Expert: Joyce A. Anthony - 6/5/2009

Question
Dear Joyce,

I am hoping you might be able to help me I have an 8 yr old son who was just diagnosed as bipolar last week. I had always been told he had ADHD by 4 different Doctors since he was 4 yrs old. My son has had many outbursts in school had been on adderal XR but still having many problems even on the medication. He has begun being very violent and threating towards myself and teachers to the point he has stated he wanted to kill us with a knife or a gun he was suspended from school for his behavior. He seems to be getting worse day by day and is going down hill fast. He was finally taken to a differant PHY Dr. Who has now Diagnosed him with a form of bipolar that mimics adah I was told he is now being tried on a new medication for bipolar and is no longer taking the adderal. In the mist of this We have recently had a very tragic occurrence that has disrupted all of our lives I would rather not go into to it on a public board like this but would be more than happy to speak with you about it privately. Pls contact me to let me know what your thoughts are on this thanks in advance so much.

Answer
Hello Janet:

I am glad you finally found a doctor that recognizes the possibility of bipolar disorder in your son.  Often bipolar and ADHD mimic each other. To make matters worse, the two often occur together.  What is necessary is to get the bipolar under control first. Medication used to treat ADHD makes bipolar symptoms worse.

You did not mention how long your son has been on the medication for bipolar, or what it is. If this change has been within the past two months, you should see improvement in his behavior soon. If it has been longer, you need to discuss a change with the doctor.

Stressful situations can cause bipolar symptoms to increase.  Situations that effect the entire family will do so even more.  It may help if you get some kind of talk therapy for your son, if you haven't already. Also, talk to the school about the home events as that will help them understand the increased mis-behavior more.

Try to keep your son's daily schedule as consistent as possible.  In times of extreme stress, children in general need to know there is something that won't change in their lives. Bipolar children need this consistency even more.

It sounds like your son's new doctor may be a good change.  Let him/her know of all that happens (keep a running journal) and give the new medication a chance to help.

                             Joyce A. Anthony