I have been asked this question time and time again by parents. First off, let me state that I am NOT a medical professional. I am just one parent who has educated herself about this illness. For informational purposes only, I am passing on what I have learned along the way.

Before looking to the extreme, you must first look to the obvious. You must first rule out all possible physical causes for your child’s behavior. The most obvious test that your child’s doctor should have run is on the Thyroid. If the Thyroid hormone levels are too high or too low, severe mood swings can result, just like you see in bipolar disorder. Some forms of epilepsy, especially temporal lobe epilepsy, can cause erratic behaviors such as you see in bipolar disorder. Allergies can also cause rages similiar to what you see in children with bipolar disorder.

After physical causes for behavior or mood problems have been ruled out, additional investigation begins.

Attention Deficit Disorder/Attention Deficit Hyperactive Disorder (ADD/ADHD) and bipolar disorder can be present at the same time. This is called “comorbidity”. Bipolar symptoms and symptoms of ADD/ADHD can also overlap, so a correct diagnosis is critical. Psychiatrists are the best prepared medical professionals to sort through the symptoms and diagnose these disorders.

IMPORTANT:

--ADD/ADHD treatment often includes a stimulant like Ritalin. A bipolar child who is treated for ADD/ADHD only can be pitched into the manic phase by the stimulant. The bipolar mood disorder must be treated and symptoms stabilized before a stimulant is introduced.

--Anti-depressants in the absence of mood-stabilizing medications can also cause mania.

The National Institute of Mental Health issued a warning and you can read it here.

Dr. Charles Popper wrote a wonderful article about the similarities and differences between the two. If you want to read it, click here.

Here is a wonderful page with some symptoms that are common with our bipolar kids. This is not a diagnostic tool by any means, only some things to look out for.

Bipolar disorder is hereditary, so a doctor will first ask for your family history for evidence of depression, alcoholism, other mood disorders, bipolar disorder, suicide attempts, etc. (This includes parents, siblings, grandparents, aunts, uncles and cousins). If the answer is yes, your child may have the genetic predisposition to bipolar. That does not mean your children will develop the symptoms of bipolar, it means they are at higher risk. Click here for further statistics.

I highly recommend charting your child's moods or cycles as they are known to be called if you are bipolar. It's relatively simple to do, and there are a couple of really good ones on the Web that you can download. If you have Excel, you can download this one. If you have MS Word, you can download this one. If you have Adobe, you can download a mood chart here (if you don't, they have a link for you to download the acrobat reader). The benefit of charting is for the psychiatrist to see if there is a definite pattern or cycling going on with your child.

Once you have the bp diagnosis, the first line of defense is to have your child put on a mood stabilizer. If you go to my medication page you will see all the mood stabilizers that are available and on the market today. For children, they usually will prescribe Depakote as it seems to be the best tolerated although it depends on each psychiatrist as to what is prescribed.

I still recommend you charting your child's cycles while they are doing the medication trials. This will let the psychiatrist know if they are getting enough or not enough of a certain medication. Also, if at all possible, only add one medication at a time or it will be difficult to know which medication is working or, in the case of a reaction, which medication it is coming from.

If your child doesn't already have an IEP (Individualized Education Plan) for school, I highly recommend you start this process. The first step is to request an evaluation be done and if you go here you will find a sample letter that you can use. Once you have the letter typed, you want to send it CERTIFIED MAIL to the school and they have 30 days in which to do the evaluation and hold the IEP meeting.

Because your child has a bp diagnosis, they should qualify as OHI (Other Health Impaired) just for the fact that they are now on medication and how the medications impact their lives (side effects). If your child rages, they could also qualify as EBD (Emotionally Behaviorally Disturbed) but please don't get hung up on the label as long as your child gets the services they are entitled to under IDEA.

Here is a very good website that has what a child with bp should have on their IEP:

Symptoms and Accommodations for Students with Bipolar Disorder

Above all, realize that your child is no different then what they were before their diagnosis. They still need your love and understanding. As difficult as what all this is for you, it is probably twice as difficult for them. Depending upon their age, they might not understand what is going on with them or why they do the things that they do, so this is going to be an adjustment for both of you.

If you have any questions, feel free to email me and I will do my best to answer them.