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PostPosted: Thu Oct 04, 2007 8:24 am 
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Location: Kuala Lumpur

Bipolar disorder in children

The attached Readers Digest story is about a condition that is now diagnosed 40 times more frequently than 10 years ago.

Please review all that I have said about the October 6th National Geographic article The Pollution within Us and download it under Townsend on my website.

If this is your patient try to see that the anti-psychotic meds being prescribed are stopgap only and are not treating the causes.

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Yes, we need to put the best possible stuff in and learn to use these simple things like Zeolite (AZC nano) and Fiber and higher doses of Vitamin C to get bad things out. Please realize that although this child no longer hears voices, his condition is not due to a deficiency of antipsychotic drugs.

Now, at age 11, Michael is taking an antipsychotic medication, a mood stabilizer and, to help him sleep, melatonin, while Dr. Papolos closely monitors his symptoms and adjusts the doses. Many of these potent drugs, which can have serious side effects, are being prescribed off-label, without FDA approval for children and adolescents, because so few studies have focused on this age group.

Garry F. Gordon MD,DO,MD(H)
President, Gordon Research Institute

What™s Happening to My Son?
Something was fueling Michael's disturbing behavior. His parents needed answers.
By Irene S. Levine, PhDFrom Reader's DigestOctober 2007

The First Signs
There were signs that something was wrong with Michael Bonis from the time he was a baby. While bright and responsive, he didn't sleep much and was prone to tantrums. His behavior was so different from his sisters, his outbursts so vague and sporadic, that his mom, Janice, chalked it up to his being a boy until she couldn't ignore it any longer.
It never occurred to her, or to many doctors, that Michael might have bipolar disorder. As recently as a decade ago, many experts thought the disorder (also called manic-depressive illness) was found only in adults. But in the past few years, more and more kids are being diagnosed. Mental health professionals have been rethinking the criteria after finding that many adults with bipolar disorder claimed to first experience its symptoms in childhood. An estimate in a Harvard Medical School newsletter said that about 1 in 200 youngsters is affected, though this is controversial: Some say the number is too high and that too many kids are being medicated for mood swings. But after watching their child slowly unravel for years, Michael's parents were at the breaking point.

First Signs
Michael was far more exhausting to take care of than any of Janice's three daughters from her first marriage. After she returned to her job as a marketing operations manager at Unilever, near their Trumbull, Connecticut, home, Michael seemed to adjust to day care. But things went downhill when he turned three and she enrolled him in a nursery school. He became inconsolable when she left, and cried on and off until she returned. The problem persisted throughout kindergarten and first grade. He would sometimes dart out the door of his school, following her to the parking lot. Whenever that happened, the teachers chased after him and brought him back.

Janice will never forget the day in second grade when Michael pounced on her in the hallway, desperate to stop her from leaving, ripping out a clump of her hair. A social worker and several aides were called to get him off her. She didn't know whether she was more frightened or embarrassed. That same year, her husband, a heating contractor, got an urgent call from the school. Michael was screaming and kicking, wanting to leave, says Michael Sr. I rushed there to stop him from hurting someone.

His teachers thought it was separation anxiety. Janice figured that they had far more experience than she did, so she trusted their judgment. For almost two months, she brought her work to Michael's classroom, sitting at a tiny desk beside his. But if she made a move to leave, he flew into a rage. There was no routine for me. I never knew what to expect, she says.

Getting Worse
Instead of growing out of it, Michael became increasingly irritable and unmanageable at home. His moods changed like a roller coaster, and no one could predict what would set him off. Sometimes it was simply the word no. We recognized what we started calling the look, says Janice. His eyes became almost feral when he was about to explode.

When Michael went into a rage, it was like a tornado hitting. He threw telephones and chairs, bashed mirrors, kicked in doors and broke the glass door of the bathroom medicine cabinet more than once. After each outburst, he was either remorseful or oblivious to what had happened.

He became more reluctant to be apart from his mom or dad. He stopped attending birthday parties and refused to go to school. This meant that Janice could no longer go to her office. She tried to work from home, but there were times when Michael broke keys on the computer, turned it off at whim and hovered over her, sabotaging her business calls. Until her husband came home from work, there was little respite.

Everyone had a different idea about how to handle Michael. Well-meaning friends and relatives accused Janice and Michael Sr. of being either too strict or too lenient. Michael’s just spoiled and needs a good spanking, said one of them. Although Janice was a confident mother, she began to question her parenting skills. The Bonises knew something was different about their son, but they reassured each other that he would outgrow it.

The Sports Star
One place where Michael excelled was the baseball field. From the age of five, he was always the first one to show up for Little League games. He would eagerly suit up in his royal blue T-shirt and white baseball pants to warm up with his father, a volunteer coach. A standout athlete, Michael played shortstop and pitcher, and when he was on the mound, everyone was confident he would strike out the other team.

On the last day of second grade, when Michael was seven, his team had made it through the semifinals. Janice was packing a cooler for the championship game that evening when Michael's scream came out of the blue. I'm not going, he bellowed.

œMichael, your team needs you, said his mother, who couldn't imagine what had gotten into him.

I'm not going, he repeated, his dark eyes welling with tears. His father and mother begged, cajoled and tried to reason with their son. The more they coaxed him, the more defiant he became. When they threatened to go without him, Michael ran in circles around the front lawn, then dashed up and down the street. Finally he returned, banging furiously on the car window.

When Janice opened the passenger door, he hopped in without hesitation. It was like a switch had turned off, she says. They arrived at the field 15 minutes before the game. Michael warmed up and went on to get three hits and pitch four shutout innings. He helped his team win the game, after which his excited teammates piled on top of him. His parents savored the moment and beamed with pride. But that evening, Janice replayed the incident in her mind and felt bewildered.

Searching for Help
Things got much worse. Michael was only seven the first time he threatened to hurt himself. Janice had found him banging his head against a wall and thrusting a carving knife inside his mouth (luckily he was not hurt). She frantically called the pediatrician, who recommended that she take him to a child psychiatrist immediately. This began a long and confusing string of visits to different doctors and trials of medications.

The first psychiatrist gave Michael a pill to calm him down, diagnosed him with panic disorder and prescribed an antipsychotic medication to take as needed. He warned the Bonises to lock up any sharp objects around their home until he saw Michael again. Two days later, Michael was admitted to the hospital as an outpatient and given a comprehensive psychiatric evaluation. The doctors added an antidepressant to Michael's medication, and he was discharged with three diagnoses: panic disorder, generalized anxiety disorder and separation anxiety.

Third and fourth grades were an on-and-off struggle. But through it all, even when Michael was treading water in school due to erratic attendance, sports remained his lifeline. Depending on the season, he played baseball or basketball, in pickup games or on organized teams. That's the one time I saw him enjoying himself, says Janice, really being a kid.

Hitting Bottom
In July 2006, things just crumbled, says Janice. Michael's rages and temper tantrums escalated. His friendships were dwindling because he had no desire to be with other kids. At home, he was literally bouncing off the walls, Janice says. He was cursing and punching his parents, jumping on sofas, throwing appliances and kicking holes in the walls. We never knew when this monster would show up. One day, he grabbed a kitchen knife and held it to his chest and, while standing atop the kitchen table, reached between the revolving blades of the ceiling fan with his pitching hand. When the Bonises took their son to the ER of the local hospital, they were sent away and told there was nothing the hospital could do for him. But soon Michael began taking more risks, such as trying to jump out of a moving car.

An Answer, at Last
It was a few weeks before Michael was to start fifth grade, and the Bonises were at wit™s end. Then the child psychiatrist came to the conclusion that Michael had all the signs and symptoms of juvenile bipolar disorder He prescribed an antiseizure drug that stabilizes moods.

That evening, after everyone else was asleep, Janice got on her laptop and went to the website of the Child & Adolescent Bipolar Foundation. She scrolled to the list of symptoms. Rapidly changing moods, explosive rages, separation anxiety, sleep problems, defiance of authority, she read, saying to herself, This is my kid! It was a revelation.

In the chat room, she found other mothers in similar situations. She learned about the book many parents consider a bible, The Bipolar Child: The Definitive and Reassuring Guide to Childhood™s Most Misunderstood Disorder, by Demitri Papolos, MD, and Janice Papolos. She ran out to buy it.

It helped me put all the pieces of the puzzle together, says Michael's mother. Once you know what it is, you can treat it. I'm not upset to know that Michael has bipolar disorder. It was more upsetting that I wasn't smart enough to recognize the symptoms.

Soon after the start of fifth grade, Michael and Janice visited Dr. Papolos at his Westport, Connecticut, office. When Michael met privately with the doctor, the child revealed a startling secret he had never shared with anyone: He was hearing loud voices telling him to hurt his mother, and he had seen monsters and frightening men chasing him. Children with bipolar disorder can experience hallucinations and delusions and have often been misdiagnosed as schizophrenic.

At Dr. Papolos's suggestion, Michael saw a neuropsychologist for further testing. Both doctors agreed that Michael had bipolar disorder. œChildren with the disorder veer from being irritable, easily annoyed and angry, to silly, goofy and giddy, and then just as easily descend into low-energy periods that they experience as intense boredom, followed by depression and social withdrawal, often with self-recrimination and suicidal thoughts, says Dr. Papolos. They suffer from severe separation anxiety, generalized anxiety and panic disorders, as well as obsessive-compulsive symptoms, including hoarding and ritualistic requests for reassurance.

Why hadn't any professional diagnosed it earlier? Janice asked Dr. Papolos. He used the analogy of the blind men feeling an elephant. Obsessive behaviors, depression and anxiety are only parts of the illness. If you look at them individually, you miss the fact that they are all part of the same disorder.

The Road Ahead
Now, at age 11, Michael is taking an antipsychotic medication, a mood stabilizer and, to help him sleep, melatonin, while Dr. Papolos closely monitors his symptoms and adjusts the doses. Many of these potent drugs, which can have serious side effects, are being prescribed off-label, without FDA approval for children and adolescents, because so few studies have focused on this age group.

But for Janice, the proof is right in front of her eyes. Michael's auditory and visual hallucinations dissipated and are finally gone. His meltdowns, which used to occur 10 to 12 times a day, became fewer in number, less intense and shorter in duration. For the first time in his life, he has been sleeping like a normal kid. He's come a long way, she says.

We're so lucky to have good doctors and to be able to afford the medicine, adds Janice. If not, where would Michael be? She answers her own question: He would probably be placed in juvenile detention. Without understanding it, you see a terribly misbehaved kid.

The Bonises recognize that pills alone won't solve Michael's problems. He missed more than 130 days of school last year. His parents and doctors believed that a therapeutic day school with small classes and trained staff would provide a more appropriate education, but it took until last May for the plan to be implemented.

No one knows how Michael will do as he enters adolescence, which can be difficult for any kid. Dr. Papolos recommends that teenagers take responsibility for their medications to avoid a power struggle with parents. Bipolar teens also have a greater risk of becoming addicted to recreational drugs. But Michael’s family is optimistic. I’m sure that medications will change over his lifetime, says Janice. I expect a shot or a patch, or even some kind of brain fix, to provide him extended relief.

Today Michael is five feet tall, 115 pounds, with jet-black hair, sparkling dark eyes and dimples that appear when he smiles. He’s affectionate to his older sisters and his pets: four small dogs and a cat. His warm personality and exceptional athletic talents have been a blessing providing him with opportunities to socialize with other kids and to excel. Michael plays baseball two or three times a week, six months out of the year. For those few hours on the field, everyone in the family feels normal. That’s the glue for right now, says his dad.

PostPosted: Sat Oct 13, 2007 8:22 am 
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C1: Every child I have seen who was diagnosed as bipolar actually had hypoglycemia and food allergies causing the symptoms.
Mary Ann Block, DO

PostPosted: Sat Oct 13, 2007 8:22 am 
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Joined: Sun May 14, 2006 11:30 am
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Location: Kuala Lumpur
C2: What crap! This is basically a PR piece to justify the diagnosis of bipolar disorder in young children and then use potent CNS drugs. This happy ending is the exception to the rule in these cases. No causes seem to ever have been looked for, much less treated in this child. Let's see what happens when he's in his 20's and 30's, and the affects of all of the drugs catch up with him. I wonder how the publication got this story?

Dr. Ted Cole

PostPosted: Sat Jan 02, 2010 7:06 pm 

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PostPosted: Sun Jun 03, 2012 8:23 am 
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