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Out of Control four year old
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Out of Control four year old

I have a beautiful 4 year old little girl, who is very intelligent for her age but most recently her temper has been out of control. She has taken on these raging fits if she doesnt get her way. She will throw things and tell me she hates me and wishes I would die. She will take a fit so hard that she will jump up and down on her tip toes and cut her toes to pieces.She will cry for me to get her but as soon as I try to pick her up to calm her down she runs from me and yells DONT TOUCH ME, LEAVE ME ALONE I DONT LIKE YOU.She talks nasty to people as if she hasnt been taught any manners, she spits at people and will in her fits kick and hit and destroy things around. Her father has been diagnosed with both ADHD and Bipolar Disorder. I am aware that childrent as young as 4 can be diagnosed with ADHD but what about Bipolar Disorder? There was an incident in December where my daughter witnessed a Domestic Dispute between her father and I. At the time I didnt feel therapy was a need but cant help but wonder if this maybe the reason for her temper and if she is in need of some therapy now. If maybe this incident has sparked something in her.
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  That incident would not have sparked something lasting that long in her.  Because her father has both ADHD and Bipolar - and both can be passed on - it is something to be concerned about.  This is something that you do want to see an expert about - probably a pediatric psychiatrist (not your pediatrician-unless for a referral).
  Normally, I would say that a 4 year old throwing fits can be common.  I see a lot of posts about that over on the child behavior forum.  What is important is how she throws the fits (sounds funny I know).  But if the fits last a long time, then it is a cause for concern.  I am posting going to add two very long posts on the difference between ADHD and bipolar.  She may have neither - but this is a pretty complete list of symptoms.  It will take two posts due to their length.  I do want to stress that if you go over to the child behavior forum and look for "out of control 4 year old", you will see numerous posts - and normally, I would say that is what the problem is.  All the other stuff I am sending you may not even apply - but the past history of her dad does cause concern.
    by gjayme31, Oct 02, 2010 04:12AM
To: arire22
Sounds to me like she has been miss diagnosed as ADHD and more likely has Bipolar and is in a manic state. The symptoms for a child in manic state are:
Feel irritable and throw violent temper tantrums.
Seem extremely happy and have high energy levels.
Touch their genitals, use sexual language, and approach others in a sexual way.
Not sleep much and go about the house late at night looking for things to do.
Talk very fast.
ADHD and bipolar are very simalar and often misdianosed here is a list of differences:
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. The moods of children who have ADHD or bipolar disorder may change quickly, but children with ADHD do not generally show dysphoria (depression) as a predominant symptom. Irritability is particularly prominent in children who are bipolar, especially in the morning on arousal. Children with ADHD tend to arouse quickly and attain alertness within minutes, but children with mood disorders may show overly slow arousal (including several hours of irritability or dysphoria, fuzzy thinking or “cobwebs,” and somatic complaints such as stomachaches and headaches) upon awakening in the morning.
6. Disturbances during sleep in children with bipolar disorder include severe nightmares or night terrors often with themes of explicit gore and bodily mutilation.
7. 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).
8. 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.”
9. 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.
10. Bipolar children tend to have a strong early sexual interest and behavior.
11. 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.
12. Lithium treatment generally improves bipolar disorder but has little or no effect on ADHD

   The rest to be continued in the next post.
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Avatar_m_tn
  The second part of the prior post.
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.

   I hope this helps and doesn't freak you out.  As I have said - this is only because of Dad's past history and hopefully has nothing to do with her.  Best Wishes.
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Avatar_m_tn
I feel your pain.  My daughter is always being told she is so cute, how adorable.  She hugs all the ladies at school and my oldest daughter's friends.  But, she is evil.  She abuses our cats, hits her sister and kicks and hits me.  She screams when someone hasn't even done anything wrong.  She will make a small comment into a huge injustice to her.  She slams doors, screams, hits, throws and if I try to calm her, she says similar things  as your daughter.  She shows no remorse.  She may know it is wrong, but says she doesn't know why she is mean.  I have begged her doctor to give bipolar a look at.  Her diagnosis is Aspergers, but they are taking that out of the spectrum as a disorder, so we are back to square one.  Every now and then, I catch a glimpse of her kindness and sweet self, but rarely.  She scares me.  The whole family is in pain.  It would be great if someone could help, but so far nothing.  She is too young, they say.  Too young, but not too young to hurt us, the cats, to have severe anger issues.  I have tried discipline and it laughable how ineffective any of it is.  I have been making her stay in her room, and that is a constant struggle.  Any way, I am sorry for you.  I pray for answers.
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Avatar_m_tn
      Discipline is a really tough thing to do.   For it to work it has to be very immediate and consistent- with a big underline under consistent.   Also, experts say that it takes at least 3 weeks of consistent actions to see a change.  All to often, parents give up on a method too soon - which a bright child will figure out and use to there advantage.
     One of the best books out there that lays out a system that could help you is  "SOS Help for Parents," by Lynn Clark.  Its worth your time to check it out.
      Also kids do need to be taught how to deal with their anger, etc.  There are  several great sets of books which are meant to be real aloud to the 4-7 year old age group.  A good starting point might be here.  "Cool down and work through anger."  http://www.amazon.com/Cool-Through-Anger-Learning-Along/dp/1575423464/ref=pd_sim_b_5
   If you scroll down you will see other books that will be helpful.
   Finally, she apparently is at school, but I don't know how old she is or what grade she is in?  There definitely are things that a school can do.  But if the problem is mainly at home - then the resources I mentioned above will help you.  Best wishes.
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My daughter is 4 and she is not at school.  She goes up to my oldest daughter's school. My oldest is 12 and we do not have these issues with her.  So many people immediately go to the discipline thing with me.  When I say we have tried everything, I am not kidding.  Books, therapy, and of course consistant discipline.  If I didn't my oldest one, I would consider what you are saying.  You can ask her now if I ever waver and she can atest to the fact I do not.  I am the one of the most strict parent I know.  I have had to teach her how to know her feelings.  Even now, we have discuss what feeling someone has.  She does not fully understand her feelings, I already know this.  I guess at this point, there is no help.  I get the same advice and it is beyond me.  Thanks any way.
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     When you said, "  I have had to teach her how to know her feelings.  Even now, we have discuss what feeling someone has."  I realized that I had overlooked your statement about her beginning diagnosed with Aspergers.  And, of course not being able to express oneself is a component of that.  But you shouldn't be the only one having to help her learn how to deal with that.  Early intervention is extremely important!  The public schools are typically set up to help in that situation.  Also Aspergers was not taken out of the spectrum but was folded "under autistic disorder (autism spectrum disorder), which would be rated on a severity scale." In other words (I believe) it is now under the Autism spectrum. So unless I am missing something - this should be followed up.
     And, of course, the discipline for a child with Aspergers/Autism would be much more difficult.  And I have noticed from the many posts over on the child behavior forum that disciplining a 4 year old is not an easy task anyway.  But the book I mentioned is a good one - highly recommended - and if you haven't read it, it would certainly be worth your time.  
     Hope this helps a small bit.  Can you provide more info on the Aspergers?
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Hi,  if you live in the United States, your daughter would qualify most certainly for early intervention.  The public school system by law must provide evaluations, preschool, and interventions as necessary for her.  They actually WANT to do this because she will be kindergarten age soon enough and they'd rather work with her before she gets there.  You should contact your local school system about this immediately.  Services that they could provide include such things as occupational therapy.  I mention this because my son does occupational therapy.  They work on so many aspects of behavior there including emotions.  They go through ways to identify what emotions others have---  practicing by acting things out, looking at pictures with facial expressions, etc.  and spoon feed understanding emotions.  My son had some difficulty with this----  we went through OT and worked on it and I checked out lots of books at the library written for kids on emotions.  'Giving her the words for it might help.  

I would also say that setting boundaries is important but things like saying she is evil isn't helpful.   Bad behavior in a child with developmental delays is often an outreach of the difficulty they have.  A child that had a meltdown in school when the other kids are drawing and throws her pencil is maybe doing that because fine motor skills are not refined for her and she is finding the task quite difficult and frustration and then her nervous system isn't regulated and she doesn't have the tools to express the emotion of frustration yet so she reacts.  This isn't evil but an extension of what is going on with her  This is when we work to give her the anger management tools but identify the trigger of holding a pencil as something she needs to work on to be less frustrated overall.  

I picked what I disciplined for and made sure that if was related to the disorder, that we worked on it from that angle verses just being upset my child acted out.  This is just a suggestion from a parent that has been there.

Aggression in aspergers kids is actually common.  Perhaps you should see a developmental pediatrician for advice and treatment.  Most children's hospitals have them and it is worth a trip if you don't have a children's hopsital in your area.  

I can't stress enough how early intervention is key to geting a child to function well in society.  So please follow up with that in your area.  good luck
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