Expert: Joyce A. Anthony - 3/3/2010

Question
My daughter is 12yrs old, she has been diagnosed with ADHD, then 1 yr later BiPolar.  She is currently taking Adderal and Abilify, (when I can get her to take them).  Her psyciatrist is trying her without the adderal because I had concerns that it may be making her violent and hostile.  I am at the end of my rope.  I am a single mother with 3 children and her father has not had any contact with her in appx. 2yrs.  I am afraid she will hurt my other children (emotionally or physicaly)during one of her "episodes" if she continues to be in our home.  She is very difiant, disobedient, rude, abusive etc.  Her sisters, classmates and family dont want to be around her.  Her counselor has chosen to discontinue seeing her after a year because she cannot break through or communicate with her, nor can I.  I am currently looking for someone new, but feel counseling has not helped at all.  I love her more than anything, I dont want to bring her into the emergency room for Eval for a State hospital, and she doesnt meet the (drug/alcohol) criteria for a treatment center, is there any facilites in Washington or near (Spokane prefferably) that can treat and monitor her as an impatient.  I am willing to do and get a loan to pay for anything that can help my family and her to get the help we need.  Thank you for your time.  
Please help,
Annette

Answer
Hello, Annette:

You are most likely correct about the Adderal.  Children who are bipolar often get worse when taking medication for ADHD.  The Abilify alone could also cause mania.  With a diagnosis of bipolar and ADHD, the ideal treatment is to get the bipolar disorder stabilized first, and then treat the ADHD if necessary.  Often, the bipolar treatment helps the ADHD.  Your daughter needs a mood stabilizer.  Wonders have been worked with a combination of Seroquel and Lamictal.  This seems to stabilize even the most difficult cases.  I would first suggest you talk with a doctor about a med change.

Now, for treatment centers, here is one that has a good reputation

Tamarack Center

2901 West Fort George Wright Drive

Spokane, Washington 99224

Toll Free 1-800-736-3410

Local 509-326-8100

You could give them a call and see what they have to say.  I know how difficult it is when you know your child is hurting and can't seem to get through to her.  With other kids to take into account, that makes it even more difficult.
                  Joyce A. Anthony