CNN Story on Pediatric Bipolar Disorder

Check out CNN online and you will see a very good article about a girl's struggle with early onset bipolar disorder.

One Down, One to Go

Our youngest daughter started school today, half-days all week. I breathed a sigh of relief. She tends to be the squeaky wheel. Now one more week until my oldest starts public school, and then I can focus on homeschooling Caroline and Jane together. Caroline will have all day classes on Tuesdays at a homeschool co-op and Jane will have them on Thursdays, so they will get a break from each other too. Caroline is VERY happy about being homeschooled and wrote me a thank you note. I posted it up on the bulletin board so I can refer to it later when she is hating it. Hopefully she won't, but you never know. I am using the Alpha Omega online homeschooling program called Monarch (it grades most of the work for you and prints out report cards too) combined with Sonlight readers and math. I think they will be quite busy between homework for their coop classes and all of the work I will be assigning to them. I pray for a good year!

It's a New Day

I am reminded this morning of God's faithfulness, His love for me, and His closeness to those who mourn. It is well with my soul. Matthew 5:4.

The Loneliness Can Be Profound

I feel like I don't have any true friends except through this blog. I have three wonderful sisters and a caring mom, but I have this deep sense of loneliness that is very noticeable when I am alone, like this weekend. I have a great church with many "friends," but no one ever calls me, asks me to go out for coffee, or for glass of wine, or just to see how I am doing. I am always the one calling other people, or the people who call me are people who need something from me, whether counsel or encouragement. In other words, I am giving, but not receiving, as far as friendships go. I don't know if this is a direct result of having a bipolar daughter, which wouldn't surprise me. Just like the invitations to get together with other families dried up after she was diagnosed, I feel like many of my friends stopped calling. I know I have stopped calling certain people because they don't call me back, and I am tired of feeling like the third wheel. I feel that I have a lot to offer others in terms of friendship, and I am used to having very close relationships with other women. There really isn't one person in my local area outside of my immediate family that I feel like I could comfortably call if I am down. It is painful the way that mental illness isolates. I need a fresh start too. Moving to another place seems very attractive right now.

A Weekend to Myself!

At last the annual crabfeast has arrived, and my wonderful hubby takes the four kids to the big event, and I stay behind and get the house to myself! I always struggle with feelings of guilt for not attending this extended family fest (his side) but at the same time, this is my ONLY weekend during the whole year when I get to organize, work on small projects, and regroup before the school year starts. I miss them by day 2, but I need the break very badly. This past week was a hard one for all of us, with the reality of no job setting in, the younger two kids completely sick of each other, everyone tired of the pool, and nothing to do. I was pulling my hair out! Hopefully I won't spend the weekend napping because I haven't been sleeping well at all.

August is Two Weeks Too Long

That's all. My kids all should have gone back to school two weeks ago. I am envious of my friends whose kids' private schools started much earlier. Just too much time and too little to do! Next year I think we need to take a vacation the last part of August, if we can afford it.

What is it about sunshine?

When it is sunny, we are happy. When it is cloudy, watch out! I am talking about myself here, as well as Caroline. I am finding that cloudy days make me feel so depressed that I am not functional on those days. Really. I get panic attacks, and feel so low I want to crawl into bed and stay there all day. Not good when you don't live in California or Arizona. I am increasing my Vit D3 to 10,000 mg on those days. A prescription dose can be as much as 20,000mg. I remember that last year at this time I began really struggling with SAD, as the day light decreased into the fall. On my ICal I put a reminder to increase my antidepressant in late August. I was right! It is amazing how the change in seasons and in the weather affect some people, including myself!

A Reader Question About Intuniv

Someone just asked me if Intuniv is still working for our ADHD daughter. I can't find their post, but I wanted to reply and say that 4mg was too much, and 2mg was too little. 3mg seems to be the right dose, but we felt that while it helped with her outbursts it didn't do as much for the focusing part, so we did add Vyvanse to the mix, at a very low dose. I am told by our psychiatrist that this has been a common finding among parents, that Intuniv doesn't help with the inattention as much as the explosivity.

Lamictal is Implicated in Meningitis?

Apparently, the FDA is now warning that there is a very small chance of developing aseptic meningitis among people who are taking Lamictal, but it usually shows up at the start of treatment. Our daughter has not experienced this at all, but I am putting this out there for anyone who might just be starting treatment. The article is at www.aafp.org on the front page.

Meridell Achievement Center Gets Excellent Results

In our book, at least! Today we received the quarterly questionnaire from Meridell asking about aggressive incidents both verbal and physical, and hospitalizations or jail time. Well, thank the Lord, no jail time, not even one hospitalization since she came home last August! No physical aggression either, and only a few instances of verbal aggression, nothing scary. I was very happy to fill out the form with a little triumph and gratefulness too for Meridell's existence.

Not a Great Day

I don't know if this has been directly the result of the 48 hour Amantadine holiday, but today was the worst day we have had with Caroline in a while. Bill wants to ask the doc to up her Seroquel, but it is hard for me to agree because I want room to go up on that med when the fall mania sets in. I think we just need to wait and see if the reintroduction of the Amantadine will bring her back to "normal." We know that when she gets really mouthy and rebellious acting that she is not right.

No job yet, but my husband has been working hard to find one. I am more anxious than I was a few weeks ago about the job situation. Today when Caroline set off towards the apartments and the boys that play basketball down there, I was a ball of anxiety. I drove down there, picked her up, took away her cell phone, and then had my husband come back from an errand so I could go for a drive until I didn't feel so anxious anymore. I couldn't deal with her at all. I woke up last night with this anxiety and spent time praying about everything I was worried about. I feel so torn right now about what direction we should be going in. I just want Bill to come home one day and tell me what his new job is and where we are to live.

So I am Not a Lacrosse Player, But It Was Fun!

My husband and I played on a parents team against Caroline and her girls team yesterday in a pick up game for fun at the end of her camp, which was coached by some world-ranked players. I couldn't catch the ball at all, but I had a blast running around the field trying to keep up with her and block her. Of course I couldn't, but my husband scored some goals! He was a college soccer player, but he picks up any sport easily. I mostly laughed hysterically the whole time. Caroline was acutely embarrassed by my antics, on the verge of really mad, but I don't care. How many moms would have the guts to do this anyway?! I did it to be a good sport, but after the game a real lacrosse-playing mom tried to recruit me for the mom's league in the fall! I can't even catch the ball yet!! How funny! I may just do it for the fun of it, but first Caroline needs to help me learn the basics.

She May Have Lost the New Friend

I was worried this might happen, that Caroline's reputation at the pool would put an end to her new friendship with the one girl there who was nice to her. She stopped responding to Caroline after they had a great time at the mall that day, and I have a feeling that her mom may have recognized Caroline and heard some of the rumors and discouraged her daughter from hanging out with her. I have seen her mom for many years, so I wouldn't be surprised if she remembered something Caroline did years ago. I am not certain about this, but suddenly her daughter is too busy to get together or to call, or whatever. Caroline was sadly perplexed.

The only bright spot is that Caroline has met another young teen girl who lives near us who is in the same lacrosse camp this week, and we are carpooling together. She hasn't known Caroline previously so this friendship could have a better chance. Life can be so unfair sometimes when you have a mental illness or other handicap.

Sweet Surprise!

Caroline surprised me this morning with a gift she bought from Bath and Body Works yesterday at the mall. She spent her own allowance on this gift, and included a very sweet note. She gave me permission to share it:

"Dear Mommy,

You do so much for me and our family on a day-to-day basis and rarely get the credit you deserve. You mean more than you could possibly dream of to me and I'm honestly not sure I'd still be walking this earth if it wasn't for you and your love and dedication to me. God has given me the deep honor to call you my mother. Please know that I'm eternally grateful for you not giving up on me no matter how disrespectful, ungrateful, selfish, hot-tempered, and cold-hearted I've been toward you and your undying love to me and my undeserving soul.

I love you eternally and forever.

From your Loving daughter,

Caroline"

Isn't that amazing! Thank you God for this encouragement and for giving her faith in You and in us her parents in spite of the suffering!

Off Topic: Middle Age Weight Gain and Women to Women

I'm there. Trying not to be, but I must need to try harder. Seems like ever since I hit 42 I have had a MUCH more difficult time keeping slender. Ok, not being fat, I said it. I can tell my metabolism has ground to a screeching halt because I eat so little all day. And most of what I eat is Greek yogurt, blueberries, flax, and a tablespoon of walnuts, for breakfast and often for lunch. Time to get the thyroid checked but I have a feeling it is the change before the change. I looked up www.womentowomen.com, a program designed by ob/gyns addressing these sorts of things and touting their all natural remedies. I think I may try them. And I need to step up the exercise. Or restart it actually. I used to run regularly but the heat made me a wimp. And sitting for more than an hour in front of the computer is now a no-no. Secretarial spread can affect stay at home moms too!

ERs, XRs, Almost Always Have Better Results

Just a note that we have found that the XR and ER versions of psychiatric drugs do seem to make a difference in the length of time our child stays "stable" throughout the day. If your doc hasn't changed your child's meds over to the long-acting version, you may want to ask.

Why You Need Good Boundaries

If you are a mom or dad to a bipolar child, one of the most important lessons for you (as I learned the hard way) is to set good boundaries with other needy people. Because you will likely grow tremendously as a lay "psychologist" due to all the efforts you put in to understand your child and this disorder, you may become a magnet for other people who recognize both your knowledge and compassion. Well, don't let yourself be taken away from your own "mess" so to speak in order to care for other people who are just as "messy" who truly can be cared for by others who don't have the amount of stress in your lives that they do. Your stress level is probably like those of the parents of autistic children who are on par with war vets (not joking, look it up!) This doesn't mean that you don't extend friendship or show kindness, but watch out for the creeping codependency that can start to sap all of your energy (what little you have) away from your primary job, which is caring for your own husband, child, and the rest of the kids. Caring for yourself is highly important (I am bad at this) and will take the form of whatever you decide: a pedicure, coffee with a friend, a great book, a weekend away at a hotel where you can just veg and do nothing. I am only offering this after almost landing in a psych ward myself by allowing someone else outside of our family way too much access to myself when my own child was in so much pain. I still shudder to think of where I was at back then. I did eventually learn to set boundaries and stick to them, and my "friend" was not any worse for it. She grew too.

Good News, Bad News

The good news is that Caroline was accepted into the homeschool co-op for the fall where she will take Algebra 1, Spanish 2, and a writing class! The rest of her subjects she will do at home mostly online, except for literature, of course. Nothing like the smell of a book you can feel with your hands! I am so relieved that she will have the opportunity to make new friends but always a little nervous as usual since we have been through this cycle: school acceptances, then something goes wrong, and she is asked to leave. With this last year's school success, perhaps we are in a different phase. I know that we will be watching for the annual mood shift at the end of September/beginning of October.

The bad news is that Bill still doesn't have a solid job lead and the main place where he could have gotten easy employment has just been axed by Secretary Gates. There go 6000 jobs in our area. Neither my husband nor I understand Gates' reasoning at all on this huge cutback on joint forces planning. So we may very well be looking outside of the area. This present administration isn't favorable to the military or contractors.

Omegas for Kids from Nordic Naturals

If you want to add fish oils to your child's diet but know they will not swallow those huge soft gels, try the strawberry-flavored tiny Omega soft gels from Nordic Naturals. Omegas, especially those from fish, have been proven to improve mood stability in patients in several studies (see the book The Omega 3 Connection by Dr. Andrew Stoll). I highly recommend adding them to the mix for any child. I have posted a link to the right under Great Websites/Resources.

Algorithm for Treatment of Bipolar Disorder by Texas Dept. of Health

I have included a link to a helpful diagram for medication treatment for bipolar disorder that you may find useful. It is not in layman's language, but still decipherable.

New Recommendation Out from American Academy of Child and Adolescent Psychiatry

CABF has posted the newest recommendations on medical treatment for children and adolescents with bipolar disorder. You will find this 63 page publication to the right of my blog under Great Websites/Resources. I haven't read it but I will shortly.

Lithium Prevents Suicides

Unlike most other psychiatric drugs, lithium has a proven track record of preventing suicide. A recent article in our local paper highlighted this fact, reporting that a local retired Navy chief petty officer committed suicide after his doctor took him off of lithium. The article states that the doctor is being sued by the sailor's family because he knew that lithium saves lives and he went against common practice. I decided to look up lithium and it's suicide-preventing qualities and found a great article citing several research studies that confirm that lithium reduces the risk of suicide sevenfold. This article entitled "The Antisuicidal Effects of Lithium" can be found at www.mhsanctuary.com/bipolar, published by McLean Hospital, and doctors Baldessarini, Tondo, Hennen and Floris.

Our daughter has been on lithium since she was 10. As soon as we switched from Depakote to lithium, we noticed a big difference. She could finally be mostly "here." The blood draws every three months or so are worth it. She is so used to them that she doesn't mind at all now. So don't rule out lithium for your bipolar child--sometimes it really is the BEST drug. Lamictal is a close second in my book, followed by Amantadine.

Missing My Oldest

Our oldest daughter, sixteen year old Elizabeth, is in Scotland right now helping to run a camp for teens with Young Life. She has been gone over a week and I am really missing her. She doesn't have cell phone service or easy access to the internet so we are not hearing from her much. We don't miss the way she instigates conflict with her younger sisters, but she is my buddy in many ways. Not my peer (as I tell her all the time), but definitely one of my best friends. I have felt really lonely without her constant running conversation with anyone who will listen about the antics of her myriad of friends. She is quite entertaining. Never a dull moment as far as she is concerned. I don't miss being the all day taxi service I have become for her many activities, school and otherwise. But I miss her. A lot. I will be a mess when she goes to college next year. It is just too quiet around here. Yes, I wanted quiet, but just for a few days. Then my extroverted side comes out and I want lots of people around me all of the time. I guess I am never satisfied!

You Know Something Is Wrong With Your Child When...

You find her in the ceiling. Or rather having fallen out of the ceiling. Funny but horrible too. I shall recount the "aha" moment when I realized that something was terribly wrong with our daughter.

We had signed her up for Awanas at a local church when she was about seven. Awanas is a Bible verse memorization club for kids with lots of fun included. We hoped it would be a nice time for her socially and spiritually. The very first night she went I left her with the leader and her group with a little fear and trepidation. She had been acting kind of "wild" for a few weeks, a lot of energy combined with very little fear. I think I stuck around for a while in the lobby. When it was time to pick her up, no one could find her. Apparently she had been doing flips on the carpet during the Bible story time and was firmly asked to stop, as she was flipping into other children. She became so mortified at being reprimanded at the first meeting, that she hid in the bathroom. In the ceiling in the bathroom. Yes, she had climbed up onto the sink and hoisted herself up into the ceiling by removing one of the tiles. We found her when we heard a big crash coming from the bathroom and discovered her on the floor covered in white dust after falling through one of the tiles.

When I heard what had happened and saw my little girl standing there amidst broken pieces of tiles, I was incredulous, embarrassed and frankly freaked out that my child would have even thought of such a thing. The Awanas leaders were quite concerned about her, and were very sweet to me, calling me the next day inviting her back, but I was so horrified by Caroline's behavior that I didn't want her to go back and neither did Caroline. In our minds, we were becoming increasingly alarmed by Caroline's antics, which would lead in a few short weeks to her first hospitalization.

Looking back on all of this we can laugh now, but at the time, we were completely bewildered. Once she was diagnosed everything made sense, but the damage was done, literally and relationally. I never have felt comfortable at that church since. Too many bad memories of public embarrassment.

New Book on ADHD Medications: ADHD Medication Rules

I just wanted to note that our daughter's psychiatrist Dr. Charles Parker has published a new book on his recommendations for treating ADHD, called ADHD Medication Rules. I haven't read it yet, but he tends to have some very different ideas than most psychiatrists. You can find a link to the book on his website listed to the right on this blog. He includes a chapter concerning bipolar disorder with ADHD.

Off Topic: Free Gently Used Kids' Clothes Through ThredUp

My little sis stumbled across a great children's clothing exchange website called ThredUP. You just box up your outgrown kids' clothing, send it to another parent who has requested that size, and you pick another box off of the site to fit your kid! They have a video for how it all works, and they send you the boxes free. Check them out! www.thredup.com

Only Two Kids Home=Mommy Gets to Organize!

Having only two kids at home during the day right now is such a welcome break. That means a lot less fighting, almost minimal actually, and with fewer taxi rides in the car, I am HOME and able to ORGANIZE!! Thank you God for the relative peace and quiet. I so needed this! To all my friends with just two kids (not counting the bipolar ones or the ones who are severely ADHD, both of whom qualify as several kids all by themselves) I am envious--to a degree, of course. I love having four kids, wouldn't trade any of them, but boy is two easy! You parents of just two don't know how much stress you DON'T have to deal with! No complaining allowed, sorry. But I am just kidding. We all have our days when even two seems impossible. I had just two once and I know I thought it was quite stressful at times. I just had no idea what was coming!!

More Off Topic: Cipro isn't for Athletes or Dancers

I just found out that antibiotics in the class of fluoroquinolones can have a negative effect on your Achilles. These antiobiotics include Cipro, which Caroline just finished, and Floxin, Noroxin, and Levaquin. Your risk for injury apparently triples if you take these drugs, lasting even months after finishing them. I read this in the most recent Runners magazine, on page 66, under Drug Bust. I wish we had known this before Caroline was prescribed Cipro, since she is an athlete who doesn't need another injury. And with our youngest soon to go on pointe in ballet, we will keep this in mind. Just for your information!

Off Topic: Playing the Coupon Game

Like many of you, I am trying to cut down on our monthly expenses, especially now that my husband isn't working. With four kids, two of whom eat like adults, our grocery budget had ballooned to over $1000 a month, including toiletries, cleaning supplies, etc. I have used coupons forever, but not as intensely as the coupon queens out there who really know how to work the system. Recently I have embarked on the hunt for amazing deals, like getting free stuff, using the online coupon sites that match up the grocery store deals with the coupons and rebates. Now I am hooked. I LOVE finding free stuff or deals like toothpaste for a quarter! I am still learning the ropes and I hope that in time I really can cut our grocery bill in half like many have done using this method. My binder is growing every day using those baseball card clear pocket holders. What a great idea!