How Did You Know She Was Bipolar So Young?

There are probably a number of readers who are wondering how and when we knew Caroline was bipolar. Well, it was a process of noting her unusual thoughts, behaviors and obsessions, culminating in a full-blown manic state at the age of seven--very scary.

When Caroline was born, she came home to happy parents, and a sweet older sister, aged 2. Jane and Mae followed within the next four nears, so at one point I had a six year old, a four year old, a two year old, and a baby. We were truly a happy if busy family. We have always had a loving strong marriage, and there was absolutely no reason to think that any of our children would have a major psychiatric disorder.

We did notice that when Caroline turned about fifteen months, she began to show quite a temper. Up until then, she was just the perfect baby. She was not overly fussy, or resistant to sleep at all. She slept through the night at eight weeks and took two hours naps three times a day. She smiled all of the time and showed no signs of being overly tempermental.

One day, at fifteen months she got mad at me and tried to bite me. That was something new that my older one had never done. But it was not unusual for a toddler. However, her temper was becoming more and more obvious. We laughed about it and called her strong-willed, just thinking we would have to discipline her more later.

But at three, she became obsessed with the story of David and Goliath. We could not read that story to her enough. Then she would try to act it out. Very cute we thought. At Christmas she wanted adventurous toys, like a fireman costume, or a spaceship. Our oldest only ever wanted dolls, kitchen toys, frilly dress ups. But we just thought, well she is just different and that's great.

Then the tantrums became very out of control. She would get so angry when she was told no it was as if she was having a seizure. And they would last a long time. She would even try to throw things at me like blocks and try to bite me. We tried every form of discipline, read books, took classes, and in spite of all of our efforts, her temper would not be controlled. In preschool, she was a bright, spiritual child, but would get in trouble for stubbornness, and once she bit another child when she was four out of anger. Her teachers always liked her a lot , thought she was extremely smart, but called her very strong-willed.

By the time she was five, I felt like life was getting really out of control. She would descend into these downward spirals, expressing dissatisfaction with herself and with life. She seemed depressed at times and had dark thoughts. So we took her to a psychologist, who did a battery of tests. The results came back that she was depressed enough to start medication. This both reassured and disheartened us because we had a confirmation of what we had suspected, but why would this child, certainly not abused or neglected, in a very loving home, be depressed? It didn't make sense.

I got the prescription filled for the anti-depressant, but something made me hesitant to give it to her. The medicine was Paxil, which later was taken off the list for use in children because of inducing suicidal thoughts. I think God was telling me that this wouldn't be good for her. I am grateful I never gave it to her.

She seemed to improve in kindergarten, and so I put off pursuing more psychological testing or counseling. But then, on the first day of first grade, she began to get in trouble on the playground. She was rougher than most of the boys, and any game she viewed as war. The same was true in PE. She was David and everyone else was Goliath. She was on top of the class academically, but wasn't getting high marks in behavior outside of the classroom.

In addition, my oldest child was becoming afraid of her. Caroline would get physically violent towards her and her younger sisters, scratching them and throwing punches or kicking. When mad, she would kick her walls and door and even try to kick or hit us. We were feeling a lot of despair and worry over her. One day Elizabeth told me she couldn't take her anymore and said "I shouldn't have to be afraid of my own sister." Those words hit me hard, and I decided something had to be done so I took her back to a psychologist, a different one, for more testing. This time she was referred to a different psychiatrist, and she also began counseling on a weekly basis. She was diagnosed as both ADHD and depressed. This time I was willing to put her on a medication because the situation at home had become unbearably stressful and chaotic for everyone.

The psychiatrist put her on Zoloft in November of 2003 and at first she really seemed to improve. Her dark moods disappeared. But then she began to do really odd things. She began to exhibit the "superman complex" where she showed no fear about anything. She would jump off of the very top of our jungle gym just for fun. A few times she climbed out of her second-story bedroom window and jumped down to the ground, again for fun. Then she began to make these weird concoctions in the kitchen from all sorts of different things. She called them potions. I found tools from Bill's toolbox in her closet, with evidence she had been trying to dig up the wood floor. She told me she was making an escape tunnel. By this time we were very uneasy about her state of mind. Zoloft had been implicated in the news about the same time for being a strong trigger for suicidal thoughts and behavior in children and teens, but she didn't seem depressed, just really full of herself. One day she actually broke into an empty house on our street and pretended that was her new hideaway. The policeman we called to explain this too couldn't believe that a seven year old had done that.

The climax was when she got on her little bike and rode far away, across a bridge, through a heavily traveled area, and into an entirely different neighborhood, several miles away, one we had only ever gone to by car. We were incredulous when she rode up breathlessly and told us of her great feat. But then she began to describe in detail a particular area that I know I had never taken her to, but I was familiar with, and we realized to our complete horror that she probably had executed this dangerous trip .

We took away the bike and locked it in the shed. She got very angry, punched my husband in the stomach hard, grabbed an axe from the garage and began to swing at the doors, puncturing the plastic with ugly gashes. As we watched her rage and chop from the kitchen window, we got her psychologist and psychiatrist on the phone, and my doctor sister. They all said take her immediately to the psych hospital. While we were talking, she turned toward us and held the axe up to her neck, threatening to kill herself. Fear gripped my heart as I watched my precious and beautiful little girl seemingly possessed by an inner monster trying to kill her. I ran out to her, and she dropped the axe and was crying and saying how scared she was. We bundled her into the car and drove to the hospital. There she was admitted for a week. They told us she was probably bipolar and was reacting negatively to the anti-depressant, as a bipolar child would. We didn't want to believe it, resisting the diagnosis initially. But they put her on a mood-stabilizer, Trileptal, and took her off of the Zoloft. She began to improve, and so we concluded she likely was bipolar.

Bill's dad is bipolar and depression does run in my family, but I never thought that meant I could have a child who was genetically predisposed to have a childhood mood disorder. An incurable, lifetime one. One with stigma and heartache attached to it. We grieved. It took weeks for the Trileptal to really have its full effect, and then she was better. Still bipolar, but better. At that time, we had no idea how much our daughter would suffer over the next six years. She has been hospitalized every year since then, sometimes twice a year, because of big mood swings or, even worse, hearing or seeing things. Usually one of her meds has petered out, or she needs something added. This has been much much harder than we imagined.

A bipolar child is different from a bipolar adult in many ways, and I will explain that in some other post. If a child is diagnosed young, it usually means they will have a more severe form of the disorder as an adult. That news was not what we wanted to hear. But this is what God has given us. So we have to just keep going, keep loving her and accept the fact that we will be caregivers for quite a while.