ADHD/ODD vs. BP | ADHD Information
My daughter was diagnosed with ADHD/ODD at a young age. Her new psychiatrist is now suggesting that maybe Bi-Polar is the real problem. Has anyone had experience with this concern. I know that 3 of her birth siblings are being trated for ADHD and her birth mother is being treated for depression. Beyond that, I don't know. We have absolutely no info on her birth father. The doctor suggested we try Depakote. What should I know about this treatment?I know a lot of times ADHD/ODD later becomes bipolar. My son has the ADHD/ODD diagnosis and his pdoc has warned us to watch him closely. Like I can do otherwise! LOL. I do not know much about the treatments but I know that mood stabilizers are usually used. Read a lot of books. I am reading An Unquiet Mind, by Kay Jamison and it has been really interesting. Maybe try Your Defiant Child by Russell Barkley. I have that one ordered through a bookstore.
Never give up hope. It is not your child's fault, and life will and can get better.
btw, i am adopted! here's something that may help: Borderline Child Questionairelaurapalmer38797.3182291667I have four adopted kids and am aware of RAD. I personally believe it is overdiagnosed in adopted kids, especially those adopted at birth. In the DSM it says that everything else should be ruled out before a diagnosis of RAD. Actually, many bipolar kids do act like my description (my son had a misdiagnosis of bipolar for three years, and he DIDN'T act that way so I questioned it). But I went to a group that was for parents of bipolar kids and the kids were just like that. One of them was manic and threatening to kill his parents and they had to call the police. It was then that I realized my son had a different problem, not bipolar. But bipolar kids can be anywhere from moody and defiant to violent, and the longer it goes wrongly medicated or unmedicated the worse it gets. Unfortunately, many bipolar kids end up in the hospital, often multiple times, before the dx. and meds are straightened out. Yes, I know bpkids is tame in itj's description, but if you read the posts by the parents, you can see the reality. I have bipolar myself, but was more moody and defiant and, when angry, I'd break things. Some bp kids will go as far as to try to strangle their sibs, especially if they are on stimulants or antidepressants. Adults with bp are the same way (been there too, since it doesn't go away). Then, when you find the right med combo) it's as if a switch is turned on and the person is suddenly in control and it's great. When I first gained control, I felt weird after feeling so chaotic for so many years! I wasn't even sure I *liked* it at first I wouldn't trust the diagnosis of a pediatrician or a therapist (without the MD). I'd take it to the top and see a Child Psychiatrist who has a good rep in the community. Sadly, it's hard to find good help for psychiatric issues. For Neurological stuff, NeuroPsychs are great and dx. anything from ADHD to high functioning autism to various LD's. They do intensive testing and it's more accurate than, say, the Conners. My son got almost 100% on the Connors but his main problem is HFA, not ADHD. He isn't even on meds now since stims make him aggressive. OlderMom38798.2205787037Thank you for your post, Christine (my name is Norma Jean-BTW). Tho you were not able to give me advice you sure did make me feel less alone.
Our situation is a bit different. Caitlyn is adopted and when we first met her on paper I was hesitant. Her case did look like she was more than we could handle. My husband's answer to that was "How tough can a 9 year old be?". As the adoption date got closer, he learned how difficult she could be. Meanwhile I became attached to her and saw her potential. There had been times we discussed disruption but each time we both promised each other to try harder. I did but eased off after a while and he never changed at all. He expects her to change her behavior and me to change how I care for her but does not recognize that he needs changes. I am afraid that this will come between us and it may end up being a choice. If I could just convince him to attend family counseling maybe this could work out better.
Oldermom, your description about bi-polar doesn't sound a lot like Caitlyn. She doesn't rage so much as she will argue about everything just for the sake of knowing more that you do. She also has a rigid sence of fairness that is hard to break through. She feels the need to police the behaviors of her peers and is constantly disciplining pur toddler (or telling me how to do it). Her anger consists of pounding the table when she's frustrated with her homework or whacking her thigh when she's arguing. She never accepts a decision even if it is in her favor. There isn't any violence or swearing. Saturday she needed to clean her room and she did well but my husband wanted her also to clean her closet. She complained and complained all the while because she wanted to see the Harry Potter movie that I rented for us to watch together. I told her to finish the job in silence or there would be no movie. She did well with that until my husband left the house to do some shopping. Then the complaining started. I was able to handle it well - she lost the movie. Then it just got worse. It was unfair because she earned it by cleaning her room blah blah blah. I was doing fine until she said that 'one thing'. Oh, it's a different 'one thing' each time but she manages to find that button every time and I flipped out and cleaned out some of her favorite toys for her. Then we got into a screaming match that was very unproductive. Then she gets into digging up past issues and comparing us to her birthparents. Then I really felt evil and reminded her that her father abandoned her and her mother let her play in traffic (literally!). Well, now you see what I need to change about myself and why I do not like confrontations. I do not handle them well at all and usually make things worse.
Norma Jean
Norma Jean, what do you think is going on? Have you read anything on your own about bipolar? Do you think the shoe fits?
ADHD plus ODD usually equals early onset bipolar. ADHD should not cause prolonged rages or violence or swearing. If you have these behaviors, it's more than ADHD. If the doc says ADHD/ODD, that usually melds into bipolar disorder and stims and antidepressants (Straterra included) only makes it worse. A Psychiatrist or NeuroPsych should diagnose your child. Therapists aren't supposed to legally diagnose and aren't usually very good at it. Here's a link for early onset bipolar. It is NOTHING like adult bipolar. It looks like rageful, destructive, sometimes even violent ADHD and, yes, the kids are inattentive and disorganized. As smallmom pointed out, if the child is given stimulants or antidepressants for alleged ADHD/ODD and it turns out to be bipolar, the bipolar and the child can be worsened for good. Make sure you have the right dx. before stims or antidepressants. My son was misdiagnosed twice and his first misdiagnosis was ADHD/ODD. Wasted three years on stimulants. Good luck.
OlderMom38797.5918981481[QUOTE=momofC]Caitlyn is adopted
she will argue about everything
She also has a rigid sence of fairness
She feels the need to police the behaviors of her peers and is constantly disciplining our toddler (or telling me how to do it).
anger consists of pounding the table when she's frustrated
whacking her thigh when she's arguing.
She never accepts a decision
She complained and complained
it's a different 'one thing' each time but she manages to find that button every time
Norma Jean[/QUOTE]
After reading this, it doesn't sound like ADHD, ODD or bp. It sounds like a typical 9 year old who has been through a traumatic few years. Since I work for a pdoc, I would say continue the family counseling. I have seen many many of these cases, and it just takes a lot of time and hard work.
I've checked out bpkids.org but have not read about it thoroughly yet. The issue only came up yesterday afternoon and the pdoc gave me the site to read. Then, when I signed on here I didn't expect this much support so quickly (much appreciated!) so I've been here when my son lets me -LOL. I will give myself more time to read that but so far what I have seen sounds like her but the description that oldermom gives sounds more extreme than what the website said. So i'll keep digging up info and asking questions. I just felt that it is good to ask someone who lives with it, too.
Actually, that extreme description sounds a lot like the problems my sister is having with my 6 year old nephew.
I must get supper ready, eat, get the kids to bed, blah,blah,blah so I'll be disappearing for the next few hours. Thanks!
NJ
[QUOTE=sarahandbabies][QUOTE=momofC]Caitlyn is adoptedshe will argue about everything
She also has a rigid sence of fairness
She feels the need to police the behaviors of her peers and is constantly disciplining our toddler (or telling me how to do it).
anger consists of pounding the table when she's frustrated
whacking her thigh when she's arguing.
She never accepts a decision
She complained and complained
it's a different 'one thing' each time but she manages to find that button every time
Norma Jean[/QUOTE]
After reading this, it doesn't sound like ADHD, ODD or bp. It sounds like a typical 9 year old who has been through a traumatic few years. Since I work for a pdoc, I would say continue the family counseling. I have seen many many of these cases, and it just takes a lot of time and hard work.
[/QUOTE]
RAD was another issue that did come up with her previous therapist but her treatment approach didn't seem to be working very well. She was 9 when she was placed with us, she's 12 now - and hormonal!
NJ
Hi, momofc, I am new to the board as well. My son was dx adhd, with possible bipolar. I am very worried as well! He isn't on meds right now. He is seeing a psychiatrist tomorrow. My husband is also very confrontative and angry, and yells all the time. There is a lot of yelling and crying in our house. I also tend to back off and don't like to confront, and my son takes advantage of that. Last night was a very rough night, and my husband said he doesn't know what we'll do if the meds don't work. What can we do? He's our child, we have to stick through anything. I feel so hurt he seems to not love our child. I wish I could give some advice, but I am feeling lost myself. Good luck, and we can be support for each other. Take care.What is RAD?RAD is Reactive Attachment Disorder.How is adhd/odd different than just adhd? I'm not sure I understand what this diagnosis is?
Hi NJ,
I don't have any experience with RAD or adopted kids, but my son is Bipolar.
Although he displays (in some cases, displayed, prior to the good meds) the majority of what you see with Caitlyn, there are additional problems with him that led our pdoc to the dx.
The biggest thing was the rages. Lasting anywhere from 15 minutes to 3 hours. The inability to deal with any emotion; frustration, anger, anxiety, disappointment. The only time he was not raging was when he got his own way and was happy. Anything else led to a meltdown. Didn't matter what it was. This is also noted in The Bipolar Child as one of the biggest symptoms of the disorder.
I personally think some of the things you mentioned in your list sound very oppositional and probably fit into the ODD category, however, I believe once you tackle the real problem, whether it be ADHD, RAD, Bipolar, or whatever else the problem may be, and with good therapy, you can get those behaviors to subside.
Have you taken her to a neuropsychologist? They do much different testing than a psychiatrist does, and you may find out more answers from someone of that nature.
Good luck.
[QUOTE=SmallMom]
Norma Jean, what do you think is going on? Have you read anything on your own about bipolar? Do you think the shoe fits?
[/QUOTE]
Thank you all. I have listened to you all and read the websites that you provided plus some others that I found on the way and I think I can feel good about not pursuing bi-polar as a dx for Caitlyn. I really think that ADHD is very definitely a part of her but I think it is RAD that is giving us all the problems. We still may try the med wash to see if any of what she is taking is not working or making things worse. Especially that clonidine which she has a lot of.
Thank you all for helping me sort this all out.I'm sure I'll be back with more questions.
NJ
Mental Help Net - ADHD - Jasper/Goldberg Adult ADD Questionnaire
Here I am. Welcome, momofC! I have two children -- nearly 13-year-old son and 11-year-old daughter -- who received a diagnosis of bipolar disorder in 2005. My son's first diagnosis 3 years ago was ADHD and anxiety. When we attempted to treat his anxiety with an SSRI (Zoloft) last fall, he had a manic reaction that I don't think he has ever fully recovered from. He is now on the mood stabilizer Depakote, and while his raging has stopped, he is depressed. His pdoc is trying to figure out what meds to prescribe next. My daughter is on a combination of the mood stabilizers Lamictal/Depakote and improving.
Some good websites to check out:
What specific behaviors is your new pdoc seeing that would lead him to suspect BP? What meds is your daughter currently on? Are they helping or making things worse?
smallmom you said that your son has never fully recovered from his manic reaction...when dillon was put on stim...he to had a manic reaction that i beleive he has never fully recovered from... but the doctor days that can't be...
dillon is also on depakote..he just started it last month and he isn't on the full dose yet..he is only 4 yrs old and we are taking things slow because of his age..
MomofC,
No, you don't worry too much. This is a very difficult time for you and your daughter. A med wash is never easy. You should ask the pdoc how to do it. Our general rule is that we remove one med at a time and gradually wean down (that does not go for stimulants because as you know, they can be used on a day-to-day basis). We weaned our daughter from Paxil after her manic reaction, and the timing just happened to be good because it was August and she wasn't in camp or school. She had withdrawal symptoms (headache, dizziness, nausea) so had there been school, I probably couldn't have sent her. But I don't know what withdrawal from Wellbutrin is. Again, ask your pdoc.
IMO, the best way to knock some sense into your DH's head is to have him go to your daughter's doctor appointments. Let him hear it from the pdoc.
Hi, thanks everyone for being here for me. We had only this one appointment with him and so far I like him. He wants to dump some of her meds while also understanding my own anxietites about doing so. I have never seen her long term without meds and am afraid that we will not be able to handle what we are faced with. Her previous pdoc only criticized me and did not offer alternate solutions. She is on 54 mg Concerta, 100mg Wellbutrin, .1 mg Clonidine twice daily and a weekly Catapres patch. Lots of meds and still flies high and is argumentative. She cannot control her attitude or her anger which is also increasing. Also, her grades have been declining (possibly an adjustment to middle school).
Our family dynamics are not ieal either. I tend to be to passive and back off from an arguement and my dh is the opposite. He is confrontational and often hostile - exactly what I'm trying to eliminate from C's behavior. He explains things to her while angry and is easily misunderstood by both her and me which also causes friction there,too. So I am constantly walking on eggshells here. C gets the wrong message when I end up teaching her to behave a certain way just so Dad won't get angry. We also have a 21 month old bio son.
So, I really can't be sure if her increasingly bad attitude is medical or environmental. I am working with her therapist (also new) who will spend more time coaching me to improve my parenting skills. Dh is not open to any advice.
MomofC, if she has bipolar disorder, both the Concerta and Wellbutrin could be making her worse. Although doing a med wash could make things worse before things get better, it may well be worth it in the long run if you can get her stable. Believe me, I've lived through it and it's not fun. But my daughter is improving daily, and I'm holding out hope for my son. Having a pdoc who "gets" it is the only way to go, IMHO. Good luck and keep posting. We're here for you.
[QUOTE=SmallMom]Sheri, our pdoc said one of the reasons he thinks our son has BP is because of his prolonged, intense reaction to Zoloft. We waited a good six weeks before putting him on Depakote to see if he would settle down on his own. He never did. Even today he just doesn't seem the same as he was before Zoloft. [/QUOTE] oh my god i have said the same thing.... dillon doesn't seem the same as he was before stim...
Caitlyn's former foster parents said that Zoloft made her very angry. Worse than normal.
I know the pdoc said that the Concerta might be what is keeping her from sleeping well but I know on the days that we have forgotten her meds she is extreme. She fluctuates from hyper to hateful (she does even on her meds but worse without them). I know a day is not enough time to measure the effects.
I've been thinking about the med wash and I really need to know what to expect before going into it. Do I wait until the end of the school year? Should I skip entering her in the summer program (she goes to a city run summer program for special needs students)? And I also have to worry about my toddler's safety. I am a SAHM so he is with me all the time. Should I enter him in a day care while we are doing this? And most importantly, how do I knock some patience and tact into my husband's head?