A Flip of a Neurological Switch

Genea was diagnosed with Early Onset Bipolar Disorder a few years back. The psychiatrist who did the diagnosing was an expert on that particular disorder and a brilliant, fantastic doctor who was willing to do everything in his power to help a hurting child. As with most kids who get to the point of requiring psychiatric intervention, she meets the standard diagnostic requirements for several disorders. And it could well be that she does have a few more pegs in her bucket but the fact is that we treat to the symptoms and not the label. Some days I think it's the RAD that is dominant, other days it is "the age of seven" that is where things stem from. Today, the past several days, it's the Bipolar shining through.

Genea has become manic. It happens every few months that she really spikes up high on the scale for a few days like this. She starts to move as if she has cerebral palsy, or another movement disorder. She becomes stiff when she walks and her movements almost look stabbing. Jerky, abrupt, she overshoots her target most often but undershoots as well. She sounds like she weighs 200 pounds when she walks. Boom, boom, boom. She cannot sit still. It's not just that she cannot sit still, her body moves, it just goes. She can be sitting down and her arm will jut to the side, her leg will go into the air or her knee clunks on the ground. She knows it is going on, she can stop some of it, and she can minimize it if we help her but she also forgets and then it starts all over.

She doesn't walk, she races. She zooms. She moves so fast we don't have time to tell her to "walk when you're in the house", she is already where she was going and has returned before we can say a full sentence.

Her voice becomes loud. She laughs when it's not funny. When I say something to her, she bounces her 200  pound self immediately over to me at the speed of light and sticks her face an inch from mine, opening her features wide. Her reactions look like those of a bad soap opera actress, pitifully insincere and overblown.

I would think her focus would suffer mightily but it isn't too bad. She manages to play with her sister, in fact, this is really strange to me, she is pleasant to play with and refrains from the negative instigating that usually makes up her play skills. She can sit and watch a movie or a few cartoons. 

Impulse control? Not a shred. Three things happen simultaneously...... see/want/do.... there is no time between the thought and the action. 

She is not irritable or easily frustrated. Oddly. She is happy and agreeable. It's nice to be around her. Is that strange? It is, I know. I don't know how she gets here any more than I know how she gets into the deep sadness and hairtrigger anger of other times.

It used to be that I could tell a manic episode was coming because her pupils would be dilated. Other signs would start to come on and always, she had her big round eyes which were almost all black. That hasn't happened in a while and this weekend there was no warning. I've said before, it's like a freight train coming. There is no way I can stop it. On Friday I had noticed her voice was loud and her cheeks were red, flushed. But by then it had already started. She was wild, all over everywhere. Talking fast, losing her thoughts. Wide awake. Normally she needs 10 or so hours of sleep. During a mania she can't fall asleep. She barely becomes drowsy. On Friday night she was up. She goes to bed at 8 and when I went up at 10:30 she was still awake. Her new psychiatrist has told us that it is okay to give her an anti histamine or some melatonin. The Husband had already given her the anti histamine. It had no effect. None. I laid down with her for a bit, usually that will make her sleepy and she will say, "you can go now, Mama". Not this time. I went to bed at 11:30 and she was still flopping around. I fell asleep after midnight and she was still awake. I asked her the next morning and she said the last time she remembers looking at her clock it said 12:50. Wow. Do you think she slept later the next day? She did not. She was up by 7 am.

The other physical reaction she has is that she will get the hic-coughs all day long. For an hour at a time, then off for an hour, then they are back.

It's like a switch has been flipped in her little body and everything changes, is different for a few days. She loses a lot of control over her body but it doesn't seem to bother her. She is giggly, fun, funny. Silly. There isn't anything to do other than wait it out. Just as with the other, at it's worst there is little to do other than be with her through it and wait for it to dissipate.