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Sunday, April 20, 2014
Bipolar Disorder (Children and Adolescents)
ADHD; ODD, Bipolar(?)
We found out that my 6 yr. old grandson has the above. He has done things that seem to be to get your attention. He has done a bowel movement outside as well as the other. I can see that my daughter is having a very hard time. Her husband only makes matters worse. He also suffers from ADHD and other things..lies, throw things,swears etc. These are just some of what my grandson has "picked up." How do I help my daughter and grandson? What steps need to be taken? He already sees a psychitrist for meds. They have taken him to a therapist who after a few times really does not want to deal with him because of his behavior. My daughter admitted that she is ready to just take off because of the stress. My daughter suffers from MS which is in remission. I am afraid that this situation will cause another episode for her.My granddaughter(13 she has ADHD)is really starting to resent her brother. Any help would be appreciated.
Thank you for your question. The first question that comes to mind, as a psychologist hearing about a new case, is whether the patient has received a comprehensive and detailed psychological assessment leading to an accurate diagnosis(es) from a trained mental health professional? You mentioned your grandson has "ADHD, ODD, Bipolar?" Do you feel confident the mental health professional conducted a comprehensive and detailed psychological assessment? If not, then I'd suggest calling your local university, community mental health center or National Association of Mentally Ill chapter to ask for names, locations and phone numbers of mental health professionals who have expertise assessing and treating childhood psychiatric problems.
If you feel your grandson has received an accurate assessment and diagnosis(es), my next question would be is he getting effective treatment (medications, therapy and special education services, if needed) for this diagnosis(es)? If not, once again, I'd suggest calling your local university, community mental health center or National Association of Mentally Ill chapter to ask for names, locations and phone numbers of mental health professionals who have expertise assessing and treating such diagnoses in children.
If your grandson does have ADHD, ODD and BP, the first line of treatment is usually medication to stabilize the BP mood problems. Possible medications include Lithium, Depakote, Risperdal, Seroquel, Abilify and/or Zyprexa. After the mood symptoms have been stabilized, psychiatrists can then "carefully" prescribe medications for the ADHD symptoms including Ritalin, Concerta, Metadate, Adderal, Dexedrine, Focalin, Daytrana, Vyvanse and/or Strattera. I say "carefully" because these "ADHD medications" can sometimes induce manic symptoms. That's also one of the reasons they can't be prescribed before stabilizing the bipolar symptoms.
In addition to having a child psychiatrist on your team, a therapist with expertise in treating children with bipolar disorder will also be important. For that, once again, I'd suggest calling your local university, community mental health center or National Association of Mentally Ill chapter to ask for names, locations and phone numbers of mental health professionals who have expertise treating bipolar disorder in children. Because of the age of your grandson and the family problems you've mentioned, parent-therapy focused on helping his parents manage the symptoms and related stress might be the most useful.
I hope this answer is helpful.
My best wishes to you, your grandson and your family.
Nicholas Lofthouse, PhD
Clinical Assistant Professor of Psychiatry
College of Medicine
The Ohio State University