what is it? bipolar, ocd, anxiety, or just temperment?

Please help.  I have an 8 year old daughter whom we're all walking on egg shells around.  When she was about 4 I took her to a child phychologist who diagnosed her with ocd, generalized anxiety, tics, separation anxiety disorder and selective mutism.  I was referred to another Dr for medication.  She was put on prozac and seemed to do well for a while, but she still had extreme episodes of crying.  We then tried paxil which seemed to induce mania in her.  Then, she was put on Risperdal.  I finally stopped medication all together and have been working with her for the last few years on behavior.  She is a model student at school who gets good grades.  She has an incredibly sweet side and is regretful when she acts out.  But lately her outbursts, mood swings and irritability are making us all miserable. She suffers from "not feeling good" often and finally explained to me it means she feels like crying.  I've read all the books: The bipolar child, Parents guide to Tourettes, the strong willed child and they all sound like her. So what is it??? Counseling has always been difficult as she will not leave my side and she'll take one little comment made and run with it. Thanks in advanced for any suggestions.

[Kevin Kennedy, Ph.D.]

Your daughter may well display anxiety disorder (e.g., Separation Anxiety Disorder) alongside mood disorder (e.g., Biploar Disorder). Biologically-based emotional disorders are best treated (unless they are very mild in severity) with a combination of therapy and medication. It would be prudent to re-evaluate her plan, and consider using medication again, in addition to some therapy.

[walkinoneggshells]

Thank you so very much.

[Anai Rhoads]

Dear walkingoneggshells,

To be honest, it sounds like your daughter is experiencing a normal - drawn out withdrawal effect from stopping anti-depressants. I have read many stories and personally can tell you as well that stopping medication such as paxil can lead to up to 3 years of after-effect.

The mood changes are very normal. I wouldn't advise putting her back on anything, but rather seek a psychologist that is familiar with cognitive therapies. These medications work as long as they are the right meds and are a permanent fixure in the person's life. Stopping them is a nightmare.. almost literally.

Paxil was touted as the best new anti-depressant on the market, that is "non-habit forming". It didn't take long before England removed that claim, yet America has not. The commercials here still claim that Paxil is not addictive.

This is not to say everyone will become addicted to it, some become ill on it and have residual effects long after a minimal dose was administered while others it works perfectly.

The withdrawal problem nearly everyone experiences. Be patient with your daughter, her outbursts can be expected.

If you need more advice - please write to me. I will check the boards often to see how you're coming along.

Best,

Anai