Son Possibly Misdiagnosed

A.,

If your son was not fully evaluated by either a board certified Child Psychatirst, or a Developmental Pediatricain (the gold standard) you don't have a real diagnosis. All the conditions in your post are medical conditions, and they simpley cannot be diagnosed correctly by a psycholgist, a pediatrician, or your sons school district.

I would suggest that you try to get in to see the developemental pediatrician at your nearest children's hospital. This specialist will call in every one you need and do a full evalauation that misses nothing. You will never wonder again if you have the right diagnosis. This will take a long time.

Alternatively, you could make an appointment with a Child psychaiatrist, who can make the medical diagnosis based on all the soft symptoms and can make a referral (if you ask) to a neuropsycholgist for evaluation to support his diagnosis. You should do go to one or the other.

We have had our children to the Developmental pediatrician for diagnsois, and we use a child psychiatrist for treatment, which works very well for us. Far and away, psychiatrists are the best prescribers for these conditions.

Bipolar is nothing to mess around with. I assume that you have based your suspicion on much more than you posted. In any case, you need a real diagnosis from a full evaluation before you are really sure of anything.

Good luck,
M.

I'm not sure I have any good advice for you, but one thing you might look into is Sensory Integration Dysfunction. Read "The Out of Sync Child". Some kids have triggers that cause outbursts, learning those triggers and proactively dealing with them can really eliminate some of the issues. Something as simple as a seam in a sock, or the sound of a fire truck can throw these kids over the edge. Best of luck.

.

It still could be ADHD. Our son overreacts, too, when he's not on medication. You really need a neuropsychologist at this point to do a thorough evaluation and determine the diagnosis. It very well could be ADHD and bi-polar, or one, or something else entirely. It's worth whatever drive you have to make to help your child.

It can take a lot of trial and error with medication. Increasing the dosage is extremely common and really just part of the process. However, if you're not seeing any improvement with the particular one he's on, then it might not be the right choice for him. Kids react differently to the medications, but if he does have ADHD, you should see marked improvement with one of the options. You may not care for certain side effects, but stimulants should help, not make things worse or the same. For our son, it took several tries to find precisely the right medication, but when we did it changed our entire family's lives for the positive. He's thriving at school now, too.

I would suggest having your son evaluated by a developmental pediatrician and/or a child neuropsychologist. They should be able to give you a more accurate diagnosis and a recommended course of treatment. As another member has mentioned, really take a close look at what your child is eating if you are not doing that already. I know, for my son, whenever we give him anything with sugar or artificial food color in it, we are almost guaranteed a meltdown or a very hyper, unfocused son sometime within the next few hours.

Wishing you and your son all the best and a speedy solution to all your concerns.

It can be so hard to diagnose exactly what is going on, and many kids have multiple issues. My daughter is diagnosed with Asperger's, and she has a really hard time with transitions--even if she knows they're coming. She can have tantrums, big and small, over stuff like this. It does sound like you need to get your son reassessed!

C.
www.littlebitquirky.blogspot.com

Have you ever had him or yourself checked for allergies. Allergies can creat reactions other than breathing problems & skin rashes. My son (age 10 now) had SEVERE emotional outbreaks on a daily basis, but I am one that is against all of these meds until all other resources have been exhausted. Homeopathic allergy tx have changed him into a healthy happy child. He was miserable, hardly smiled, was angry, had severe anxieties, such as driving on the interstate to go places (not him driving, me)...he wouldn't even go to Disney on Ice if we had to take the interstate (he was 6 then) or drive after dark. I have holes in my walls & broken applaince handles due to his rage. The other is what about side effects from the meds, even the "rare" side effects? All meds come with side effects & risks. I really hate it when they just keep upping doses instead of trying to find what really works or they put them on another med to counteract the side effects of the first. My adopted brother is on Vyvanse & he is just irritable all of the time, but my mom won't change it. She's a med freak. I hope you find something that works for him...it's got to be rough on the little guy!

we were told my son had adhd or aspergers, his behavior was similar to your sons, except he had outbursts several times a day. scary, shouting, hitting, throwing himself, hitting himself in the head kind of outbursts, several times a day.
i just could not believe that diagnoses, like yourself cuz my son would sit and do stuff and concentrate just fine, i never did medicate him for that reason.

the way we dealt with it was putting him on a completely natural diet, it is called the fiengold diet, it is for kids with add.

the difference was dramatic...he had a bag of skittles the other day, and it was like a monster coming out of him, he was a horror was about 2 days.

also what helped him was putting him in a VERY strict school, with very consistant teachers, he is one of the best behaved children in his class, and has a B average now - please try the diet before you try more docs

Hi. I used to work with kids with special needs as a Child Developmental Specialist. From what I have seen, I would advise most parents to stay away from child psychiatrists and psychotropic meds unless they are at a last resort, and still get a 2nd opinion.

Does your son hate transition times and throw temper tantrums, mild or severe, over having to end one activity and go to the next? He may be doing this out of high anxiety. One thing you could get him screened for is asperger's. Aspergers' is closely related to ADHD - normal to high intellect, socially immature for age, sensitive to certain sensory stuff, stress at transitions, but overly focused on things. If your child had ADHD, he has a very hard time concentrating and focusing on things and a hard time with transitions, too. Asperger's is similar, only more severe to ADHD.

Either dx has added stress and tension for your child. I would recommend asking your kids' school psychologist to refer you to someone trained in ADHD/aspergers, after your school psychologist performs an eval, for some one-on-one regular counseling to teach coping skills and social skills to your kid in a way he will understand. They should not be a talky-talky, touchy-feely type, but more of someone that can teach skills visually.

Best.

it can be vexing, but you may want to try your local social services office ask about psychiatric services and get all the numbers they have...then just start callin them ask what they require which insurances they accept in whole or in part and then always follow up initial phone calls with "can you suggest any other numbers people services that may get me pointed in the right direction" then call all of those people etc whittle it down and get your son seen by a psychiatrist!!! (psychologists don't work in meds)

also check with your local school district for additional screenings or district services

ADHD and Bipolarity are sooooooo close to each other, that misdiagnosis is actually quite common. Our hyperfocus can be mistaken for mania (and vice versa), our mood swings look like rapid cycling, our temper tantrums or sensory overload meltdowns look like mixed episodes, etc., etc., etc..

Honestly the blowup about the teeth is one of those classic "is it, isn't?" sorts of things. If he's adhd he could have been spinning in his head reliving some sort of emotional event, or in any other kind of sensory overload... and the first word out of anyone's mouth that in any way fed into what was spinning in his mind / emotions triggered the launch into kablawhahsudauewhlayashflkasasdf;idjakj!!! skadoosh!!!! Or it could be the bipolar equivilent.

One of the many differences between adhd & bipolarity, however, is that we adhd'ers can LEARN control over our emotional outbursts, while as you know, bipolarity doesn't. We can learn to breathe, and slow our heart rate, and recognize what's going on, and take ourselves into something blissfully calming (like really loud, really fast, music that downs out the world... i know, that just doesn't SOUND calming), and calm down. We can't stop the mental spinning out of control... but we CAN learn (and learn is such the operative word) to disconnect our mouths and bodies from the maelstrom... until we cool off and reason has a chance to elbow it's way through.

What personally concerns me the most about adhd/ bipolarity misdiagnosis... is that the meds for the wrong one REALLY make a person crazy. ADHD meds keep a bipolar person in a constant state of mania (so they look really productive, but as you know with mania's... you're just not YOU) and in a mania memory gets screwed up.. which looks even more like adhd, because things are being forgotten all the time, and about 50 other things. OTOH, if an adhd'er is on bipolar meds... it's like speedballing. They have to be on super high doses, some of the cocktail causes hallucinations (which makes it look even more like bipolar) moods get REALLY wacky... oy. The list just goes on. Simply put, medicating the wrong disorder actually makes the person LOOK like they have the opposite disorder that they actually have. The meds just don't work.

A friend of mine in the field (psychiatrist specializing in adhd, bipolarity, & addiction... who is adhd himself) says that very occasionally he gets patients who exhibit so many of both disorders (aka massive/bipolar moodswings, but everything else looks adhd or vice versa, someone who's actually bipolar but looks more adhd) that there are times he and the patient decide to do a trial run... one set of meds for a month and the other set for a month ... to see what's really going on. One thing for certain, while the disorders overlap as much as 70%, you NEVER find the two of them together.

<grinning> Meant this to be short. Whoops. Point being... if you're getting a bipolar "feel" from your kiddo, as someone who is bipolar themselves... I would REALLY trust your instincts and follow it up.

Being ADHD my radar certainly "pings" sometimes, and as yet (IRL) I've never been wrong.

With the family history, your son may be bipolar, although the incident you related is not a typical bipolar picture. Also, don't be fooled by his ability to sit forever in front of the T.V. Even ADHD kids can concentrate on what they want to, particularly something as stimulating as the T.V.

Consider having evaluated by a child psychiatrist rather than psychologist - I believe they have more experience and training to diagnose bipolar disorder. The Children's Health Council in Palo Alto is a
possibility, though they have a long waiting list. I am a Child Psychiatrist in Palo Alto with a lot of experience with Bipolar, and could talk to about an evaluation.

Consider having your son re-tested. Could be lots of things and early intervention could make a big difference. Go with your gut. If he has not been mis-diagnosed then at least you know he needs more. I'd suggest calling a top notch Children's Hospital near you and get some names. Have your child re-tested as a start. Talk to people at the Children's Hospital........like nurses, and get personal opinions on good doctors.

I don't know of any doctors in the East Bay, but there is Children's Health Council in Palo Alto and CPMC in San Francisco. Both have many different kinds of doctors on staff that can diagnose and deal with these types of issues. If they can't help, they may be able to direct you to an appropriate doctor. Other places that may offer recommendations, or just information, are Parents Helping Parents (PHP), some of the Jewish Community Centers, and Parent's Education Network (PEN). A developmental pediatrician is a great kind of doctor to help you figure this out. A neuropsych evaluation would also likely help, though they can be quite expensive.

Saying ADHD is an "attention deficit," is a misnomer ... it's more "attention disregulation." Many people with ADHD can hyperfocus on areas of great interest, and therefore great reward, to them. For kids, this is often TV and video games, which have immediate rewards and are like candy to an ADHD child's brain. The real question for the attention part of ADHD is whether the child can decide what to pay attention to, even if it's boring. Also, lots of things look like ADHD, as said by so many other responders, so getting a diagnosis by a doctor skilled in teasing these issues apart is really important. I'm not a doctor, I've just been told this by some other moms, so it may be worth all you paid to hear it ... $0 :) ... and I don't want to make you nervous ... but it is important for you to find someone to help you understand what is really going on with your child as there is some indication that some of the ADHD meds can be "activating" for bipolar. In other words, they may cause a brain already susceptible to bipolar to tip towards going down that path. Starting and stopping those meds, whether there is bipolar involved or not, needs to be done under the supervision of a doctor who really understands them and the child involved ... even more so when bipolar might be an issue, such as when there is a family history of it.

Also, if you haven't already, you might want to read How to Talk So Your Kids Will Listen and Listen So Your Kids Will Talk by Mary Sheedy Kurcinka and The Explosive Child by Ross Greene. Both have some good suggestions for dealing with discipline issues and improving the parent/child relationship, which is especially hard in the face of behavioral issues.