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When Bipolar-ADHD Appeared; A Parents Story

I loved to dance and was finally able to start taking lessons in high school.  I had passion and love of the art.  For most of my life from that time until my mid thirties, I continued to take and teach dance classes.  My forte became lyrical dance, which is a beautiful form of jazz with modern and ballet influences; the music and movement was addicting.  I thought I would continue to dance for the rest of my life!

I had married young, at the age of twenty.  Completely in love, we entered into a new chapter and adventure in our lives.  We were married nine years before our son was born; it was a planned time frame.  We wanted time for just the two of us, and I was still pursuing my dance career.

Our bundle of joy arrived a bit early; almost three weeks.  Little did we know that was a sign of whirlwinds to come with our son.  I loved being a mom, and even though it was difficult to leave my darling, three weeks later I was back to teaching.  We were lucky that my husband worked a different shift than my teaching hours; we only were in need of a sitter for 12 hours a week.

Being a first time mom, sometimes a parent does not know what to expect.  Our precious child started to grow, crawl and hit the normal milestones.  However, no matter how hard we tried to keep him on a schedule, he stopped taking naps at six months old.  Before he could walk the little guy learned how to get out of his crib and dumped himself over the edge.  For safety reasons we chose to have a family bed, so we would know where our little one was.  Sleeping next to us, he would wake us up rather than leave the bedroom, if he awakened before us.

Concerns about what appeared to be hyperactivity were brought up at each pediatrician appointment.  We were told he's young, get him on a schedule, etc., etc., etc.  No matter how hard we tried, getting our boy to adapt to a schedule was impossible.  This little one had an internal schedule of his own!  For three and a half years I brought up concerns of my son's hyperactivity with his pediatrician, and at one point was told, "He's a boy."  I was absolutely exhausted, beyond exhausted trying to work and run after my son.  I had taught many years of children dance lessons and had never seen a child this active.

We are sitting waiting to go in to see the pediatrician for a 4 year old check up.  My son is on the go in the waiting room, as always.  I am thinking to myself that I just didn't understand how it was to raise a boy; this must be normal.  What did I know as an only child and teaching dance to primarily girls.  We proceed to the exam room where my son is climbing the walls.  The doctor comes in, gives the four year old check up, and suggests that we see a psychologist because of his hyperactivity.  What?  Had I not for YEARS asked about this?  The doctor explains that until the age of four, a decision is not made since different children mature at  different rates.  She then explained that the nerve endings in the brain take longer in some children to coat than others.  I may have the last statement wrong, it's now been twenty years since that day.  I was relieved and upset all at the same time.  A well of four years of emotion shot through me.

The pediatrician recommended a psychologist named Dr. Robert A. Simon.  Dr. Simon was wonderful!  He worked with my son and helped me to understand how to raise an active child, teaching me the steps of behavior modification technique.  One year and eight months later at 5 years 7 months old, he was diagnosed as Bipolar with ADHD.  This was extremely controversial.  Twenty years ago it had only recently been realized that older adolescents could be diagnosed as bipolar; children my son’s age were not diagnosed as bipolar.  We were referred to a psychiatrist for medication and continued to see Dr. Simon.  By this time I left teaching dance full time to teaching only one day a week.  I was having stress symptoms between running a dance studio and trying to keep up with my son.  When my son was in fourth grade I found work at the local school district which allowed me to have work hours that matched his school hours more closely.

After briefly seeing my son, the first medication Doctor insisted that Patrick was only ADHD, saying, if it looks like a duck and quacks like a duck, it’s a duck.  The doctor totally disregarded the diagnoses from the well known child psychologist who had spent a year and a half seeing my son, and Ritalin was prescribed.  By the second dose of Ritalin, my son was having involuntary limb movement and talking faster than you can imagine, and he talked fast already.  The Ritalin caused him to become manic.  It turns out that Ritalin does not always work well on children who are bipolar.  Hello, let me hit my head on a wall, work with me people, and Mr. Med doctor, my son is not a duck!  Turns out he can be ADHD and bipolar at this young age!  Lithium was prescribed, which worked more or less OK.  Because of a side effect that caused a tremor (hands would shake), he could never get enough medication in his system to level his mood completely, but it was far better than before.  Routine, medication, and seeing a psychologist were all vital in our lives.  It wasn’t easy, but manageable.

On the flip side of this story is a boy who is so much fun to be around the rest of the time.  During the summer we had fun where laughter exudes from him.  Waking up and cuddling together, water play, watching how tender he is with our animals; there were many, many precious moments.  If we lived in a world that we didn’t need to go to work, or stay on a schedule of a school day, life would have been easier for my son, but, that’s not life in the real world.  At the beginning of the school year many parents are happy that their kids are going back to school, my feelings were completely opposite.  I loved summer, Patrick loved summer; we all loved summer!  Summer was free with less restriction, even though we kept the days consistent.  With that said, I knew my son.  We often stayed away from places that were not conducive to keeping a peaceful child, which also helped to keep a calmer mom.

School!  My son entered school taking Lithium for bipolar disorder and Clonidine for ADHD.  Later on Clonidine changed to Guanfacine.  He was in main stream education with resource support.  Being bipolar is difficult, add ADHD on top of it and school is a monster.  The hyperactivity in the brain makes school frustrating and difficult.  It was vital for my son to have teachers willing to work with him.  Thank goodness for the dedicated teachers he had which were handpicked.  Teacher’s who were rigid within their classrooms, or who would not make allowances for a child who learned differently, was not a good placement for him and would have set up failure.  We were very fortunate through elementary and middle school. 

High school is altogether a different story.  We moved and were in the San Diego Unified School District.  If I knew what I know now, we would have gone to great lengths to stay in the Grossmont Union School District.  High school, a district that has a mass of people to work with, adolescent hormones and medication that is not working is a terrible combination.  My son’s attention span and moods were speeding through as if he lived on a roller coaster, which frustrated and infuriated him.  At one point during a period of time, a very low mood he was experiencing was of great concern and worried us the most.  The Lithium with the tremor side effect caused him to never have enough of the medication in his system.  A change in medication to Depakote was started and worked even worse on him.   At one point we became greatly concerned for our son’s safety.  High school was hell and even though we could not afford it, by his senior year I stopped working.  Neither my son nor I were handling stress well during this period.  It was frustrating, difficult, sad, and heart wrenching all at the same time.

It seems like a miracle!  It is the medication Seroquel that is my son’s miracle medication for bipolar disorder.  At the time it was a medication that was only given to adults, so he began taking Seroquel when he was 18, and life has been on an upswing since.  He has slowly matured into a fine young adult man and now in his early twenties, continues to go to college.  He is learning to manage his stress better, and most importantly takes his medication every day.  There still can be struggles or moods can still roll, but they are far more manageable.  Part of the reason moods are manageable is that this medication works well and the other is that as he gets older, he is able to handle his moods and use organizational tools for the part of him that is ADHD.  His brain will always work at a fast pace and his moods will always vary.  He also has the emotional support of his family; we have tried to provide a life conducive to helping him, not in spite of him.  I have seen less than responsive families who have resented the time taken to care for a child that needs special attention, and chooses not to.  I have seen families who put forth every effort and their child grows up to confront insurmountable difficulties.  I feel extremely fortunate to be a family with a good outcome. 
It continues to amaze me the unsolicited advice people in general and family members freely give out.  It seems to escape some people that we have had hours upon hours of guidance from our family psychologist, guidance from the school psychologist, and information from numerous books I have read.  It can get frustrating to hear, “If you would give him chores he would do better.”  “If you disciplined him better, he wouldn’t act that way.”  The last one often means, “If you would spank him...”  It took some time, however, I learned to become very firm saying, “We see professionals to help guide us, and I’m sure you do not have as much experience or knowledge as the doctors we see.”  This may sound harsh, but it usually stops the comments.  It is something that will often need to be repeated.  Trying to explain anything beyond a firm statement is usually ineffective.  Most importantly, do not let an unknowledgeable person make you feel bad, because of their ignorance about your child’s, or your families situation. 

There is more to the story than I have written.  To very briefly explain, my son’s father is also bipolar and was not diagnosed until after our divorce.  We were married for 20 years, 18 of them together.  He fought hard to keep sobriety and did for some time.  Unfortunately, at the time my son’s father did not see that his difficulties went further than a drinking problem and would not seek help beyond AA.  He fell off the wagon when he moved from our home during our divorce.  After an extremely rough time, he was diagnosed bipolar, became sober, started medication, and has been living clean and sober for the last ten years.  I reconnected with an acquaintance eleven years ago who is now my husband, a true partner and wonderful parent.

Studies show that bipolar disorder runs in families.  Most people with bipolar disorder can find at least one relative who is also bipolar.  There are families with a higher risk of the disorder, but the risk is not absolute.  You may be predisposed to bipolar disorder, but it often does not come to the forefront of someone’s life until they are under stress or illness.  In my son’s case, it showed up on its own at a very early age.