ADHD/Bipolar (How do you know?) | ADHD Information
I can tell you about when Dylan (who is dx'ed Bipolar) is manic. For now, and fortunately, he seems to be leaning closer to Bipolar I, mixed states, but doesn't seem to have the depressive end (thank goodness).
When he is manic he gets 10x louder. He gets giddy, too happy, dances around the house, is unable to sit still and concentrate. He gets a little defiant, a little aggressive (not physically, but verbally), blurts out inappropriately (we can be talking about camping, for ex., and he'll spit out something about Kool Aid LOL). He can't stay on task, can't stay focused, and has a hard time relaxing.
Now that he's on the right meds (Lithium, mood stabilizer, HUGE difference), the mania is clear. I don't know how often he was manic pre-Lithium, because he was wired 24-7, so I am unsure if it actually slowed down the manic episodes or not. I would say I see cycles ranging from every 2-3 weeks to 2 months, lasting anywhere from a couple of days to a week (it's a long week LOL).
Janna
I would call and make an appt with a pdoc and then take notes about the behaviors. Often, the good pdocs have at least a month waiting period for appts. Call your insurance, get the info on your benefits and call the pdocs on your list. 3 or 4 weeks waiting for the appt gives you plenty of time to doc the behaviors.Can someone help explain the mania episodes in Bi-polar a little more in detail?
Yesterday Boo was so hyper you had to put your hands over your ears just to listen to him talk.He took his Ritalin and Trileptal in the morning but at !:00 he was super-charged.I will consult a profesional after I take notes about the behaviors.
It's easy to tell the difference. The child is so out of control that there is no reigning him in--he could be violent, have tantrums for hours (the evening in often a time for mania), the word "no" is a big trigger for a rage in bipolar kids, yet they can be sweet as pie at certain times. Some go days seeming better than *bam." Some cycle continuously and have that good kid/bad kid situation. A great example of bipolar vs. ADHD is on a site by Dr. Poppler. "Both ADHD kids and Bipolar kids break things. The difference is the ADHD kid does it because he unintentionally falls into something and it breaks. The bipolar kid does it with anger and rage." Also, stims do not stop bipolar cycling, and can, in the long run, make the bipolar worse. Antidepressants often help at first (kick the kid into a nice sort of low-key mania) and then a month later, the kid is a raging wreck, when the blood levels of the medication rise, throwing the child into childhood mania. Anyone with an off-the-wall kid isn't looking at ADHD, no matter how much they hope they are. If kids start talking about blood, gore, suicicde, etc. you're progressing in the disease and the child needs a mood stabilizer--desperately. I recommend visiting the Conduct Disorders board if you want to know more about the diffrences. The paernts there can maybe explain it better than me. They are a tough and seasoned group of parents who have seen it all. They're compassionate, and will make good suggestions, but won't pull any punches. Basscially, they will say "It sounds like more than ADHD. You need to see a Child Psychiatrist (the guy who has the MD). Good luck :)
OlderMom38880.5711689815It may just be a side effect of the medication your child may be on, when I hear defiance I think of oppositional defiency. I agree with Oldermom have him diagnosed by a professional to know for sure.ODD, however, doesn't stand alone. Dr. Chandler, the Big Cheese of ODD, even states, in The Chandler Papers "ODD Rarely Travels Alone." It is a symptom of a bigger disorder. It goes along with every childhood disorder. When the child is so bad he or she is breaking things or stranging the cat or getting thrown out of school, the usual reason is that it's really early onset bipolar, wrongly medicated or unmedicated. Bipolar has probably the biggest ODD factor of any of the childhood disorders. The kids are not in control of themselves and can't "shut down." It's a very sad disorder, but, again, it's treatable. I survived it and am sure I had it as a kid.
The best way is not to diagnose it yourself. Take your child to a Child Psychiatrist (with the MD). Forget the pediatrician, therapist, or even psycologist. Write down your family history. If there is substance abuse or bipolar or depression/anxiety in the family, those are red flags for bipolar. If the child is off-the-wall out of control, that's really not ADHD. If your child is being suspended from school, can't hear a "no" and can be loving one moment then raging and banging holes in the wall the next, you are probably looking at early onset bipolar. It does NOT look like adult bipolar, but the same meds are used. Stimulants and antidepressants make it worse. ADHD is a fluid condition. Bipolar kids are erratic in their behavior and their attention spans are often worse than those with ADHD. If the cycling isn't stopped, the disease can progress, but it's treatable. THis isn't the best site for bipolar info. I did post a few other links on my "Pediatric Bipolar" thread. I'll post them again.You would get more info going there. This is an ADHD site so there is very limited information on Pediatric Bipolar. Good luck!
OlderMom38879.7062384259My son is 9 and has ADHD but when I look at the symptoms for Bipolar, it seems like he leans more towards this. And if this is the case are there any medications that are more effective than adderall for the ADHD? Has anyone one had experience with this situation. My son exhibits so much Up & Down mood swings and psycho outbursts and defiance and it lasts for hours some days, and it seems like afterwards he is as sweet as pie, like it never happened, it is amazing! And of course I mean amazing in not a good way! Help.
yes my son Dillon has been dx with bipolar... but i'm still learning about the illness myself... infact most of what i have learned has been by oldermom or smallmom... both of them are GREAT 
I feel the same way my child also has just as many bp symptoms as adhd and the temper is way out control. It seems like he ia always in attack mode .what would I need to ask of his doctor to do . How do u really know the differenceyou might find sheri.m to know alot about the differences. i think her son has bipolar and she would be able to answer a lot of your questions. sorry I cannot help any more than pointing you in that direction.
And the problem here is, ADHD meds make bipolar worse. Our psychiatrist told us it's better to try bipolar meds first to see if they work than put stims into a kid who may have bipolar as ADHD is not a progressive disorder, but bipolar is. And this doctor is doubling the dose of the stims. That's the problem with some of the psychiatrists. An ADHD kid will not react badly or get worse on a mood stabilizer (he will remain the same), but a bipolar kid can flip out and disintegrate on stims or Straterra. May psychiatrists do things backwards. Stims aren't helping. More stims will probably continue to not help or make things worse. Since these disorders have no blood tests, often we parents get 100 different dx. The only way to know the truth is to see which treatment works. It's discouraging at times. Been there with the wrong diagnoses twice. And since parents can handle hearing ADHD, often a psychiatrist will give that diagnosis than another one, even when that isn't helpful to the child. If the child smashes the cat or swears at the teacher, they'll tack an ODD diagnosis on. That isn't very helpful either. ADHD/ODD usually ends up with a bipolar diagnosis. We had a joke on a bipolar board I used to chat on that "ADHD/ODD" is a just bipolar. It usually is. And the doctors throw stimulants or Strattera at these kids or continue to call it ADHD and finally put the kids on a mood stabilizer, which is what they needed all along. Some are so stubborn, they will continue to call a kid on Depakote and Seroquel--ADHD. We used to laugh about it (in a sad way). OlderMom38881.2183217593[QUOTE=ogram]sheri, did they say he was adhd before they found out it was bipolar? if so, how old was he, if you don't mind me asking.[/QUOTE] long story... i will try to make it short 
1st i was told he was having complex partial seizures...went for a 2nd and 3rd opinion and seizures was ruled out by two neuro's. last neuro mention depression and told me to take him to a pdoc.1st pdoc put him on ADHD meds (big mistake) dillon went into a manic state.. that is when they realized he wasn't ADHD..we took dillon to the 1st neuro right before his 3rd birthday.. we knew something wasn't right long before that...Hi my son was thought to have bipolar, by all the Dr's, and therapist, then after his appointment last week , the psychiatrist said right now there is not enough evidence that he has. He said i honestly think your son has been dealt a double dose of adhd, so for now his meds. have been raised, and if that doesn't work then he'll look into other things.Hi everyone....
I just wanted to comment on the original question. I agree that OlderMom is very knowledge on the subject and I to agree with her as far as getting the answers from a MD.
I wanted to share my experience with you guys and maybe it might shed some light.
My mother has Bipolar and my younger brother has ADHD. I also have a 6 year old son recently Dx'd with ADHD. I have a 13 year old son who has ADHD which is accompanied by ODD as well. And although he is a very loving child there have been some rough patches along the way. After my son was Dx'd we went through the process of finding the appropriate medication which at one point they put him on Adderall XR, all I can say is that ADHD + ODD + Adderall XR not a good combination for my son. He showed some classic signs of a child who has Bipolar.... He was violent, displayed severe mood swings, and he was depressed. But through close communication with his Doctor we decided that a med modification was needed. Once we changed the medicine (to Concerta) I noticed that some of the behavior issues disappeared as well.
Now as for my 6 year old, recently trying a new med (Concerta) for him as well he dispalyed some unacceptable behaviors but again through close communication with his doctor we changed his med (to Ritalin LA)and now all is well and he is doing great.
My son, Dylan, was originally dx'ed ADHD at age 3. Then it went on to ADHD/ODD through age 6. From then until November of this past year, the dx'es have been varied. Mood Disorder, NOS, PDD-NOS, Intermittent Explosive Disorder (totally bogus LOL).
I had no clue what Bipolar Disorder was until th is past November when I went to conductdisorders. I think OlderMom already gave you that link. Between her and smallmom, they have been an enormous help to me on Bipolar. Additionally, I read The Bipolar Child and have learned more in 6 months than I had learned in the 6 years previous.
Severe rages are NOT in the DSM Criteria for ADHD. If your child is having massive mood swings with severe rages that is probably something else. And as also stated already, if your child was not having these mood swings and agression pre-Adderall, that could also be an issue. Adderall is known for causing aggression in kids.
The best medication to start with on a child that is Bipolar is a mood stabilizer. There are many to choose from, depending on your child. My son is on Lithium, which has been a Godsend to us. He has not had a rage since January of this year.
Janna
i have asked dillons doctor to put him on lithium and they look at me like i'm crazy.... i keep getting told he's to young... but they'll put him on seroquel,risperdal,abilify...i just don't get it... i have heard so many good things about lithium i guess we'll just have to just wait.. as of right now dillon is taking depakote and seroquel...I'd say that the behaviors would go away if it were the right meds. Adderrall is hard for mood disordered kids and, with bipolar on the family tree, the ADHD/ODD is probably bipolar (as we say on the bipolar board). If he is only having some success with stims, he could have co-morbid bipolar. Some doctors just wont' diagnose it or call it by name, but you should keep on top of him. It's a very hereditary disorder and a bad reaction to stims or antidepressants is a red flag for bipolar, not ADHD. His family history alone warrants a trial on a mood stabilizer. I really get angry at doctors. As for Lithium, it's not recommended for kids under 13 so some doctors are afraid to prescribe it, although it is far more effective than Risperdal, Abilify, and any of those antipsychotics. On top of that, the antipsychotics aren't approved for young kids either (in fact, they have no ideas what the side effects of those meds are). I don't get that either. I think there are just a lot of BAD professionals in the mental health field. I couldn't get my own bipolar diagnosis until I was 23, and I'd been having adult-like highs and lows since my teens. I started early with the adult onset type, but clearly had early onset too, with the rages and stuff. Go figger. sheri, did they say he was adhd before they found out it was bipolar? if so, how old was he, if you don't mind me asking.Thanks Janna,
This sounds so much like my boy. He is 17 and just this morning was up at 5:00 am and was ready to go to school but school doesn't even start till 8:00. So he was outside playing with dog and from one thing to the other.Horseplaying is his favorite word for this. Couldn't carry on a simple conversation.Wanted to talk about everything in 2 seconds.By lunch time he will get frustrated at himself and have a stinky attitude with everyone.Then when he gets into trouble or hurts someone's feelings he will get mad.Also alot of the other stuff like not relaxing is also what I see but the social worker tells me is this from ADHD.So I will take notes and make him an appt. this morning to discuss all my new info.
Thanks again, momsanders
Hi,
I am a new member and new to the parents of children on Ritalin.I just received custody of a 17 year old boy that has so many diagnoses that it is a wonder he is not in a mental hospital.I am told he has symptoms of RAD,ADHD,onset bi-polar,depressive disorder,conduct disorder.
My concerns are that he is on Ritalin and Trileptal[mood stablizer] but still has angry outburst and impulsiveness and says he has trouble getting A GRIP on things sometimes. He sees a therepist and every 6 months sees a mental health doctor.Because I don't know family history, can someone help me to ask the right people the right questions? It breaks my heart to see him on a roller coaster ride that he wants to get off oif.
Thanks, momsanders
Has he ever seen a Psychiatrist? I wouldn't trust a therapist with his diagnosis. Seems he's been diagnosed with everything under the sun, some that contradict one another. You either have bipolar or depression. Depression is PART of bipolar. Bipolar looks like RAD, and often is. CD often also is bipolar, wrongly medicated. I wouldn't like those meds if my kid had bipolar (I have it). Ritalin makes bipolar worse and Trileptal alone won't help, especially with the Ritalin on board. It also has to be a high enough dose, and is less effective than Lithium or Depakote, with Lithium the most effective. I'd get another opinion. Here are a few other links:
Thanks,
I am assuming that the mental health person is a psychiatrist. I have known this boy for a year and a half and don't know what all he has been treated for or with. He lived in several foster homes before coming here.He is a good kid and most of the time trys to control himself. But if I ask him why he gets so angry[got angry the other day and punched a stop sign after getting out of the car]he says he doesn't know why.Then he gets upset at himself.I want to try to take him off the Ritalin but don't know if it is a good idea.He says he has been taking it since he was 8.He doesn't know his family medical history since he was removed from them when he was also around 8.
I will check out the sites you have recommended.
Thanks,
momsanders