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Bipolar Disorder (Children and Adolescents)

Child with Bipolar Disorder?

09/15/2008

Question:

Hello, I have a simple question with a complex answer. My son who we adopted at 4months has been hospitalized over aggression. He is 9yrs. old. He has many "meltdowns" that last quite some time. It seems lately he has demanded an enormous amount of attention from my wife and I.

My question is, can he still have bipolar disorder if he is in control at school, church, and in public places? (the doctors he sees is certain he has some type of mood disorder) He is very high functioning and has been diagnosed with Asberger`s Syndrome. He is not of the more autistic spectrum. It appears he only "acts" up at home and in certain instances. He is currenly on Depakote (500mg) total/day for about a week. The weekend has been very stressful as he has destroyed many items, mostly his. Thank you

I realize this is not his entire file, however I question if a child can be bipolar in certain circumstances.

Answer:

Hello and thank you for your excellent question. Regarding your specific question of "can he still have bipolar if he is in control at school, church, and in public places?" Yes, it's possible but infrequent. I say it's possible because some kids can "hold it together" outside the home and then "let it all hang-out" in the comfort of their own home. However, children with bipolar disorder usually have problems across many areas.

Another possibility is that these meltdowns are associated with his Asperger's Disorder and he's "holding it together" in more public places where he is more fearful of negative consequences and then the "holding it together" and associated stress overflows into the comfort of his home. In addition, the "trigger" might be related to him not knowing how to cope with these public places because of his social-skills difficulties associated with his Asperger's. I find that children with Asperger's who are high functioning are often aware they are "different" and want to "fit-in" but don't quite know how to do that, which can lead to frustration and mood problems. If you haven't read the following books on Asperger's, I'd suggest you take a look:

1. Asperger's Syndrome: A Guide for Parents and Professionals by Tony Attwood. 2. A Parent's Guide to Asperger's Syndrome & High Functioning Autism by Sally Ozonoff

Of course, another possibility is that the meltdowns are caused by another disorder or some other trigger at home. I'd start by discussing these possibilities with your son's treating mental health professional(s) and collecting more information on each before focusing on a specific intervention.

I hope this answer is helpful.

My best wishes to you, your son and your family.

For more information:

Go to the Bipolar Disorder (Children and Adolescents) health topic, where you can:

Response by:

Nicholas   Lofthouse, PhD Nicholas Lofthouse, PhD
Clinical Assistant Professor of Psychiatry
College of Medicine
The Ohio State University