I don't think you can be sure until they are at least teens.
NoTellin39423.9097569444Actually my dd's first doc never mentioned bipolar, but my sister was dxd bipolar a few years back and I have the dx of being "possibly bipolar" and have had "major depression" since I was in my early teens. This doctor today said he thinks she is in "the bipolar spectrum". When I asked for a better explanation he basically explained it as it being "half bipolar, half oppositional defiance disorder", but that there was no "clear cut" dx of bipolar. He has added a third dose of Ritalin for when she is at home, Clonidine to help her get to sleep at night (otherwise she is up anywhere from 10 to midnight each night), and is starting Abilify for her moods. After reading the responses though, now I am a bit worried about it. How can we be sure she is or isnt bipolar? I dont want to medicate her with something that is not needed. To me, the Ritalin is doing no good in her activity level, so why continue it. His explanation for that was, from my understanding, once the moods are more regulated that will help with the activity level in conjunction with the Ritalin. Its awful....I want her medicated in a way b/c I just can NOT take it anymore, I just cant handle her, but at the same time I dont b/c Im afraid.
Oh, BTW I asked him about the testing for food allergies and he said it was possible that could be part of her hyperactivity, but talked like it would not cause it to the extent that she has. I dont know. I may just have to talk to the family doc about that and see what can be done there. I dont know if her insurance will cover for it or not w/o more "cause" for needing it.
Thanks for the help!
My dd was dxd with ADHD combined type. She is 9. She has been on Clonidine, which just put her to sleep and nothing else. She was tried on Adderall 5 mg up to 7.5 mg and that made her more aggressive. Then (and now still) it was Ritalin 5 mg in the a.m. and at noon. To me, it does nothing. In fact, to me it seems she is much worse in the evenings when she gets home from school. Her teacher (on the Ritalin) said at first she was still "too active", but then on the second week she says she is doing "much better". I thought Ritalin was pretty much an "immediate" drug with fairly immediate results and then when it wears off, it wears off and that is it....this is the regular release that she is on not the extended. My understanding was it does not take time to "build up" in the system, so this is a bit confusing that she now says she is doing much better on it. Does it actually take Ritalin time to work?
Now....for a number of reasons we are switching medical facilities. In talking with her therapist, she wonders if my dd is possibly bipolar. She said that the Ritalin wont help if she is bipolar. She wonders if she needs a mood stabilizer instead. She will see her new psychiatrist tomorrow. Talking with my dd she said tonight that the medicine does make her feel calmer and she is doing better. When I ask her about her behavior at home she says that is b/c she "can only control it at school and then has to let it out". Says she can only "hold back" for a short period of time. How do I really discern what is just bad behavior and what she really cannot control?
I have food allergies, my son has food allergies. My sister believes I should have her tested as well as she wonders if it could be a food allergy causing the hyperactivity. Has anyone done this and did you have a problem with your insurance paying for it? With a change in diet was medication still needed for your child?
Sorry this is so long, I am SO desperate for something, anything. I cant deal with her much longer, something HAS to be done. Thanks.
If your daughter id showing siggs of bipolar then taht NEDS TO BE TERATED FIRTS then go back and trea the ADHD.This is important.Yes, food allergies can cause hyperactivity. It would be worth investigating if you and your son also have allergies. MSG and artificial colorings are other things that throw some people out of wack.
It is very common for our kids to hold it together at school and then totally loss it when they get home. They work so hard to keep it together. When they get home they let it all out. My daughter does just this - total Dr. Jeckell and Mr. Hyde. People at school would be totally shocked by some of the things she has done at home.
Once we found the right med at the right dosage (currently she is taking Concerta), things where easier at school which then made things easier at home - even after the meds had worn off.
If your daughter is getting some symptom relief from the Ritalin, perhaps you need to up the dosage or switch to a different delivery system or longer acting version.
My friend's son is ADHD and Bipolar. While both our kids have had some pretty crazy episodes, his behavior is really different from my daughters. He has issues in all aspects of his life - not just at home. Based off of my experience (very limited as it is), I would be cautious about jumping to the bipolar diagnosis.
Good luck with your new doctor.
bipolar and ADHD can coexist and the Ritalin would help with the ADHD. The concsensus is get the bipolar under control then address the ADHD. I also wouldnt jump on the bipolar theory. If you are concerned, mention it to the new psych and have them evaluate. I agree that she may just need a longer acting or higher dose of med.
Absolutley check her for food allergies. SO many things can mimic ADHD you must rule out everything.
Good luck, it can be so overwhelming...................be patient you'll sort it out.