Expert: Ivan Goldberg, M.D. - 9/14/2004

Question
We have a 7 year old son who has been diagnosed with Bipolar Disorder.  I have home schooled him since the beginning; he is in 3rd grade now (with an extremely high IQ, and is a straight A student when he is in the right frame of mind to do his work).  However, many times just the mention of the word "school" will send him into a rage because he gets "stuck" and is in a "cognitive wheel chair" as far as being able to do his work.  I can offer him anything to get a paper done, but he just can't do it (eventually much later after the long, violent episode is over and evening comes around, he usually sits down and does a great, quick job of getting his school work done).  To try to make this unbelievably complex issue short and to the point, I have 3 questions:
1) His rages are very violent, and up until this past weekend, we had a "safe room" to put him in as soon as he started.  But since he kicked 18 holes in the walls with his bare feet, we no longer have a place or plan to contain him during the rages.  Can you recommend what we might do to restrain him during these fits?  (He is on Depakote and just started Risperdol as needed on the bad days.)
2) Is there any way of knowing how much of the violence he can control?  It's hard to know if we are doing the right thing discipline wise, since we don't know which parts he can and can't help.
3) Do you know of any recommendations on schooling Bipolar children?  I continue to home school because I don't want him thrown into the special ed label and shifted from school to school and feel even worse about himself.
Any advice you could give would be much appreciated.  We have been diligently researching, but we feel very alone in this.  We have a stable, loving, calm family (except for our son) and no family history of mental illness.  It is so foreign for us to deal with this and to support him properly when we don't understand what happens in his head.
THANK YOU!

Answer
Hi Robin,  I wish I could help you with the problem you are having with your son but I am not a child-adolescent psychiatrist and have no experience with children of his age.

Your question makes me wonder of you are working with a psychotherapist and a child psychiatrist. Id such people are involved in your son's care, they should be able yo help you with questions such as the ones you asked me.

Best regards . . .

Ivan
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