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My 4 Year Old Daughter Might Be Bipolar

Our 4 year old daughter has been exhibiting a lot of behavior and is being evaluated to see if she is bipolar. Do any of you have bipolar children? How do you handle their discipline? It is heartbreaking and so difficult to know how to best handle the rages and the meltdowns. Let me explain that I have a degree in psychology and have worked in the mental health field for years. It is really difficult when it is your own kid. Yes, she is very young to be diagnosed but more and more children are being diagnosed this young. We are very very skeptical about putting her medication and intend to do diet change etc before medication. We also intend to get her evaluated at STL children's hospital and not down here.

What can I do next?

So What Happened?™

Well, we found a fantastic pediatric psychiatrist. He has treated many children as young as two years old. Anyway, he was fantastic. We had a whole list of questions and he listened and answered them all. He was right on target with her symptoms and did not treat us like we were morons. He gave us the option of starting medication and complimented us for all we have already tried. Anyway, he started her on very low doses of Concerta, for ADHD, which he said she definately has. He also started her on an iddy biddy dose of Risperdol, which is to treat the bipolar symptoms. He is not going to officially dx her bp because he doen't want to stigmatize her. She is reacting very well to the meds. She is getting good sleep at night, waking up and getting ready for school without incident and she is finally getting happy faces at school..and that is only 3 days of medication. We are so pleased. Thank you for your suggestions and encouragements.

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My six year old son is autistic and had similar meltdowns and tantrums throughout his toddler, preschool, and kindergarten years. I understand how difficult and stressful it is. I also refused to put him on medication when he was diagnosed with autism. The diet change really helped and the better teacher and schools are fantastic for him. He is now excelling in school and is a very happy little boy!

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I would be VERY VERY careful about accepting a diagnosis of bipolar in a child so young. I would also recommend at least 3 different evaluations (by different specialists) including behavioral pediatrics, psychiatry, and neuropsychiatry before accepting that diagnosis. There is controversy as to whether the disorder can even be diagnosed in the toddler years, as so many of the developmental stages can mix and lead to misdiagnosis on many levels. Extreme behaviors that may fall outside the spectrum of "typical" toddler behavior can often wind up "labeling" a child for life. I would be EXTRA cautious of accepting prescription medications such as mood stablizers or antipsychotics as they have not been tested on children and the side effects can be very dangerous.
You sound like a wonderful mom, and I hope you don't take this as preaching. It's just that, working in medicine, I have seen WAY too many children medicated when there were other things that could have been tried first or at least in conjunction, but unfortunately, some docs jump to the meds as a "quick fix". Wishing you all the best and hope things work out for you and your daughter. Hang in there.

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I would STRONGLY agree with Amy - please take your daughter to at least three different specialists before she is diagnosed. I have worked in a mental health office for many years, and it is truly heartbreaking to see some of those kids come in there when they've been misdiagnosed. The side effects of most medications haven't been properly tested for children, especially in such young children.

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Oh My M., personally I think a 4 yr old is way to young to be tested for this serious of a problem. That is just me a Nana of 5 talking. Children exhibit many forms of rebellion, anger, tantrums etc.. They Have so much energy flowing through their little bodies and minds it is sometimes hard for them to separate. If I do this I get more attention even if it's not the kind of attention they actually want. If I am good, I get a good girl, and life goes on.

I went to a web site last week to check on bi-polar as one of our daughter's in law, exhibits wild tantrums and violent behaviors as times. I did a google search on Bi-polar. Read through that list M.. I really can not see a Doctor actually testing a 4 yr old for this horrible illness.

They ( pre-school teachers)said our 3 1/2 yo gr son should be tested for ADD/ ADHD. This is a very smart, intelligent little guy who is bored if not challenged or active in a project. In Preschool they learn numbers letters, colors, shapes etc. He knew all of those a long time ago. He listens to his mom read her Physiology book in the evenings and can tell you the real names of bones muscle and where they are.
Since he is active or wanting to do more then normal they have decided he should be tested. They aren't qualified to decide that. They told me last week They didn't realize how smart he was. He is the only child in his class who knew every child's name and teachers names. 18 kids and 3 teachers. The other children say Hey Teacher or the kid over there.

Parents know their children best, if time out doesn't work removing a privilege might.
In a few weeks or months her behavior will change to something entirely different.

I will keep you all in my prayers.
Big HUGS M., may your heart be healed
K. Nana of 5

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M.--I know this is a difficult time for your family; waiting for a diagnosis and not knowing what is going on, how you can help, etc. is difficult. Also, it is so very hard on parents to see their children hurting and not be able to "fix it." I hope that you are able to get your daughter in for a full developmental evaluation soon, that will look at behaviors, development, mental health, etc. If you would like, you can call us here at the Missouri Developmental Disabilities Resource Center. We are a part of the Institute for Human Development, located at UMKC. The Institute is a University Center on Excellence in Developmental Disabilities Education, Research, and Services, serving the State of MO. We have experienced staff, most of whom are also parents or family members of individuals with disabilities, who are available to assist other parents with information, resources, and referrals. In addition, we have a parent mentoring program that can connect you with another parent who has had similar experiences with their child in the past. Mentor parents are there to sahre experiences, listen, and help you with those feelings of being "alone" in your current experiences. Please feel free to contact us here at the MO Developmental Disabilities Resource Center--800-444-0821. Our resources and support does include information about Mental Health issues. Sincerely, J. Hatfiel-Callen

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Before you get swept up in the world of medications & diagnosis, please look into some alternatives. I have seen too many children & adults end up on an extreme amount of meds & alot of time not even the correct ones from psychiatrists that prescribe one med to cover the side effects of the first & then another med to cover the side effects of the second which was prescribed to cover the side effects of the first & so on - you get the picture. Look at allergies & other things that may cause erratic behaviors. Try some natural meds/vitamins, sometimes we just need to be balanced. There's natural alternatives you can try to like NAET & Crossinology that help emotional disorders, allergies & brain functions. Four years old is VERY young to be diagnosed with such an extreme condition. I wish the best for all of you!

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My six year old son is autistic and had similar meltdowns and tantrums throughout his toddler, preschool, and kindergarten years. I understand how difficult and stressful it is. I also refused to put him on medication when he was diagnosed with autism. The diet change really helped and the better teacher and schools are fantastic for him. He is now excelling in school and is a very happy little boy!

1 mom found this helpful

You are so much more qualified to answer your own question about meltdowns and discipline than i am, so take the following for what it's worth :)

My son has sensory issues that fuel his meltdowns, so the biggest thing that has helped those is OT and learning how to help him de-sensitise - but here are a few other things we do

First, I'm not fond of the time honored, 'just let them cry'. For a tantrum yes, but for a meltdown, well... i won't let someone else bite my son's arm until it bleeds why would I let him do it and just stand by?

If he was in a meltdown we just sit by and try to keep from hurting himself and have his'comfort devices' ready for when he breaks through. (his comfort devices include a bottle which he is too old for and only uses for comfort, but i'm good with it. he'll replace it with something else as he gets older, but it helps him break through and calm down it's worth it to me)

the best for us is avoiding them in the first place ... transitions are hard for evan, so we have pictures of the steps for an item - (i.e breakfast, turn TV off, dress, daycare)that we reference hundreds of times - it takes us 30-40 minutes to get dressed now in the morning or go to bed, because we keep referencing the pictures until his mind is ready to move to the next step - but we do it without meltdowns (usually). Routines are supposed to be great, but my job doesn't allow that, so this was the closest we could come.

If we're out in public, i talk him through it .. ok, at the store we're going to get these 5 items ....ok we have 4 of them, i just need you to stay in the cart until we get the other one, it's going to be 'milk' can you help me find it? what color of milk should we get today? .. it's an ongoing dialogue that i'm sure makes me look crazy, but it helps a lot. It also helps if i keep to my word, i can usually get by with saying, oh i forgot we need to get cereal too, let's stop here, but if i do that for more than one or two things we're in for it.

If you find any secret tricks, let me know!

There is a book called bipolar child. A friend of mine's mother read it and said it sounded just like my friend. She was diagnosed as an adult, not as child though. I haven't looked at the book but want to read it someday.

I have a child who had bipolar symptoms as a toddler (her dad is bipolar), we took her to the Dr and he said it was very rare for a child that young to be diagnosed with bipolar. Many of them outgrow the behaviors as they learn to better control their emotions and actions, she is now in 2nd grade and still is very emotional but can better control them. Also, remember once a child receives a "label" it sticks with them through out their school career and unfortunately can affect the way teachers and classmates treat them, as a parent of school age children no child wants to be the "different" one so think seriously about if this is a true diagnosis or something she may outgrow with your help. Best of luck in whatever happens.

Hi M..

My first question before responding is, has this been diagnosed by a doctor?

I ran across a blog that has some very pertinent information about bipolar. it is http://onewomaninamillion.wordpress.com/

It is about a woman with bipolar and she has done extensive background and research on this subject. I think this might help you.

I am very unsure of a child having bipolar. It takes a very long time to find out and it is a still ongoing discovery on how bipolar happens etc.

Good luck

My daughter was diagnosed with Bi-Polar at the age of 4yrs old. If I would have listen to the many parents who do not have a child going thru this who told us Bi-polar in children is not real, just be stricter with her and she will grow out of it we would have not been able to get her the early treatment we did. She had a full IEP, play therapy,and nutrition couseling before she started Kindergarden. She is 8yrs old now and with medication, early treatment and alot of education and research on are part she is doing extremly well. We still face a huge amout of stigma from uneducated parents in her school and we still have rough days. No parent takes this diagnoses lightly. Every step we have taken in her treatment we have done with a great deal of questions, 2nd opinons,research and education thru special schools and NAMI. Listen to your gut you know your baby better than anyone else.

Hi M.,

I don't have a child with bipolar but am a special education teacher and have worked with children with mental illness. First, I would be very cautious about diagnosing a child with anything, especially at 4. Sometimes, as I'm sure you already know, kids get stuck with these labels and those working with them see a label before an individual. I would see a few experts and get a few opinions. There is a book called The Explosive Child by Ross Greene. It is a wonderful book and it gives lots of great advice on dealing with children who have some pretty difficult behavior. I highly, highly, highly recommend it. Hope this helps, and hang in there!

As you likely know, a Bipolar diagnosis follows the child through life. I have heard of other therapists diagnosing children at the age of three, but professionally I would never do that. I think a "rule out" might be more appropriate as there are so many other diagnoses that present as BPD symptoms. As I sincerely tell my clients: If you feel unsure about my diagnosis or treatment modality, please feel free to see another therapist!

Wow, it would amaze me if they gave her a bipolar diagnosis at this age. My husband wasn't diagnosed until the age of 17, but they knew around the age of 11 that he had issues. My oldest son was diagnosed at the age of 8 with ADHD. His psychiatrist said that he exhibits signs of bipolar and has bipolar tendencies, but will not lable him bipolar at this point. He did put him on Zyprexa and that seems to work really well for him. It also helps with his compulsive behavior. I feel for anyone that has relatives with bipolar, because everyone that is close to that person is affected by it. The good thing is that if it is treated early, they have a better chance of not self-medicating in the future. I hope that you get good news, but if not, keep your head up through this long road ahead.

All these people who say 4 is too young are not on the cutting edge of mental health. My son was diagnosed with Bipolar Disorder at 3 years 4 months. He is Bipolar. He has an awesome psychiatrist, theraputic preschool, case manager and he's so much calmer and happier now.

Please feel free to message me since I've been there. He was tested extensively, multiple issues were ruled out and Bipolar was the diagnosis that fit him.

I work in the mental health field and it is rare that a child is diagnosed with Bipolar, ESPECIALLY at 4!! This is almost unheard of! I just realized you said you were in the mental health field as well, so Im sure you are very well aware. Getting tested is great whether it just be to rule something out. Unfortunately there arent a lot of things out there to help parents with children with Bipolar. If she isnt in therapy I would get her in. Maybe its just a phase, maybe its the age, maybe she just needs someone to talk to. Could be she needs someone to teach her how to appropriately express anger, frustration, sadness, etc. Hang in there. See what a therapist has to say about it. Good luck!

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