"Ever since my son Tommy was born
he was different from my other two children. It seemed to take forever
to get him to sleep and once he was sleeping he frequently woke crying
for no reason. I was exhausted and at my wits end trying to settle
him down…all the advice given to me by mother, grandmother and friends
was to no avail. I began to think there was something wrong with
me. As Tommy grew older there were more signs that something was
Hyperactivity, fidgetiness, problems
with making changes and high levels of anxiety (particular with separation
anxiety from mom) began to appear. In addition there were signs that
frustration, impulsiveness and poor anger control were leading to prolonged
and violent temper tantrums.
What is Bipolar Disorder?
Everyone can relate to the word mood.
We are all happy, excited, sad or depressed at some point in our lives.
Bipolar Affective Disorder (Manic Depressive Illness) is a biochemical
causes gross mood changes from the
high reaches of mania to the lows of severe depression. For the one percent
or twenty million Americans who have this condition it can mean hospitalizations,
life time of medication, disability
at an early age and the reduced income associated with it. Bipolar
Affective Disorder can be life threatening.
What is COBPD?
COBPD is the abbreviation for Childhood
Onset Bipolar Disorder. Bipolar Disorder is an illness of mood, or
affect. In adults moodswings usually last for weeks or months before
remitting or changing to the opposite pole (thus the term bipolar: having
two poles). Children often cycle many times during one day, a condition
known as ultra-ultra rapid cycling.
What Causes Bipolar Disorder?
The exact cause of bipolar disorder
is unknown. Recent studies have shown that heredity plays a major
Diagnosing COBPD can often be a difficult
process. Attention-deficit/hyperactivity disorder (ADHD), Obsessive-compulsive
disorder (OCD) and Oppositional defiant disorder present many of the same
symptoms. In addition, fifty to 80 percent of those individuals diagnosed
COBPD have concurrent ADHD. The symptoms of Bipolar Disorder are
not the same as those in adults other than the alternating mood swings,
and these may be overlooked.
The following symptoms are often
seen in BOTH ADHD and COBPD.
Lack of Attention to Details
Difficulty Waiting One's Turn
Interrupting or intruding on Others
Destructiveness or Misbehavior
Physical Outbursts or Temper Tantrums
In addition, the mood fluctuations,
sleep disturbances (night terrors and nightmares) and irritability are
commonly seen in COPBD but not ADHD.
What is the Difference Between COBPD
Although many of the symptoms of
the two disorders are the same, their origins differ. A child with
COBPD often seems to intentionally misbehave and destroy, while an ADHD
child with the same symptoms appears to be careless and inattentive.
Physical outbursts and temper tantrums seem triggered by sensory and overstimulation
in an ADHD child, but a simple "NO" (limit setting by a parent) will cause
the same effect in a child with COPBD.
Children with ADHD usually calm down
within 15-30 minutes, while it may take the COBPD child several hours to
be relieved of his anger. In addition COBPD children often show remorse
for their temper tantrums and express that they were unable to control
Treatment of COBPD
Due to the difficulty in diagnosing
COBPD caution must be taken with prescription medications. Some drugs
prescribed for ADHD (stimulants like Dexedrine, Adderall, Ritalin and Cylert)
may escalate mood fluctuations, especially in a child who is genetically
predisposed to bipolar disorder.
The COBPD must be treated first by
stabilizing the child's mood and treating any sleep disorders and psychotic
symptoms present. Once the child is stable, therapy to help him understand
the nature of the illness and how it affects him is critical.
Medications used for stabilizing
mood include lithium, depakene and tegretol. New mood stabilizers
such as neurontin, topamax and lamictal are currently being tested and
used for children. Psychotic symptoms and aggressive behavior are
often treated with anti-psychotic medications such as risperdal, zyprexa,
mellaril, trilafon and haldol. Klonopin and ativan are also used
to treat anxiety, induce sleep and slow rapid cycling.
Antidepressant medications are very
risky and not recommended as they may induce mania and hypomania in children
with bipolar disorder.
How Can I (as a parent) Help?
The first thing you must do is never
give up! The second thing is to learn all you possibly can about
COBPD! The Bipolar Significant Others web site at http://www.bpso.org
has links to many excellent sites and articles about Bipolar Children.
Bipolar Parents is another site with information and plenty of warm support
for parents of bipolar children. Visit them at http://bipolarparents.virtualave.net
In addition there is a brand new
book called The Bipolar Child by Dimitri Papolos M.D. and Janet Papolos.
Read all about it at http://www.bipolarchild.com
You are the voice for your child.
Ensure that he/she keeps all doctor appointments, remains compliant with
medications and all treatment plans prescribed by the doctor. Do
your best to keep your child on a regular routine including eating, sleeping,
exercising and school. If you are not happy with your child's progress
obtain a second…or a third opinion.
Your child is young. Hope and
pray that a cure for this illness will be found!
Know that your child loves you and
is not intentionally putting you through hell…bipolar disorder is too big
for anyone to control on their own. Support your child as much as
you can, but know your own limits at the same time. Taking care of
yourself will help your child.