that much. I have held him down a lot, but he is starting to get too big for me. After one of Caroline's rages, did loss of privileges have any affect? Did you feel like she needed to have consequences, or did you just focus on getting past the rage and praying for her?

Megan said...

Heather, what other meds is he on? I don't know why he wouldn't be doing well on Amantadine all the time, except to wonder if he is on the med protocol recommended by the American Psychiatric Association: one or two mood stabilizers (one usually being lithium) and an atypical anti psychotic like Geodon, or Zyprexa or Abilify, etc. I know he is on the Trileptal, but is he on other meds?

Megan said...

Lauren, loss of privilege usually didn't do anything to stop the fits or prevent them. When you realize that these tantrums are akin to selzures then you understand that they cannot be disuaded from them with tactics that work with other kids or punished in a way that will make them change. Behavioral modifications don't work with these kids if they are not chemically stable, of that I am a firm believer from both personal experience and observation of other kids as well. If their issues can be solved with behavioral therapy alone, then they aren't really bipolar, in my opinion, but have heart issues combined with learned bad behavior that was reinforced by not bringing the right consequences soon enough, consistently enough. I cannot tell you how much helpful advice I got on how to better discipline Caroline, knowing deep down that none of it would be helpful until she was stable, and we were right. We still have to teach right from wrong, but our kids have a disease very much like diabetes, and if they have meltdowns, it is akin to the diabetic low blood sugar meltdowns that are not within their control.

Heather said...

Megan- He's On over 2100 mg Trileptal now, and 10 Abilify...(plus Amantadine) our pdoc doesn't seem to want to go near lithium... I think maybe to hard to manage with blood work etc - DS would not be happy. But it is perplexing the Amantadine sitch... we added it in for an onset in extreme irritability, and like I said, for a couple weeks it's great, then it's HORRID. Today was a rage comparable to pre-meds--- I watched him from down the hall, kicking the walls, flopping on the floor like a fish out of water, he tripped on a garbage can in the hall and said he was going to kill it, he was so mad at the GARBAGE CAN... two days earlier, he's my charming boy. What is wrong!!! Pdoc is OOT... so I am searching online....
AGHHH!

Megan said...

Heather, lithium has been found to be protective of the brain from further damage (see pg. 81 and 116 in The Bipolar Child, by Dr. Demitri Papolos), and is the gold standard for treating bipolar disorder. Yes, there are risks with the kidneys and thyroid, but the rages carry risks that may be worse, truly life-threatening. The blood tests aren't that bad, it is only every 3 months or so. My daughter has gotten completely used to them. Until my dd went on Lithium she was REALLY bad, couldn't do school at all. The amantadine was the icing on the cake, not the primary drug. Trileptal is great, but some kids really need the Lithium as the main mood stabilizer. You may want to get a second opinion from another psychiatrist.

Megan said...

Oh, and about Meridell...we sent her there when we realized that she hadn't had any long period of stability that whole year, had been hospitalized three times in a few months, and had given up on achieving anything in life, quite doing school, and was just hopeless. We knew that if we didn't act fast, we would lose her in so many ways. It was the best decision we could have made. Her life was completely turned around and they got her meds just right, without us having to go through the difficult trials at home. Her academic confidence shot up and she has been so much better since.

Megan said...

Heather, how many times a day is your son taking the Amantadine? Twice a day? And when in the day?

Also, you know how we parents of bpkids will look under every rock to help them. Has he been tested for food allergies? Sometimes a gluten or milk allergies can produce bipolar like symptoms. Just a thought.

Also, my dd was on 30 mg of Abilify before we saw a complete sessation of the really scary rages/suicidal thoughts.

Hartley said...

Thank you for this post. We have been containing rages for months now. It is horrifying -- with the last true rage (not just flip out/meltdown) two weeks ago.

I can always tell when it is a true rage, because when he comes down, he is exhausted like he ran marathon barefoot in the snow. He crashes hard, and ususally sleeps. Heartbreaking.

Thanks again Megan - you are helping so many of us with your honesty!

Hartley
www.hartleysboys.com