Expert: Joyce A. Anthony - 2/7/2008

Question
I am a young mother, 22 years old and, well, believe I may be bipolar and will be going to get evaluated next week for the first time. My question is not about me but that of my 23 month old daughter. She has intense/ very aggressive temper tantrums at least 6 times a day. She'll get so angry, she will throw anything in sight and if someone is holding her at the time of her tantrum, that person is gauranteed to either be bitten or end up with a scatched face, most often resulting in bleeding. There is no way to calm her down unless we bribe her with cookies or a toy of some sort, and even then she'll still remain angry. She is a very intelligent toddler with a huge vocabulary and picks up everything, even bad language, unfortunatly. When she gets angry she will curse. She will say the D word, the F word.. the S word.. and she knows the context of when to say it. It wont stop. Another thing that I know can not be normal, is she pulls her eyebrows/eyelashes/ and picks her lip enough to make it bleed. I also have these OCD tendencies and dont know if she is just imitating what she may see me do from time to time or if it is inherited. My question to you is, Is she too young to be diagnosed with being bi-polar. Too young for treatment? What do you recommend I do. She also will have these anger overly aggressive temper tantrums in her sleep. Where she'll be completely asleep yet screaming in anger for her crayons or whatever it may be shes dreaming about at the time. She'll scream, "Gimme my crayon.." Followed by curse words sometimes. And we cant get her to wake up and realize its just a dream. We obviously cant discipline her since shes sleeping. This occurs almost every night, sometimes even during naps throughout the day. She'll just be very angry in her sleep and start screaming/crying.. for a period of 15 minutes, then goes back to sleep. She has had this problem forever. Benadril does not help her sleep at all. she still has these temper tantrums in her sleep. What can we do to fix this? We havent got one good night of sleep in, well.. I cant remember. It scares me that she's able to get this angry, and shes so young.

Answer
Hi Lacy:

I can understand your frustration at this situation.  When dealing with children your daughter's age, a diagnosis is not possible.  She is just entering the "Terrible Twos" and that is often full of tantrums.  It sounds like your daughter is beyond simple tantrums, and could very well be bipolar.

I would suggest that you first go through with your appointment and see if you are indeed bipolar.  If you are diagnosed as such, you will be able to ask about Early Intervention programs available in your area.

What these programs do is see a child who is considered "high risk" and monitor behavior.  This way, there is background evidence to present to a doctor in the future, when your daughter is old enough to be evaluated and diagnosed.

In the meantime, try keeping your daughter's bedtime and rising fairly consistent.  Develop a routine the last hour before bed that is calming-such as bath time, reading, singing. Try gently rubbing her ack as she drifts off. The calmer she is as she goes to sleep, the less likely she will be to have the nightmares.  Giving her Benadryl is not a recommended way to help her sleep; save that for when she is ill.

Your daughter's age makes it difficult to diagnose or treat her.  Being with her, you are the best judge of the severity of her meltdowns.  Remember, although it is very difficult at times, that if she is bipolar, this is not something she does on purpose.  You are her best advocate--contact a mental health agency in your area and ask about early intervention programs.
                           Joyce A. Anthony