4 Yr old with ADHD, aspergers, OCD and bipolar tendencies

[nicole1647]

So my son has been diagnosed with ADHD, Aspergers, OCD and bipolar tendencies and I am just curious what this means for him in the future. He is only 4 years old and I guess I am needing to know what to expect, will he have a normal life or will he never be normal. I have three other children and another on the way and was shocked to find out my son has such big problems. For years our old pediatrician said nothing was wrong but once we moved to our current city our sons new dr immediatly sent him for testing. How could our sons old dr miss such a huge problem? Now my son is extreamly agressive and threatens to hurt us and the baby and to be honest I am actually scard of my 4 yr old. Is this normal behavior? I really don't know if he is capable of hurting our youngest but for the past 6 months we have had our 1 1/2 yr old and 10 month old sleep in our room. He only became agressive when we move to our new house 6 months ago and although he has bitten his sibblings and pushed them down he has not seriously hurt them. He has broken two of the windows and has no fear of anything. I don't know what to do and am hoping that someone has been through this and can tell me what they did and how I can protect both him and his brothers and sister from him. I have removed all toys from his room and screwed his windows shut as well as had plexiglass installed in his windows to protect him from himself but I need more Ideas to provide a safe envirnment for all of my children. Thank you

[knowledege]

These are also signs of abuse.  It is not always some medical mistery...In my experience working with kids...its usually a tramatic experience that brings on these behaviors.

[concetta76]

This post touched my heart in so many ways. My son is now 14. He has aspergers, ADHD, bipolar, mild retardation. As a mom I can relate to your post. I have been a very proactive mom for my son. He has many doctors, therapists, psychologists that work with him in and out of school. He is involved in many different programs for help. I even became a nurse and educated myself in this field of care. It became my passion. My son has all the same behaviors and still at 14 it is hard to keep him and others safe when he is in a maniac state. He has been aggressive and then gets suicidal at times. He truly doesn't have control over his own emotions and needs help in a healthy way to release anxiety or depression or anger. At this point in his life he has been classified as disabled. I try everyday to keep him on a set schedule and routine and try my best to not interrupt his daily routines. He will never be like children his age completely but neverless he is very artistically talented and we use that as his outlet. He has come to an understand he is different from his peers but I always encourage him and let him know that different is a good thing. God didn't create us all to be the same. I then showed him all the wonderful artists, actors, famous people from our past and present that has these disorders that made a huge impact on the world we know today and remind him if it wasn't for the difference they would. Have never invented or created the things they did because they wouldn't of seen the world the way they did. These diagnosis are not a disability but rather a gift from God to see the usual in a unusual way.....and that my dear is the definition of art.

[Sandman2]

    Just in case you haven't bought the video equipment - or find that you do need camera enclosures - here is a very good (and cheap) site.  
          http://www.newegg.com/Store/SubCategory.aspx?SubCategory=277&name=Accessories&cm_sp=SurveillanceandSecurity-_-flashstorefront-_-surveillanceaccessories&Pagesize=50&Page=2
         Also check out their security cameras.

[Sandman2]

   Thank you for all of the information.  It does clear things up.  I was really afraid that you were almost going this alone. I am really glad to see that the doctors all appear to be working in concert.  The behavioral therapist is well worth all of your time.
   Melatonin is used a lot for sleep problems.  Did you say he was also on stratterra?
   Sounds like you are doing a lot of the right things.  I guess my one piece of advice is to not be afraid to let your psychiatrist know if meds don't seem to be doing what they should be doing.  At this age, there is no tried and true dosage.  Its kind of experimental, and the doctor does wait for parent input before trying something else.
   You are going through a very trying time.  Don't know if I have come across someone in the same situation, but don't know if that's simply because they weren't willing to share.  I am pretty sure that if you were not getting the help that you are getting, his chances would be pretty slim of leading a normal life.   Best wishes.

[nicole1647]

Thank you very much, unfortuently jonathan doesnt like to go outside much because he has very little tolerance to the heat or the cold. He is on 9-12mg of melatonin every night,  this is a natural sleeping medication that your body usually produces however in some children they dont produce enough to cause them to sleep, as well as strattera which also causes drowsiness. He is in behavioral modification at the willows of vincennes, they come here once a week, he also already has and IEP from his preschool which is now homebased as they did determine at our meeting this morning that he cannot continue at head start due to the high chance of harm to himself and others. We do see a phychiatrist once a month but he would like to put jonathan in the pshychiatric center he is currently prescribing the medications for jonathan but we see his phychologist every week because of his problems that i told you about. Our understanding is that he has all four diagnosis and a pretty severe case which is causeing his unusal reactions. Initially the pychatrist thought jonathan may be showing signs of child onset schitophernea- i am a horrible speller- but we were able to quickly rule that out with his constant testing, i guess i should have told you he has 6 doctors in total, his phychiatrist, the phychologist who work together, he has a behavioral therapist that visits us once a week to try to help us get him under better contole, he has a neurologist and childrens mental illness specialtist at rileys hospital for children his pedatricain who actually did his recidency with our sons mental illness specialtist, (He was listed under specaltist child drs on our health insurance coverage book so we called and he was able to take our son into his practice but our other children have another ped dr that well lol takes care of snot and shots and my husband says) The Diagnosis is a final one but unfortuently even with behavor mod. its not making any difference yet so we are trying to make the best of it. TY for the Tv and camera idea im going to have my husband get the stuff tonight, hopefully in the next few weeks we will be able to have everyone in thier beds once and for all. I still have yet to meet anyone with these problems and would love to know if he can get married and have children in the long term, i realize that he is only 4 but it would still be nice to hear a success story

[Sandman2]

   Mount the video camera high up on the wall.  There is no way he can get to it.
   Get a flat screen lcd tv and mount it on the wall.  On either side of the tv mount a 1x4 or 1x6 (have the lumber yard rip it to that size for you) with L shaped brackets.  Across the wood (and thus across the flatscreen), screw in a plexiglass sheet like this from home depot - http://www.homedepot.com/Building-Materials-Plexiglass/h_d1/N-5yc1vZ1xhcZbrdg/R-202038053/h_d2/ProductDisplay?langId=-1&storeId=10051&catalogId=10053
If the wood doesn't stand out far enough from the wall, just add L brackets to the wood and attach the sheet to the brackets.
     I am curious as to what medication he is taking to help him sleep, and what kind of a doctor prescribed it.  There are several studies that show that lack of sleep causes serious behavioral consequences.  http://www.sciencedaily.com/releases/2009/04/090427131313.htm.   Getting this problem under control might make a difference.
    Thank you for your long message to me.  I am still digesting it.
I do want to address my original  post when I said, "   I believe the biggest challange will be to figure out what he has and the conditions are treated differently."  What I meant was, "AS the conditions are treated differently."  That was the reason for the long post on the differences between ADHD and bipolar.  There is a lot that can be done in terms of behavioral modification for children.  But it varies based on whether it is ADHD, Aspergers, OCD, or bipolar.  That is why it is so important to find out what is going on.  The longer you wait to start, the harder it is to change.  Many of his traits do sound Autistic .  If that is the case, the sooner he starts getting help for that, the better his chances are to lead a normal life.  I would hope that your present psychologist has done more for you with behavioral modification techniques, then to just tell you to child proof his room.
   You said, "we have seen many doctors who all agree on the diagnosis."  No where have I seen that info in your posts.  I get the feeling that they are all taking guesses at what is going on.  Sometimes it just takes a lot of looking to find the right doctor.  I really think you need to see a pediatric psychiatrist.  Your psychologist cannot prescribe medication.  Only a psychiatrist can do that (or a pediatrician and this is way out of their league).  The sleep problems alone demand that you seek knowledgeable help.
    You are an incredibly busy woman with that many kids under 4.  Your boy needs to get outside and be very, very active.  Find some way for him to do that and I think the results will please you.
   Oh, (I know you didn't ask for all this info).  You need to get your school involved.  You may or may not need a home teacher.  You definitely want him evaluated for special education and an IEP drawn up as soon as possible.  I would think that this is already going on if they offered a home teacher, if not they are seriously out of the loop and need to be brought back in as soon as possible..  
   Anyway, hope some of this helps.  Best wishes.

[nicole1647]

He has seen 19 doctors in all since our move here, psychatrists phcholoogists rileys metal illness specialists we have seen many doctors who all agree on the diagnosis. Really my day is really calm for the most part, jonathan is anti social so he plays for the better part of the day in the livingroom. we had to remove ALL his toys from his room as he was able to rip the stuffed animals apart and tied string around his neck one night in a fit. He doesnt sleep in his room currently since we dont feel he is actually safe in there. hes on the couch and i set an alarm for every 1/2 hour to make sure hes still asleep. they have him on a sleeping medication yet he is still not sleeping more than 3-4 hours a night. Hes up until 1 am and by 4 or 5 hes awake. I guess i am now used to the routine as well as my husband who gets up with the baby when jonathan is asleep since i only get a few hours a night currently. We dont take jonathan out as he does horrid in social places such as stores but he does great at church so we never miss a sunday. We have adapted but I am desprate to make his room a safe place for him so that he can have the closest thing to a normal life. We have ordered a survaillance system for his room so that we can always have an eye on him but we need to know where we can find items such as the padding they use for floors and plexiglass tvs and such so that he can have a normal room in which he cant hurt himself. We have been looking for a plexi glass box that we can enclose the videocamera so he cant break it, that we can mount. He prefers to be alone but I am not confertable with it but am told that the constant presence of us can cause him to act more aggresivly however i will not let him endanger himself, I am hoping to make his room safe like a psych center without him being at one. I was told this is a great way to keep him at home while making sure hes safe. So if anyone has any ideas I would appreciate it.

[specialmom]

Sandman, those were my thoughts as well.  I'm wondering who diagnosed all of these things-------- one physician?  A psychiatrist?  A developmental pediatrician?  And what types of treatments and therapies are being suggested.

My son has sensory integration disorder which can look very much like adhd.  He is well known for making many impulsive and unsafe choices but it is because his processing and nervous system are not always working properly.  A child (and my son) does occupational therapy to treat this and it has helped tremendously.  We also have had to change our lifestyle at home to accomodate his diagnosis.  It includes doing things like daily trips to parks to allow him to run, roll, jump off play sets into soft mulch, slide, swing, work on social skills with kids his exact age, hanging off of monkey bars.  Every day, rain or shine-------- we do something very very physical and this helps keep his nervous system regulated.  He's doing fantastic with this approach.  I mention this for two reasons.  First, you might want to google sensory integration disorder and see if any of it applies to your son.  And second, to show that how something is treated is very important.  I full comprehensive approach is the best way to success.  Medication does not work for sensory, but occupational therapy and sensory strategies does.  So---------  I just wonder with the broad range of diagnosis------- what all will be in place with your child.

Also, if you live in the United States, your son should qualify for the local public school early intervention program.  This is in a preschool format and services to help with your son are provided.  It is free and provided under a federal law.  Have you contacted your local school to start the evaluation process for your child to see if they concur with your new physician?

It is concerning to me the major jump from one doctor that said things are fine to another that gives you so many very diagnosis all at once.  Can you tell us about your son prior to your move?

Lastly, you must be one tired mom. A 4 year old and two younger siblings with another on the way and one older than that!  You must be very overwhelmed.  I have only one younger child to my son with the developmental delay and he has just joined us in everything we do.  He does all of the sensory strategies my older son does as it can benefit all.  Your younger children will become well versed in helping their older brother.  It has been of benefit to our family in terms of closeness and I hope that you see it in the same positive light as well.  We bring children into the world not knowing what we will get.  We have to adjust our idea of normal to what is normal for our own family.  My family does far more than the average-------- but it is our normal.  So good luck and maybe you can fill in some of the gaps of information.  

[Sandman2]

  Hi nicole, I went back and reread your post.  Some things bother me.  Lack of information is the main one.  If you were to go over to the Child Behavior forum and scan through the posts - you would see a lot that start out with "Out of Control 4 year old".  A lot of what you described is not that unusual for a 4 year old.  I got caught up in your doctors diagnosis, and wanted to give you more information of how to tell one thing from another.  
  What I would like to know is what kind of a doctor gave this diagnosis?  What suggestions did he give to help him and you?
   You said, "For years our old pediatrician said nothing was wrong but once we moved to our current city our sons new dr immediatly sent him for testing."  
    Does this mean that your son had a lot of problems before the move?  If so, I would like to know what some of them were.  Or does it mean, that they started after the move - which changes everything.
     Hopefully, when you said that you removed all his toys - you meant only hard objects.  Soft objects would not only be ok, but important.  Anyway, please get back to us!

[Sandman2]

   Shoot, Specialmom is going to be very mad with me.  I should have mentioned that sensory integration also has a lot of similar things in common with what you have mentioned.  You definitely should google it, because many times it doesn't get noticed by doctors.  I send specialmom a note and also have her take a look at your post.-

[Sandman2]

  This is  the second part to the post below.  I went above the 8000 word character limit so I had to do this in two posts.  Hope some of this helps.  Also check out the bipolar forum on this site.  

    Here are the list of diffferences
Sent by gjayme31 Oct 05, 2010 02:27AM
This is a list of the differences between ADHD and Bipolar because they are very similar:



1. Destructiveness may be seen in both disorders but differs in origin. Children who are ADHD often break things carelessly while playing (“non-angry destructiveness”), whereas the major destructiveness of children who are bipolar is not a result of carelessness but tends to occur in anger. Children who are bipolar may exhibit severe temper tantrums during which they release manic quantities of physical and emotional energy, sometimes with violence and physical property destruction. They may even exhibit openly sadistic impulses.
2. The duration and intensity of physical outbursts and temper tantrums differs in the two disorders. Children who are ADHD usually calm down in twenty to thirty minutes, whereas children who are bipolar may continue to feel and act angry for up to four hours.
3. The degree of “regression” during angry episodes is typically more severe for children who are bipolar. It is rare to see an angry child who is ADHD display disorganized thinking, language, and body position, all of which may be seen in angry bipolar children during a tantrum. Children who are bipolar may also lose memory of the tantrum.
4. The “trigger” for temper tantrums is also different. Children who have ADHD are typically triggered by sensory and emotional over stimulation, whereas children who have bipolar disorder typically react to limit-setting, such as a parental “no.”
5. Disturbances during sleep in children with bipolar disorder include severe nightmares or night terrors often with themes of explicit gore and bodily mutilation.
6. Children who are bipolar often show giftedness in certain cognitive functions, especially verbal and artistic skills (perhaps with verbal precocity and punning by age two to three years).
7. The misbehavior in children with ADHD is often accidental and usually caused by oblivious inattention, whereas children with bipolar disorders intentionally provoke or misbehave. Some bipolar children are described as “the bully on the playground.”
8. The child with ADHD may engage in behavior that can lead to harmful consequences without being aware of the danger, whereas the child with bipolar disorder is risk seeking.
9. Bipolar children tend to have a strong early sexual interest and behavior.
10. Children with ADHD usually do not exhibit psychotic symptoms or reveal a loss of contact with reality, whereas children with bipolar disorder may exhibit gross distortions in the perception of reality or in the interpretation of emotional events.

There are 3 levels of bipolar. Bipolar I, Bipolar II, and Cyclothymia. Lithium is usually used to treat bipolar because it treats depression and mania but it cannot be given to a child under 12. I have never used drugs. If a child is hyper I use the adkins diet as it will bring a hyper person down within a week. Pure protein and dairy. The will be lethargic by week 2 but I usually keep it going for a month. Stimulants are good for treating depression. Its only dangerous for mania because when a person is in mania they are secreting large amounts of adrenaline and endorpines and they are stimulants. When a stimulant is added you get kids that can't ever sleep and they will develop psychotic symptoms quick.
Oh BTW let parents know that even if its ADHD or bipolar any cough syrup or flu medication over the counter will triple symptoms. All of them state under warnings do not use if you have a psychiatric condition. I use thyme to treat sinus congestion, hey fever and sore throat. Oregano is a heavy seditive and sometimes I use chamomile teas.

  

[Sandman2]

    The safest environment that you can provide for your children is to get the most help possible for your son.  Pediatrician do not have the training to handle the conditions that the new testing has suggested.  Kudos for your new doctor for realizing that something was going on and getting the testing done.  Hopefully, you are now seeing a pediatric psychiatrist.  If not I would find one.
   I believe the biggest challange will be to figure out what he has and the conditions are treated differently.  The one thing I can tell you is that the sooner you start treating his condition, the better chances all of you have.  
   The other thing that complicates things is that with all of the other kids in the family and with the new move - at least part of this may be attention getting.  I would definitely try to make sure that he is getting some extra attention. I realize that it would be difficult for you, so hubby will have to step up to the plate and help out.  Also make sure that somehow you make a special time each day just for him.    Hopefully, a lot of this will turn out to be due to the lack of attention that comes with a new move and all the new additions to your family.  
    But just in case,  I have included two very long posts on the differences between ADHD and bipolar.  As far as I can tell the information is good.  It is very important to figure out what is going on.  What you are doing now are defensive measures.  You need to attack the source to deal with the problem.  Take you time reading these.  Best wishes.
   Differences
Sent by gjayme31 Oct 04, 2010 11:46PM
There are some differences between bipolar and ADHD and it's important for schools to know these especially since the Columbine shootings. When a child or teen is in a manic stage they are a danger to others especially teachers and students that have persecuted them. When a person is in a depressed state the are a danger to themselves. These drugs they are using to treat ADHD are very dangerous to a bipolar person and the people in schools. If a child doesn't go to daycare; school will be the first place he shows obvious signs.
Stephen King writes such good scary movies because he has dreamed them all of his life. He doesn't openly admitt he is bipolar but if you've read about him you'd know he wittnessed his friend getting hit by a train when he was young and totally blacked it out but had a speech impediment for weeks after. These are signs of bipolar.  Thats where his story Stand By Me came from. Winstin Churchill had bipolar and called his depression the big black dog. Vincent Van Gough cut off his ear in a fit of mania and eventually shot himself to death. Most actors, actresses, comedians and singers are bipolar and this is why they eventually self destruct.
Bipolar kids start punning and showing an overly mature since of humor at the ages of 2 and 3. They are master manipulators by the age of 4. They close up and don't talk about their innermost secrets very early because too many people have told them about how bad they are (including the parents sometimes). I know these things because I'm bipolar, my father is bipolar and out of my six kids 4 are bipolar. We have a very hard time even opening up to each other because we each think we are right and everyone else is wrong. Two of my boys started off as manics and two girls as depressed. I can cycle my moods according to the energy in a room but in learning situations I go into what I call sensory shut down. Some people call it day dreaming but when i do it trust me the lights are on but no one is home. I have to be shaken to come out. This is how I learn in a room full of people. At night in my dream my whole day replays. The whirring thoughts come from not being able to process. Believe this or not... My son's teacher (1st grade) told me your son was not listening during story time. He just sat spinning on the floor. Well he came home knowing the whole story by heart. The little guy is failing reading he just memorizes everything on Monday. He excels at math. I have only had psychotic episodes once and that was after being in a manic state for more than a week. I definatly have "trigger" words but I have no idea what they are because we don't remember psychotic episodes. My sons "trigger" words are "I'm going to call your parents." He throws things including his desk and he is only in first grade. His teacher keeps triggering him even though I've told her not to say it and to just do it. She is bound and determined that he's adhd when I know he's not and he doesn't do these tantrums at home because I never say those trigger words. All of the kids in our schools are selling adderal and ritalin for $3-$5 each and it's become a real problem in our schools.
Well anyway here are the list of bipolar symptoms for children. The symptoms in adults are different.
Very Common Symptoms of Early-Onset Bipolar Disorder
• Separation anxiety
• Rages & explosive temper tantrums (lasting up to several hours)
• Marked irritability
• Oppositional behavior
• Frequent mood swings
• Distractibility
• Hyperactivity
• Impulsivity
• Restlessness/ fidgetiness
• Silliness, goofiness, giddiness
• Racing thoughts
• Aggressive behavior
• Grandiosity
• Carbohydrate cravings
• Risk-taking behaviors
• Depressed mood
• Lethargy
• Low self-esteem
• Difficulty getting up in the morning
• Social anxiety
• Oversensitivity to emotional or environmental triggers
Common Symptoms of Early-Onset Bipolar Disorder
• Bed-wetting (especially in boys)
• Night terrors
• Rapid or pressured speech
• Obsessional behavior
• Excessive daydreaming
• Compulsive behavior
• Motor & vocal tics
• Learning disabilities
• Poor short-term memory
• Lack of organization
• Fascination with gore or morbid topics
• Hypersexuality
• Manipulative behavior
• Bossiness
• Lying
• Suicidal thoughts
• Destruction of property
• Paranoia
• Hallucinations & delusions
Less Common Symptoms of Early-Onset Bipolar Disorder
• Migraine headaches
• Binging
• Self-mutilating behaviors
• Cruelty to animals
I also have a list of sure ways to distinguish between the 2 written by Dr. Popper. I will send to you.

   The second post follows in another post as I exceeded the character word limit.