Since no one reads on a weekend anyway...

I took Genea to the psychiatrist on Thursday. He has known her since she was with the first family, so about 3 years. Whenever I get in the office with him and Genea I seem to lose my ability to communicate, I forget everything I wanted to mention, and what I do manage to eek out makes no sense. Why is that? Got no idea. I have no objectivity, I am Genea's Mom. So this time I made a list. I went around and collected a list of symptoms for childhood bipolar disorder and for reactive attachment disorder. Then I highlighted everything that fit and emailed it out a few days ahead of time. I also included a list of things I see as on going problems that do not seem to fit anything. PLEASE keep in mind that I do nOT see Genea in only this negative light. As her Dr will say himself, (the only male doctor I have ever met who has any sense), he is not there to hear about her accomplishments in table setting or that she likes cheese. He needs to hear what the problems are to put the pieces together to make an accurate assessment.

I am shrinking my font because this is so very long!
May 18, 2009
Here is a list of symptoms from a diagnostic list of child and adolescent bipolar disorder on cabf.org everything in bold is something I see in Genea.
An expansive or irritable mood
Extreme sadness, unwillingness to play
Rapidly changing moods lasting a few hours to a few days
Explosive, lengthy and often destructive rages
Separation anxiety
Defiance of authority
Hyperactivity, agitation and distractibility
Sleeping little or alternatively sleeping too much
Bed wetting and night terrors
Strong and frequent cravings often for carbohydrates and sweets
Excessive involvement in activities and projects
Impaired judgement, impulsivity, racing thoughts and pressure to keep talking
Dare-devil behaviors
Inappropriate sexual behavior
Delusions , hallucinations
Grandiose belief in abilities that defy logic
Genea shows all of the above except for the last 4. Night terrors are infrequent and defiance is fairly minor although is elevated. Rages are explosive, over minor snags and not usually destructive.

Attachment Disorder diagnostic criteria from attach.org
Superficially engaging and charming
Lack of eye contact on parents terms
Indiscriminately affectionate with strangers
Resistant to affection on parents terms
Destructive to self, others and things, accident prone
Cruelty to animals
Lying about the obvious
Stealing
No impulse controls, hyperactive
Learning lags
Lack of cause and effect thinking
Lack of conscience
Abnormal eating patterns
Poor peer relations
Preoccupation with fire, blood, gore
Persistent nonsense questions and chatter
Inappropriately demanding or clingy
Abnormal speech pattern
Triangulation of adults
False allegations of abuse
Presumptive entitlement issues
Parents appear hostile, angry


Here are some of our daily issues:
Frequent urinating on self, in cycles
Binges on liquids, deliberately setting self into coughing episodes
Tactile defensiveness yet craves touch and pressure
Stiff, always stiff. Toe walks, muscles are tense even when sleeping.
Falls, trips, knocks things over many times an hour- is able to stop
Able to spontaneously vomit
Hurts sister without cause, expressionless both at the time and when caught
Unable to occupy herself, polar opposite of previous behavior
Able to maintain herself well in school. Report cards are really good. Teacher loves her (not just saying that, I think she really does). They note a delay in physical abilities, both fine and gross motor.
She may need glasses, going for appointment.
Her short term memory is terrible. It feels to me like she sees her days as one mountain after another and once she has pushed through her day that’s it, like it never happened. For example, she rarely remembers what she had for lunch. Even though we ask daily, she is only just recently able to pluck out events to tell about. Then it is usually something that caused her stress, such as a child being absent that day. Or, the day there was an unexpected substitute teacher wow, she just blew up when she got home.

Previous diagnosis’
Failure to Thrive ages 28 months to 4 years old. No growth or weight gain
Autism- Moderate, probably inaccurate, age 3
Addisons syndrome (similar to) age 3 to 5
Anaclymic Depression

She will go to time out and will do as told for consequences. Since I have started her doing jumping jacks when she takes on her vacant expression to “get her brain unstuck” her brain is much less stuck. Also has stopped coughing on liquids since I gave her a spoon to get her liquids with. I did it for one day and she quit choking entirely when she got her cup back. Have her in diaper at school after 4th wetting incident in about 3 weeks time. She loves it. I have her paying me back for the extra expense of the diapers by doing a ‘nasty’ chore every time she comes home with a wet diaper. So far, only one day with a dry diaper. But, a lot of nasty chores are getting done.

Spontaneous tantrums have reduced slightly. Able to accept ‘no’ about 20% improvement. Does not go to full blown screaming crying fit immediately as first reaction to every thing she doesn’t like. However, will go to it as second reaction when she does not get what she wants. VERY unpleasant past 2 weeks or so. Have stepped up strong sitting and tapping, using more restrictive therapeutic parenting (Nancy Thomas).
I see cycles with Genea, usually it is 2-3 weeks of sort of stable behavior then 1-2 weeks of explosive wild behavior. She reports feeling nervous, or worried often.


So that is what I sent them. After much discussion, we increased her medication in order to try to stabilize her moods more. Hopefully if that works, we will be able to effectively address some of the behavioral manifestations of her neurological imbalances. It has been 2 years. Originally I heard a lot of "its going to take time" and "you are trying to rush it" but I don't think that can be said anymore.