Bipolar Kid Connection

Our Experience:

Lamictal is a medication that is supposed to bring bipolar kids out of depressive states without throwing them into manic states.  Because of this ability to stabilize moods so well, it is often used in the treatment of bipolar disorder in children as well as bipolar disorder in adults.  I know that the last time we used it for our daughter Abbi, she was doing VERY well.  Lamictal is the first drug since lithium to be approved by the FDA as a mood stabilizer.

Then trouble struck.  Lamictal does not have a ton of side effects but there is one major one.  It is coined as the Lamictal rash but also known as Stevens-Johnsons Syndrome (SJS).  The last time we tried Lamictal, Abbi developed this nasty Lamictal rash and it was STRESSFUL.  The first thing to note is that the rash is very itchy.  She itched so much that her skin was raw.  It is also hot to the touch.  The rash only develops in 5%-10% of users, one of which we were one.  We had to stop taking the medication right away and switch to something else.  The Lamictal rash can be a serious thing.  It is so important that when your child is adjusting to this medication you stay in contact with your child’s psychiatrist.  Rashes are more prevalent in bipolar kids than bipolar adults.

So a month ago the doctor asked us how we felt about putting Abbi back on the medication that had cause discomfort and stress.  After doing a lot of research we discovered that if you increase very slowly the chances of developing the rash decrease.  After discussing it with Abbi and each other, we decided to give it a try.  The good news is that there is no rash yet.  We have increased at half the rate we did last time.  So far it is working and to top it off she is feeling “better” emotionally.    I would highly recommend trying this medication if it is recommended for your bipolar kids, but be sure to use some caution.

As a follow up to this post we did eventually choose to put Abigail back on Lamictal.  We increased the dosage slower this time in order to help assure that she would not get the rash.  I am happy to report that she has been back on Lamictal for 6 months with no rash.  As a parent it is my advice to slowly introduce Lamictal.  Of course your child’s psychiatrist will know what is best!

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Recent studies have shown that bipolar kids often have learning disabilities in addition to suffering from bipolar disorder. If you bipolar kid has been referred to the committee on special education in your school district it will be important that you know all there is to know about the IEP (Individualized Education Plan) process. Below is a list that will briefly describe the process to you. It is important that through this process you remain educated as to the next step. You are the best advocate your child will ever have!

1. Referral:  In this first step in the process.  The referral can come from someone within the district or from a parent or guardian.  If you as the parent this referral will have to be given to the school in writing.  The school then has 10 days in which to respond to the referral for evaluation.  At this point the school will ask for signed permission from the parent or guardian so that they may move forward with the evaluation process.
2. Evaluation: By this point there is already one hurdle jumped and it is on to the next step.  It is important that the person referring the child assures that the school will be testing the child in the areas of concern.  While bipolar kids can show attention concerns it is also important to know that many times bipolar kids have other learning disabilities.  Identify where you feel that your child’s evaluations should focus and communicate those concerns in writing.  According to federal law IDEA 2004 the school has 60 days to complete this process.  Some states may have laws requiring it be completed sooner.  Idea 2004 also requires that children also be evaluated in all areas of concern.  It is often recommended that a child with bipolar disorder be tested in all 8 areas.  Recent studies have shown that many bipolar children also have sensory integration deficits.  The 8 areas in which a bipolar kid should be tested includes: health/medical; vision; social and emotional status; hearing; academic performance; general intelligence; communicative status; and motor abilities.  These 8 areas are often referred to as domains.
3. Determining Eligibility: After laying out an evaluation plan the school professionals will conduct the steps of the plan.  This will require many individuals within the school to work together.  Your child will be pulled out of class in order to be properly tested and evaluated for an IEP.  These tests need to be completed within 60 days although it differs state to state.  IDEA 2004, the federal regulation, requires 60 days.  If your state requires a different time period in which testing should be completed it has to be below the 60 day federal IDEA 2004 requirement.
4. Meeting: Once testing has been completed you will be asked to attend a meeting.  In this meeting you will hear the test results from each person who evaluated your bipolar kid.  In this meeting they will communicate if your child was eligible for an IEP under any of the 13 classifications.  If your child is not found to be eligible it may be recommended that your child’s needs be covered under a 504 plan.  Section 504 is a section of the Americans with Disabilities Act.  Before your meeting it is a good idea to learn more about a student 5 04 and what accommodations may be fitting for your kid with bipolar disorder.  If your child is found not to be eligible for an IEP you have the right to request an Independent Educational Evaluation (IEE).  If your child is found eligible for an Individualized Education Plan (IEP) your child will be provided special education services. Some schools combine eligibility meetings with the IEP writing into one meeting.
5. Writing the IEP: It is important to understand that according to IDEA 2004 parents must be informed of this meeting in writing.  In this written communication the school must provide information on meeting time and location, the purpose of the meeting, and who will be attending the meeting.  There will also be notification that the parent may be accompanied by any individual that may be able to assist the parent in the development of the IEP.  This meeting will determine services that are to be provided.  In some cases this may mean a change in class settings for your bipolar kid.  You have the right to see this new class first.  If at any point in this meeting you are feeling uncomfortable you have the right to table your meeting.  A parent also does not have to sign the IEP.  You are provided 10 days by IDEA 2004 in which to work out any disagreements or move for state mediation.  After that 10 days the school is under no obligation to provide the accommodations listed in the IEP.

It is important to remember that the IEP process is protected and ruled by laws.  The more familiar you are with these laws the better you will be able to advocate for your bipolar kids.  It is also important to remember that there will be progress reports, re-evaluations and bumps along the road.  It is important to enter each meeting with your emotions in check.  Yelling will not be a benefit to your or your child.

For more extensive information as to your rights and each step click here.

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Meditation is the ability to let go of the thoughts and stresses of everyday life and live in the now.   Children with bipolar disorder and other mental illness can greatly benefit from meditation.  While meditation can be difficult at first for a child with bipolar disorder, with practice they can master meditation.  All it takes is some practice and persistence.

Tips for meditation in children with bipolar disorder:  These tips are for bipolar kids and teens:

1. The child with bipolar disorder will need to find a quiet place.  This location should be somewhere that the child will not be disrupted.  This means that they should remove themselves from areas where there are other people, TV and other background noises.  It is often helpful if you discuss with your bipolar child where the perfect spot would be.
2. Sit in a comfortable seat.  This could include a chair, a cushion on the floor, the grass or even the floor. Be sure that the child’s back is aligned and that they maintain proper posture.
3. The child should then rest their hands on their lap or their hips.  The important thing is to be as comfortable as possible.  If they are uncomfortable there is no way that they will stay and gain the benefits of meditation.
4. Remain still.  This will be hard for any child, let alone a child with a mental illness such as bipolar disorder.  Have your bipolar child close their eyes or lower their gaze to their nose until it goes out of focus.  If they struggle just remind them to try again.  Do not allow your child to become frustrated.  Encourage them to try again and again.  Meditation is something that takes practice for adults and children as well.
5. The child should focus on their surroundings and breathing.  Tell them to feel the air on their face while deep breathing.  Have them listen to their breathe as it goes in and out.  Encourage your bipolar kid to notice how they feel.
6. Clear your mind of all thoughts.  This will be difficult but improves with practice.  Have your child put their thoughts in their place and let them go.  Some psychologists suggest giving your child a visual to go with this.  Tell them to place all of their thoughts into a suitcase or box.  This will take your bipolar kid a while to master.  Many adults have trouble with this step.  This is why it is safe to assume that your child will also have a difficult time with it.

It is important that you understand that there are many different ways to meditate.  The Mayo Clinic offers various tips on how to meditate.  The National Institute of Mental Health states that meditation can help quell anxiety.  There may also be meditation classes in your area offered for children with bipolar disorder.  No matter where your child is meditating it is an important skill for anyone with bipolar disorder to learn.  It affords them the ability to self calm when necessary.

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1. You will never know the pain I feel each time our bipolar child tries to hold it together but just cannot!
2. You will never know what it is like to walk into a room and know that people have been dreading your family’s arrival!
3. You will never know what it is like to hear your bipolar child cry because they cannot be the person they try so hard to be!
4. You will never know what it is like to go through manic and depressive episodes with your bipolar Kid!
5. You will never know what it is like to watch your bipolar child try to jump out of a moving car or a window and be a few second too late to stop them!
6. You will never know what it is like to lose people, both friends and family, because they cannot deal with your bipolar Kid!
7. You will never know what it is like to fear for your bipolar child’s life each and every day!
8. You will never know that the looks you give me hurt to the core of my soul!
9. You will never know that I am actually a wonderful mother who struggles right along with my bipolar child!
10. You will never know what it is like walking into school praying that your bipolar child has not found trouble that day!

By:  Rebecca Boardman

It is so simple to see a mother struggling with their child in the store.  It is harder to have compassion and understanding.  Not every child having a raging fit has bad parents!  Many of us work very hard to make our child’s life as close to normal as we can.  Rather then make comments about parenting skills, perhaps offering a helping hand would be a nicer and more understanding thing to do!   Rather than make a bipolar child feel as if they are a bad person, perhaps you could offer them a helping hand.  Rather than leaving a child with no friends, perhaps teaching your child about bipolar disorder is a better way to go?   Awareness is important not only for a bipolar child but for their entire family!

We love children in spite of their disability.  People do not understand that these children already feel so left out.  That they already feel as if no one loves or even likes them.  Please do not judge a bipolar kid or their parents.  It really is not about parenting but more about understanding.  Also, remember that no child is perfect.  They all make mistakes, have bad days and struggle with mixed emotions!  What you can do is be there for the bipolar children and their families.

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Lamictal is a medication used in the treatment of bipolar I.  Lamictal, also known by it’s generic name Lamotrigine, is a medication that has the ability to lengthen the amount of time between mood episodes.  This medication helps to alleviate your child’s bipolar disorder symptoms.  Lamictal is a medication that is approved by the FDA for long term use in the treatment of Bipolar I.  Lamictal and Lamotrigine are not anti-depresents but are know an mood stabilizers.  Lamictal may be a medication that your doctor may consider for your bipolar child.  It is important that you understand that there are side effects to all medications.  Lamictal and Lamotrigine are certainly not excluded from side effects.  Below you will find information about Lamictal, how to properly take is and things to watch out for:

• Lamictal Rash: This rash can be serious and require hospitalization.  If you child has bipolar disorder and is prescribed this medication it is important that you call your treating doctor immediately if a rash develops.
• May cause suicidal thoughts in some patients.   1 in 500 patients this side effect was present.  This means that it is important that you monitor your child’s bipolar depression level closely while on this medication.
• Always be sure that you have been given the correct medication.  There are many medications that have similar names.  If there is an error contact your pharmacist and doctor immediately.
• Do not abruptly stop taking Lamictal:  This can cause serious health concerns.  It is important that you discuss stopping this medication with your physician.
• If you miss a dose:  If you miss a dose it is important to take the missed dose as soon as you remember.  If you are close to your next Lamictal or Lamotrigine dose skip the missed does.  DO NOT TAKE A DOUBLE DOSE!
• Be Patient:  It can take several weeks for your child with bipolar disorder to feel the effects of the medication.  Lamictal and Lamotrigine are medications that build up in your system so it will take several weeks to notice and feel a difference.

Lamictal and Lamotrigine build up over several weeks or months.  It is important that your dose increase gradually.  It is important during this time that you track your bipolar mood.  This can be done through the use of a journal or a mood chart.  Find what works best for you and your child and remember to work with your physician in the treatment of bipolar disorder.

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The diagnosis of bipolar disorder in children is rapidly increasing.  For years many doctors felt that children could not have bipolar disorder.  As this school of thought is changing, more doctors are diagnosing and treating bipolar disorder in children.  There are many things that doctors look for while examining a child in regard to bipolar disorder.  When we brought our daughter to the psychiatrist we handed in a questionnaire that we had filled out at home, were asked to complete another one when we were there and our daughter also filled out a self assessment with the Doctor.  In the end it was clear that she was in fact bipolar.  While on my search for answers I read many article regarding signs that a child is bipolar.

Looking at the signs of adolescent bipolar was very helpful.  It enabled me to make the first call.  While I had believed that she was bipolar for a long time, reading the list prompted me to take action.  She hit all but one symptom which was an indicator that bipolar was bigger than I was.  If you are interested in learning the symptoms of bipolar please click here.  I know that for our family it was helpful to know that these symptoms were more than just an unruly child.  This was a medical disease and realizing that helped to create urgency for getting my daughter help.

Symptoms of Bipolar in Children

Bipolar Kids go through manic and depressive states as do bipolar adults.  Children tend cycle more rapidly than adults and can go through many cycles in a matter of minutes.

Symptoms of Bipolar Mania in Children include:

• Elation- an elevation of mood to the point that it is impairing and not appropriate.  Acting extremely silly in inappropriate situations.
• Grandiose Delusions: Believing that nothing bad can happen and that they are invincible.
• Rapid and Excessive Speech: speech that is constant and quick.  Child may not be able to keep all thoughts together in conversation.   They often feel a pressure to continue talking.
• Inability to Focus: Extreme distractibility by everything around them.
• Insomnia: A decreased need for sleep is present with no signs of daytime fatigue.
• Racing Thoughts and Fast Flow of Ideas: Cannot keep up with the thoughts in their heads. 
• Hyper-Involvement in Pleasurable Activities That Involve Extreme Risk: Daredevil acts and hypersexuality are included. 
• Poor Judgement: Unable to judge decisions in the moments although they know the difference between right and wrong.
• Irritability or Hostility When Demands Are Not Met: Upset when things do not go according to plan.  Inability to adapt to change. 
• Psychosis and Hallucinations: Occurs in extreme cases

Symptoms of bipolar depression include:

• Lack of joy and pleasure in life: Bipolar individuals are a glass is half empty population when in a bipolar depressive state.
• Pervasive sadness and/or crying spells: Some say this is sadness with no given reason.
• Sleeping too much or inability to sleep: Bipolar patients have trouble sleeping in manic states but in depressive states many bipolar patients cannot get out of bed.
• Drop in grades or inability to concentrate: This lack of ability to concentrate is why so many bipolar individuals have been mistakenly classified as ADHD.
• Thoughts of death and suicide: This is a huge concern and talk of killing oneself should not be taken lightly from an individual with bipolar disorder. 
• Irritability and severe agitation: At the drop of a hat they fly off the handle for no reason.  Everything seems to bother bipolar kids when they are in a depressive state.
• Feelings of worthlessness: Bipolar children feel as if their life has no purpose and that they do not matter to anyone. 
• Significant weight loss, weight gain or change in appetite: This can be cause by different medications used to treat bipolar but should not be considered any less important.
• Withdrawal from activities formerly enjoyed: I think of this as checking out of life.

If your child shows any of these symptoms it is important that you contact their doctor or a psychiatrist.  Although bipolar is difficult to control there are different forms of treatment that can be very effective.

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Bipolar Medications and Weight Gain:  Our Experience

Weight gain with the medications used to treat bipolar disorder, is very common.  It is one of the many reasons patients stop taking their medications.  My daughter was taking Abilify last summer and was doing very well.  For the first time ever her moods were as stable as a tweens mood can be.  She was doing so wonderful except for the fact that in one month she gained 8 pounds!

It is important to understand the genetically our children are predisposed to a life with obesity.  So far we have done well to keep the kids weight in check.  We have even worked on our own weight.  When my daughter gained 8 pounds in a month I was faced with a difficult decision.  Should I keep her on this medication because it is working or do I concern myself with the weight gain?  I chose to worry about the weight.

Having been an overweight teenager I know how children could be.  In one word they are MEAN! The words that they chose to call overweight individuals last a lifetime.   I remember a close family friend telling me that I was pleasantly plum.  He thought that it was a compliment.  I was always outwardly happy although I was dying inside.  I did not want this for my child!

So as her mother I chose to take her off of the medication that was working so well.  It was not an easy decision.  I figured that we could live with a poorer disposition rather than an unhealthy child.  With the child obesity rate in this nation I really felt that her physical health was more important than her mental health.  It is just such a sin that the medications that work the best for bipolar children are the ones that are most likely to make them overweight.

UPDATE:  We recently put Abby back on a very low dose of Abilify.  She has gotten her period and seems to have had no weight gain this time around at all.  Her mood is wonderful and she is doing just as wonderful with this medication this time around.  Puberty is a difficult time to try medications.  Once your son or daughter has fully matured physically you may want to try medications that they had trouble with.  Because their body has changed they may handle the medication differently.  As always this is a discussion that you need to have with your child’s psychiatrist.  I can only speak of our experiences and am in no way trying to provide advice.

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Weight Gain and Bipolar Medication:

Many of the medications administered to children with bipolar disorder cause extreme, rapid weight gain.   For many parents a choice has to be made as far as removing these children from the medication or sacrificing mental health for physical health.  These medications can increase hunger or decrease metabolic rates.  Both can lead to obese bipolar children.  Some common medications that cause weight gain in children are:

1. Mood Stabilizing Medications:

There are many mood stabilizing medications which include Eskalith, Depakote, and Lamictol.  Most of these medications are known for causing weight gain in children with the exception of Lamictol.  Asenapine is not known to cause weight gain but further studies are being conducted examining a correlation between asenapine and weight gain.

2.  Antidepressants:

These medications can cause weight gain in some individuals.  Recent studies show that the use of selective serotonin reuptake inhibitors (SSRIs) do not seem cause unwanted weight gain in bipolar children.  Medications such as Paxil and Remeron are more likely to cause weight gain along with MAOIs.  These medications are also known to further depress some individuals.  It is important that you monitor your child’s mood in order to assure that they are not falling deeper into depression.

3. Antipsychotics:

These medications are often prescribed to treat bipolar.  Medications in this family include Geodon, Zyprexa, Seroquel, and Risperdal.  These medications are not noted for signifigant weight gain in adults unless combined with a mood stabilizing medication.   Antipsychotic medications do cause rapid weight gain in some children.  Children taking these medications should be monitored.

For our daughter the medication that caused a large weight gain was Abilify.  Although this medication was very effective use had to be discontinued due to rapid weight gain.   It is said that all people react differently to these medication.   It is important to remember that children react differently to many of these medications than bipolar adults.  I have found that medicating my daughter has been a trial and error situation.  Please speak to your child’s doctor in regards to weight gain and the medications being prescribed.

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I think that bipolar is the most misunderstood disorder out there.  While shows like ER have tried to raise awareness of bipolar, they fall short in showing that people can live healthy lives with bipolar.  They fail to show that there are families who are able to deal with bipolar and all it is.  They focus on the negative aspects and forget all of those positives bipolar individuals have.  They forget to portray that bipolar individuals are extremely creative.  They forget to mention the passion that bipolar individuals feel for everything they do.  They forget that they are people.

As a parent with a bipolar child I think about my daughter’s future and frequently feel that it looks grim.  I try constantly to protect her from so many things to the point of exhaustion.  I try to help her not feel the hurt of not fitting in.  I try to help her to understand why people may not want to be her friend.  I try to get her to see that she is a wonderful person inside.  As for her future, I am terrified!

There are so many things that go through my mind.  How will she be able to go to college without falling prey to drugs?  How will she find someone who will be able to deal with her moods?  How will she have children when she cannot control her rage?  Will she have any friends?

All of these questions and there really is no answer to any of them.  It is a  mallow her to opportunities to mess up I am scared.  I want her to be so much.  She has so much talent and such a passion for everything.

I frequently find myself telling people that she will be a successful adult; it is our job to get her there.  There are days that I believe that and there are days I am concerned about my ability to get her to the point of success.  As for her future I am unsure of what it will be.  She has passion for so many things but the only career aspiration she has is to be a rock star.  How do I bring her to a more realistic goal without crushing her dreams?

As for her future… it is unwritten!  No one knows what it will be.  I just hope, as a parent, that I can prepare her for anything she wants to achieve.

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Each day I struggle with being the parent of a bipolar child.   It is often like walking on eggshells and trying not to break any.  You never know what will set them off and you never know how far to go.  It is like living in a war zone and you never know when you will be attacked.  While there are a lot of days like this there are a lot of days where my daughter is everything I have ever dreamed for my child to be.  She is kind, compassionate, full of life, has a desire to learn, is inquisitive, remains active, and loves all of the way!  I often wonder how she can possibly be both!  How can she be so nasty and hurtful and yet so sweet and thoughtful?  Welcome to the world of a bipolar child.

As the years progress I find myself worrying more about her and less about myself.  For a long time it was all about how I was going to make it through the day with this child.  It was about how I would face the school.  It was about how I could not deal with sending her on play dates.  It was about how I would survive this.  Now my sights are different.  I sit and I wonder how she is living though all of this.  How can it feel for her to lose it all of the time.  How is she able to deal with the fact that no other children want to play with her.  How does she smile each day with the burden that has been placed on HER!

The fact is that bipolar children have a terrible time.  As parents we often think more about ourselves and how this disability is impacting our family rather than how it is impacting our children.  I cannot imagine living the life that my daughter lives.  I worry about her, cry for her and strive to make her the best person she can be.  It is important that all of these kids have a bipolar kid connection where they can share their triumphs and failures.  A place where they know they will be understood and a place where they are accepted.  It is a difficult task but that is what we are hoping to create here in this small niche of the world.

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