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The Bipolar Child, Part 1

by Daniel on June 18th, 2012

During our telephone interview, Kelly Farrell Wells, a mother in upstate New York, stopped the conversation briefly to speak to her daughter, Mary-Pat, 5, who wanted to go out. Wells said to her, “Mommy’s on a business call now. Just go in the other room, put your tights on and we’ll go out in a few minutes.”
Mary Pat said OK, then left the room to do what she was told. In most households, that would be a typical scenario. In the Wells’ home, it still feels like a miracle. “That response wasn’t even an option a year ago,” said Wells. “She would’ve been screaming for two hours.”

But now that she has been diagnosed as bipolar and put on mood-stabilizing medications for several months, “she’s stable,” said Wells. Although there can still be difficult moments, “the rages have stopped.” Most of all, “we have a little girl now who skips and plays and sits on my lap. She has joy.”

Before, everything was a fight, whether it was getting dressed, going to a store or passing the ketchup. When Mary-Pat met with anything she didn’t want or expect, she’d be angry without control, even violent. “We knew it was an illness,” said Wells, but “to help her get well, we needed the proper diagnosis.”

In many families, that diagnosis is long in coming, if at all. “For years, it was believed that the onset of bipolar disorder in childhood was extremely rare and the diagnosis was not commonly made,” said Dr. Demitri Papolos, associate professor of psychiatry at Albert Einstein College of Medicine in New York City and co-director of the Program in Behavioral Genetics. In fact, he said, “very little was known about it.”

Not any more. Papolos, who is also in private practice in Manhattan, is the co-author of a new book with his wife, Janice, called “The Bipolar Child: The Definitive and Reassuring Guide to Childhood’s Most Misunderstood Disorder,” (Broadway Books, 1999, $25). He explores the diagnosis, treatment, genetic issues and brain chemistry of the disorder, and discusses coping mechanisms for families.

Wells, who communicates with other parents of bipolar children via the Internet said, “Many of us literally walk around with that book in our hands. It’s been an eye-opener.”

Now that the issue is increasingly being brought to the public’s attention through books, television and the World Wide Web, Janice Papolos said they have received “literally thousands of e-mails” through their Web site at www.bipolarchild.com, which has a questionnaire, education plan and monthly newsletter.

The newly founded Child and Adolescent Bipolar Foundation in Willmette, Ill., also recently launched its Web site, www.bpkids.com. Since January, they’ve had about 2,000,000 page views and now have 13 online support groups with about 100 people participating in each, according to the foundation’s executive director Martha Hellandar. Their message boards, she said, are filled with words from people “who pour their hearts out with poignant stories.”

As its name indicates, bipolarity is about opposites. It is characterized by wide swings in mood, energy and thought. A child can be feeling way up at one time and way down at another. Or he may be veering between the two. Janice Papolos said the process is called cycling, and can send a person directly from an energy surge of superactivity to the lethargic state of immobility, guilt and dark thoughts.

It was a battle with mood swings in her own daughter that caused Mitzi Waltz of Portland, Ore., to write “Bipolar Disorders: A Guide to Helping Children & Adolescents,” (O’Reilly, 1999, $24.95). “I am hoping to put the information out there that I needed at the time,” she said. “There are so many other parents who need this type of book so they can understand.”

The problem lies not just in the difficult symptoms associated with the disorder, but with the fact that it is misdiagnosed as any one of a number of other psychiatric conditions that appear in childhood and adolescence, including attention deficit disorder with hyperactivity (AHDH), oppositional defiant disorder (ODD), obsessive-compulsive disorder (ODD), generalized anxiety disorder (GAD), and depression.

Waltz said adolescents with bipolar disorder also may be substance abusers, which further clouds the diagnostic picture and increases the mood swings. What may happen is that the drug or alcohol abuse is addressed, but the underlying disorder is not.

About one-third of the children diagnosed with ADHD or depression eventually are diagnosed with or manifest the bipolar form of a mood disorder, said Janice Papolos. She said that, according to some research, the number is actually closer to 50 percent for children with depression.

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