She said the "B" Word!

It's not the first time I've heard it.  Many people don't have any idea what it means.

Bipolar!  

Hearing that word from the psychiatrist's lips this morning was like being punched in the gut.  Having grown up with a mother who had been diagnosed with Bipolar Disorder, I understood the ramifications of the "B" word. From the moment I knew I was expecting our first child, I have carried around the fear that one of our children would be diagnosed with bipolar disorder.  My sister and I prayed we would not ever have to deal with mental illness ourselves or in our families, knowing that there was a chance that we or our children could inherit it from our mom.

Going back for a med recheck, I shared our son's IEP and the fact that he was now attending a therapeutic day school with our pediatric psychiatrist.  She asked some questions about family history and read through the evaluation.  Then she said the "B" word!  She suspects that our son may be dealing both with ADHD and Bipolar Disorder and prescribed a mood stabilizer that was familiar to me because my mom took it.

For those who are not familiar with this term, bipolar disorder used to be called manic depression.  It is a disorder affecting the neurotransmitters of the brain causing a person to shift from periods of extreme manic behavior to episodes of severe depression. These shifts can happen every few months.  The person with bipolar disorder can have well periods in between or shift from a manic state directly into a depressive state.

According to The Bipolar Child by Demitri Papolos, M.D. and Janice Papolos,

"Bipolar disorder in children presents very differently from how it presents in adults. Children rarely fit the same recognizable pattern  They may have a more chronic course of illness where they cycle back and forth with few discernible well periods in between.  Some tend to cycle rapidly (more than four times a year); some cycle within the week or month...and many cycle so rapidly that they fit a pattern  called ultra-ultrarapid cycling).  They may have frequent spikes of highs and lows within a twenty-four-hour period.

Almost all bipolar children have certain temperamental and behavioral traits in common.  They tend to be inflexible and oppositional, they tend to be extraordinarily irritable, and a large majority experience periods of explosive rage."

Now that you have a basic understanding of the disease, let me tell you why this word induces fear in me. ADHD seems pretty commonplace and accepted in our culture.  There's an opportunity to appreciate and focus on the positive traits of ADHD.  With a multimodal approach to treatment, a person can have a pretty normal life.  However, Bipolar Disorder is labeled as a mental illness.  It is considered a disease that requires medication.  A person with bipolar disorder can lead a pretty normal life, but the mood swings can be extreme and come with life altering consequences.  Medications are very important in treating it.  Bipolar also comes with a stigma.  When I was young, I remember my mom telling us not to tell anyone about her illness. She did not reach out for support because of her fear of being stigmatized.  There was another man in our community that also had Bipolar Disorder who was nicknamed "Crazy Ed".  He would wander the streets in our neighborhood and all the kids were afraid of him. Looking back, I am sad that even my parents didn't dispel the rumors about Ed.

Though it's not certain that BD is what my son is dealing with, I don't want him to carry the stigma of that label around with him.  He's a wonderful kid with a colorful personality.  Our approach to him won't change. We continue to focus on his strengths and work with him to recognize and deal with his emotions in a productive way.  If he indeed has BD, I will grieve for him (and me) knowing the challenges ahead, but I am thankful we have gotten help when he is young, knowing that early intervention may save him from carrying negative coping mechanisms  into his adult life.  We proceed with much prayer and taking it a day at a time.