It is interesting that Griffin’s Mom wrote in her blog a few days about bipolar because I have been doing internet research on Bipolar because it has been suggested by the psychiatrist that the out of control behavior Billy Ray is experiencing maybe a worsening of his bipolar. I have been told there is a link between bipolar and autism and I am hearing of more children who have both diagnoses. Thus have been trying to understand where one comes in and the other one comes in.
I don’t talk as much about Billy Ray’s experience with bipolar. Maybe that is because it has been controlled with medication a lot of the time since his diagnosis. There are things that occur in Bipolar that could also be symptoms of Autism or ADHD.
When he was seven, he had already been diagnosed with ADHD and was using stimulants for that. We had experienced a family trauma. My late husband had been in the hospital for two months with lung problems. A few weeks after his return home he drove the little Mazada pickup that was special between father and son to observe the highway construction project he had been working on before his hospitalization. An 18 wheeler pushed a car across the median into Raymond and he was back in the hospital. The combination of Dad being back in the hospital and their little truck being totaled set in motion Billy Ray’s first manic episode. The psychiatrist explained that bipolar can be brought out younger than it normally would if there is some sort of trauma.
It was clearly different than what he had exhibited with ADHD. He was literally a wild man and incredibly strong. The developmental pediatrician sent us to a pediatric psychiatrist. It didn’t take long for the psychiatrist to make the diagnosis of bipolar. Once we had established that he was able to control it with meds for a number of years. Billy Ray had not been diagnosed with Autism at that point though I now understand that he had symptoms of mild autism I didn’t recognize then.
I wanted to find links for you which would explain how bipolar manifests in an Autistic child. That was difficult to find. I did find a MSN group site Bipolar and Autism. The beginning of it is fairly detailed and a bit hard to read, however, when you get to “Mania” it has specifics about mania in an Autistic child might. It is not clear who this group is so I am not going to quote it as authority. Here’s the link, you can decide for yourself. http://groups.msn.com/TheAutismHomePage/bipolardisorder.msnw.
Here is how Billy Ray experiences hyperactivity and mania (which can be combined but aren’t necessarily):
Hyperactivity: A basic inability to sit still or remain focused on anything. It includes bouncing up and down in place or running and throwing behaviors. Note that some of these behaviors are also a part of mania as we experience it. The main difference is the degree of excitement involved. Hyperactivity can quickly escalate into mania for Billy Ray.
Mania: Similar to the mania in adults with bipolar disorder (sense of being invincible, no impulse control, sleep issues, irritability, etc.), but it also includes the following:
- Hitting, kicking, pushing.
- General silliness that is out of control.
- Running from us, both outside or taking off across the room to grab something.
- Throwing things down the stairwell or just aimlessly across the room. This can be anything he sees sitting on the kitchen counter, clothes from his hamper, his shoes, garbage, etc., particularly something that is out of its normal place. We had to take his wastebasket out of his room because it seemed he couldn’t stand even small amounts of trash in it. Now he is beginning to do the same with kitchen garbage.
That old question of where is this coming from is a constant source of wondering for me. I pray a lot and review his journals repeatedly to try to figure how to handle each new challenge. In Billy Ray’s case, I have basically come to understand that Autism responds to the programs and schedules that I have learned works for him. For the most part when he is not responding to things that have worked in the past, we have tried to adapt and communicate with him and he is still manic it is most likely coming from bipolar and we need to call the psychiatrist. Usually the only thing that has worked for bipolar in Billy Ray is medication no matter how much I would prefer to avoid it.
Billy Ray recently started on a new medication. He is not perfect but he sure is better (sigh).
I would love to hear from others of you who have children with the dual diagnosis of Bipolar and Autism especially if they also have Down Syndrome.
Until Monday,
Peggy Lou Morgan
http://www.parentingyourcomplexchild.com/
http://www.ligthhouseparents.com/
Posts
12 comments:
Great post, very interesting indeed. I wonder if Griffin is BP or if he will become so. I often wonder when he is in a hyper state of mind if he is BP, when he tantrums and can't seem to get himself under control I wonder. But then I wonder if it could be ADHD either way I don't know how to tell at such a young age. The poor little guy doesn't have much of a chance since I have both and mental illness runs rampant on my side of the family. Unfortunatly I don't know that much about Griffin's father's side except that he is probably BP. The rest I will tell you by e-mail.
I happened on this site as I was searching for information about autism and mania. My son is high-functionig and very bright. Fortunately, we can explain things to him in a mater-of-fact way and he understands that sometimes he can get super=hyper and lots of peop[e and excitement make things worse. He has figured out that he needs to go outside to run until he is tired. He is one cool kid. He does get distressed when he can't sleep at night. We started on Remeron and it helps the sleep cycle. Ben can tell the difference. I am so glad. Hopefully, his care team and I will be abble to come up with a way to help Benjain manage himself. THanks for being here. JAent
I am glad that you are here. I was looking for something on autism and mania. The postings and article re AD/HD and mania have been helpful. I read some things that I will ask our medical team about. I am relieved to see that the cycling is fairly common. At least more than I thought. Fortunately, my little star is smart enough to learn some self-management skills. He is only 8.5 so it' still early enough to get some helps ingrained.
THanks for being here.
I have no formal diagnosis as of yet, but I've been going round and round whether my son has Asperger's or bi-polar, and of course he is extremely energetic. He is now 7, almost 8. I knew he was different since he was an infant. I have been to various therapists since he was 3 and have been unsatisfied with the results. He can be quite enagaging in a short session. Only today I thought I'd try to google the two disorders and am relieved to find that there is a co-existence. I visit the child neurologist next week. I'm also unsure whether a child psychiatrist would be better.
My nephew who is 11 yrs old, was diagnosed with adhd @ 5 yrs old and recently diagnosed with bipolar. He has been on every kind of medication possible. The recently put him on depacoat along with his adderall. This I think has only made thing worse. His Dr is now talking about sending to see a neuroligist.
If there are other going through these same issues, I would love to hear what the treatment plan is .
thanks
My 6 year old son has Asperger's/bi-polar disorder. I have learner in a support group that stimulants used for ADHD can increase mania in these children, so the recomendations have been for a combination of mood stabilizer and anti-psychotic such as Abilify. So far we have gone with the mood stabilizer, which seems to help, but we are wary of introducing anything else into his young body. We just work, work, work with him and teachers and therapists.
I have a 10 yr old son with bipolar and aspergers. It is extremely hard to find any one out there with kids that have both. I have been feeling lost and confused. If anyone would love someone to talk to about this they can email me at chefaid902yahoo.com. I would love to talk with other people about this.
Lisa
I find it interesting that someone can actually be diagnosed as bipolar AND autistic. The reason for my surprise is the nature of each disorder practically prevents the other. People with bipolar disorder are highly emotional, and people with autism cannot interpret emotional signals from internal or external sources. There is a certain skepticism that I think needs to be taken when diagnosing children with psychiatric or behavioural disorders, because the symptoms for these disorders in children can be very different from those in adults. I have briefly read some of the studies regarding bipolar and autism, and they seem to find a familial relationship, but nothing concrete that one person can have both disorders.
If your child is on medication I would seriously look into getting a second independent diagnosis. I may not be an expert, however I am studying to be a psychologist, so considering the limited peer reviewed studies in this area, it would be wise to make absolutely certain of this diagnosis as medications on the developing brain (particularly if they are not needed) can have adverse effects on cognition later in life. Also the side effects in children are often unknown, because most drugs used to treat bipolar have not been tested for use in children.
TanyaD:
It is a common mis-belief that autistic individuals are incapable of displaying or feeling emotions. I think this may be true on the severe end of the spectrum. What you are stating, that the two cannot co-exist for that reason is not factual. My 6 yr old son has mild-moderate autism and I've seen him display, fear, happiness, anger, silliness/humor, shyness etc. Yet he is still Autistic. To say that autistic individuals cannot interpret emotions either internally or externally is not accurate because I've seen it in my own autistic child. I am considering possible bi-polar disorder in him because he has periods of extreme irritabilty (lasting a week or so) and then calm/normal, and then right back to the irritabilty, aggression with no know trigger. The cycling of emotional display is characteristic of bi-polar disorder. In an autistic child it may look a little different but it is the same nonetheless.
Anonymous, what you are saying is correct, obviously all humans experience emotion to some degree, it is what makes us human. I also understand that as you have a child with Autism you would know better than most from experience. However, I not only have studied autism and autistic spectrum disorders for the past year, but I also have a father and nephew with autism. It is not that they do not experience or express emotion (that is not actually what I said in my previous post), it is what appears to be in most cases a miscommunication between "interpretation" of emotions and expression of emotions in the biology of the brain. Their emotions do not always match the situation, or the emotions of others are misinterpreted or not interpreted at all, thus resulting in frustration, often anger, sometimes sadness etc on the part of the autistic person. These are quite obviously emotions.
I am not saying it could never happen, simply that it is surprising if it does co-exist because of the nature of each disorder and studies of co-morbidity are not conclusive. Bipolar also does not have clear diagnostic criteria in children and misdiagnoses often occur in children because even "normal" children can have ups and downs and erratic behavior. Your child's behavior may be a learned response to his frustration with his disorder and the environment that can be treated with Cognitive Behavioral Therapy, Interpersonal therapy or other less invasive therapies than the pharmaceuticals often required for bipolar disorder. A diagnosis of bipolar disorder in a child, particularly one with autism, should not be taken lightly and perhaps should be left for diagnosis until the child's formative years are over...this could just be his personality and the way he deals with things, not a disorder.
13 yr old daughter with high functioning Down Syndrome also now is diagnosed with Bipolar. Anyone have this experience? All meds this last year have made her hallucinate more or manic. Any info would be appreciated.
Thanks
Karen
I would love to connect with others who have kids that are aspergers with fits of rage. My 6 year old nephew has not officially been diagnosed as Bipolar, but is on Risperdal (SP?) and Imipromine (Sp?) and has been in intense therapy since age 2. He started the Risperdal at age 3 (very young). He has episodes where he loses control of his rage and gets this vacant look in his eyes like a wild animal. He threatens to hurt himself and my sister. It's only a matter of time before he does. She is beginning to be scared of him, as he has head butted her several times and recently said he wants to kill her. It's heartbreaking. He has been to numerous child psychiatrists. If anyone else has similar stories, please e-mail me. She is at her breaking point and I am trying to find some hel for her. Thanks erinb007 at yahoo.com (so the spam doesn't find me)
Post a Comment