[Mackenzie]

My 15 yr. old daughter has been living in residential care since Nov. 2002. She has been diagnoised as having Bipolar in the last 4 months. According to her therapist, she is also hearing voices. DD has been asking to go to the hospital and isn't functioning well at all during school hours. She is extremely tired most of the day and very sad. Seems to me that she has crashed as a result of the cycles she has been going through.

The problem is that she latches on to anything someone suggests could be wrong with her, so we don't know if she is really hearing voices or not. Her way out of dealing with life is to go to the hospital. It's difficult to know if she really needs to be hospitalized or not but the therapist is encouraging us to. Due to her aggressive behavior, if she assaults another child they are likely to kick her out of the home.

We are at a loss as to what to do. We do think they need to start over on her meds which don't seem to be working. She is on 5 different meds at the moment. Is hospitalizing her the only way to stablize a Bipolar child?

Robin

[Dr. Art]

First of all, it is important to know that no one can diagnosis at a distance. So, the answer to your question is really a big, It Depends. Some forms of Bipolar Disorder can be very difficult to effectively treat....However, the more likely issue here is (assuming your child was adopted and has a history of early maltreatment in the first two to three years of life), that she also had Reactive Attachment Disorder. About 50% to 80% of the children adopted in the U.S. through U.S. fostercare, who have histories of maltreatment, have reactive attachment disorder. Of those children, maybe half also have bipolar disorder, in addition to the RAD. The behaviors you are seeing may be a function of the RAD, if present. Since very few mental health professionals have the requisite experience and training to diagnosis RAD, you really need to find a licensed mental health professional in your region who can do this for you. Check out Association for the Treatment and Training in the Attachment of Children for a list of registered clinicians in your region who can do this or who can recommend someone in your town who can accurately assess and make treatment recommendations for you and your child.

Best of luck

[Dr. Art]

Attachment Disorder Checklist




A professional assessment is necessary to determine whether or not a child has an Attachment disorder. At the Center we use several tests as part of a comprehensive assessment to determine what attachment issues are causing problems and what will be the most effective treatment plan. We work very closely with the parents to develop a plan to help remediate attachment problems. This check list can help you identify areas of potential problem. This check list is not meant to substitute for a professional assessment and treatment plan.

Circle the items if they are frequently or often true.

1. My child teases, hurts, or is cruel to other children.

2. My child can't keep friends for an age-appropriate length of time.

3. My child doesn't do as well in school as my child could do even with a little more effort.

4. My child pushes me away or becomes stiff when I try to hug, unless my child wants something from me, in which case my child can be affectionate and engaging.

5. My child argues for long periods of time, often about meaningless or silly things.

6. My child has a large need to control everything.

7. My child is hyper-vigilant.

8. My child acts amazingly innocent, or pretends that things aren't really bad or a problem when caught doing something wrong.

9. My child does dangerous things such as runs away, jumps out of windows, or other potentially harmful actions. My child seems oblivious to the fact that my child may be hurt.

10. My child deliberately breaks or ruins his things or other's things.

11. My child doesn't seem to feel age-appropriate guilt when my child does something wrong.

12. My child is impulsive. My child seems unable or unwilling to stop doing something my child wants to do.

13. My child teases, hurts, or is cruel to animals.

14. My child steals, or shows up with things that belong to others with unbelievable, unusual, or suspicious reasons for how my child got these things.

15. My child likes to sneak things without permission, even though my child could have had these things if my child had asked.

16. My child doesn't seem to learn from mistakes, consequences, or punishments (my child continues the behavior despite the consequences).

17. My child makes false reports of abuse or neglect. My child tries to get sympathy from others, or tries to get us in trouble, by telling others that I abuse, don't feed, or don't provide the basic necessities.

18. My child seems not to experience pain when hurt, refusing to let anyone provide comfort.

19. My child does not usually ask for things. My child demands things.

20. My child lies, often about obvious or ridiculous things, or when it would have been easier to tell the truth.

21. My child is quite bossy with other children and adults.

22. My child hoards, sneaks food, or has other unusual eating habits (eats paper, raw sugar, non-food items, package mixes, baker's chocolate, etc.)

23. My child often does not make eye contact when adults want to make eye contract with my child.

24. My child has extended temper tantrums.

25. My child chatters non-stop, asks repeated questions about things that make no sense, mutters, or is hard to understand when talking.

26. My child is accident-prone (gets hurt a lot), or complains a lot about every little ache and pain (needs constant attention).

27. My child acts cute or charming to get others to do what my child wants.

28. My child is overly friendly with strangers.

29. My child has set fires, or is preoccupied with fire.

30. My child prefers to watch violent cartoons and/or TV shows or horror movie (regardless of whether or not you allow your child to do this).

31. My child was abused/neglected during the first year of life, or had several changes of primary caretaker during the first several years of life.

32. My child was in an orphanage for more than the first year of life.

33. My child was adopted after the age of twelve months.

If you find that more than a few items (more than five or so) have been circled, your child may be experiencing difficulties that require professional assistance. If, in addition to several items being marked, any of the last three items is check, your child may be experiencing attachment related problems.





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[Mackenzie]

Thank you for the advice and the check list.

She does have attachment problems, another disorder we were not aware of when we adopted her. We have been addressing it in therapy the last 3 - 4 months and have been making a lot of progress in that area. Through everything we have been through with her she is finally starting to trust us.

Robin

[Dr. Art]

Glad to hear it. Attachment work takes tiime and special effort; attachment-based parenting, which is not like usual or "automatic" parenting (what one does without thinking because it is how one was raised.).

Good luck

[mrc4578]

I am so sorry to hear of your problems. Our adopted son (18) was diagnosed with schizo-affective disorder. He has been hospitalized 29 times in 2-1/2 years. Finally he is somewhat stable and has learned coping techniques for minor psychotic episodes. I can't offer much advice except to say that you have to be very proactive in seeking treatment for your daughter. I'm sure you have been but I'm just providing affirmation for your actions. Be assertive with the doctors. Research, research, research. We've found that the more intelligently we can talk to the doctors the more they talk to us. If you're not pleased with the medications make sure you let them know you want a change. Obviously something isn't working if she's been in residential treatment for so long. Do not slack up on therapy. It has helped our son tremendously. We adopted our son as an infant so there's not the detachment disorder. In fact he says he has NO problems with the fact that he's adopted. Find your local NAMI organization (National Association for the Mentally Ill). Join them. They're great for resources and sharing.

When your daughter is 18 (if that's age of majority in your state) you can lose control of gaining information. Seek an attorney to get some sort of legal control where you have a right to her medical information and can have her treated when you think it's necessary in case she doesn't want to be. We have that for our son, although he's never refused treatment. However, we've been able to always get his medical information in spite of him being an adult legally.

I hope it helps and even though I don't know you will pray for you.

[ndoscoptec]

My nephew was dianosed as Bipolar at about age 15. This was after years of problems that started with him choking his baby brother at age 3. He had problems in school and at home. He was treated for ADHD, Ritalin made him worse. He finally ended up in an adult prison at age 15. He had violated his parole and his Mom turned him in out of desparation and thought he would go into the juvinile system. Because of space problems he ended up with the adults and it really scared him. His Mom got him into a program with a group called Kidspeace. This was in Miane but there are others in the country. They diagnosed him, got him on proper medication and taught him some self dicipline to keep his behaviour in check. It was in a boarding school type atmosphere and he was able to earn privalages and visits from us by staying on track. They gradaully gave him more and more freedom to come and go with his family then he was able to move home. The program was exellent for him. He managed OK in school. Didn't get into trouble with the law anymore, held a job, and was planning for the future in culinary school. Sadly we lost him in a car accident, at age 17 only two weeks after getting his licence.

Please look into Kidspeace. I know they made his short life much better!

[pandora1]

HI my name is mike I am 40 now I suffered bipoler when I was 16 after trying to kill myself it seemed nothing would help, it took me 20 years to find the right meds here is what I have been taking for the last 6years and it works
200mg Seroquel at noon
atavin 1mg 4 times a day
800 Seroquel bedtime
60mg Remeron bedtime
these meds will put you to sleep and keep the voices away, the best thing you can do is never give up trying new drugs like I said it took me over 20years to find the right drug combo , good luck and god bless

[Mackenzie]

Hi Mike,

Thanks for the info. Actually since I wrote that post, my daughter is finally back home. But it has been a very long and difficult couple of years. She just came home again in the last couple of months.

But I could really use any info you have that could help me. You see, my son has a friend who has been living with us for the past 2 years. This young man was a mess, mentally and emtionally when he moved in with us.
I finally got him to a psychiatrist and he was diagnois with Bipolar. He's had his ups and downs. Taken his meds, and not taken his med. But just in the last couple of weeks, he has lost all motivation and doesn't even care about himself. We have had a special bond between us since he moved in and right now I feel I am loosing him. I am the only person he will talk to and now he has hit such a low that he won't even try. He says he just doesn't care anymore and is tired of fighting it.

I don't know what to do. I can not turn my back on this young man. Things from his past play into some of this, there are a number of issues he won't deal with and I have tried to get him to talk with a therapist but he refuses to do it because he has no insurance and I have had to pay for his meds and doctors. Even when he has had a job, he can't keep it. I don't know where to find the help he needs. Do you have any suggestions?

Glad to hear there is hope.
Robin

[Mackenzie]

Hi Mike,

Thanks for the info. Actually since I wrote that post, my daughter is finally back home. But it has been a very long and difficult couple of years. She just came home again in the last couple of months.

But I could really use any info you have that could help me. You see, my son has a friend who has been living with us for the past 2 years. This young man was a mess, mentally and emtionally when he moved in with us.
I finally got him to a psychiatrist and he was diagnois with Bipolar. He is now 21 yr. old. and he's had his ups and downs. He is on Effexor XR, but just in the last couple of weeks, he has lost all motivation and doesn't even care about himself. We have had a special bond between us since he moved in and right now I feel I am loosing him. I am the only person he will talk to and now he has hit such a low that he won't even try. He says he just doesn't care anymore and is tired of fighting it.

I don't know what to do. I can not turn my back on this young man. Things from his past play into some of this, there are a number of issues he won't deal with and I have tried to get him to talk with a therapist but he refuses to do it because he has no insurance and I have had to pay for his meds and doctors. Even when he has had a job, he can't keep it. I don't know where to find the help he needs. Do you have any suggestions?

Glad to hear there is hope.
Robin

[rindava]

to the social security office and try to get on SSI...

You just let him live there with no income????

Also, he can get help with the department of rehabilitation for getting a keeping a job if he has a disability with causes him problems in getting or keep a job....