Monday, February 21, 2011

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.


  1. This sounds all too familiar to me. With an adult not a child but still. Ugh.

    Hiccups? That's really interesting I'd never put together nor the dilated eyes. Some things are making a lot more sense to me now.

    Thanks for assimilating. Eye opening indeed!

  2. although my sons have other dxs, i often wonder if there is not bipolar too since it runs in our family.

    It must be hard to deal with. i hope things get easier.

  3. Oh my gosh, that is astounding. It's amazing what the brain can do when something goes wrong.

  4. Hiccups! I get hiccups a lot too. I wonder if there is a pattern to when I get my hiccups. I will have to watch and see now.

  5. Do you feel relieved at all now that you know what to look for? Like at least you know it's coming, even though you can't do anything about it? I hope that as she gets older that if her mania continues, it will continue to be something more on the pleasant side.

    You rock!



  6. I know nothing at all about thsi topic, and so I'm just going to say - this is very, very interesting. The brain = frankly terrifying, imho.

  7. my good friend,gets hiccups quite often, they also suffer from bi-polar. hmm.

  8. my son with bipolar had all of the same kinds of tells when he was a kid--flushed cheeks, dilated eyes, the inability to sleep. one of the things that we found was that this behavior ramped up during the winter months when it was not light very long during the day. it helped him to have some time in really bright light every day.

    as spring approached, we'd see a shift in behaviors as well.

    it was zero fun.

    hope you find an answer that works for you. soon.

  9. wow, I never realised the hiccup thing either. 11 sleeps, hang in there.

  10. I can't say that hiccuping has anything to do with it, it's just something I noticed happens at the same time.
    I wondered if anyone else's kid would have the same "tells"! I almost wrote that, then I thought, nah. Go figure!
    The brain really is amazing. Before Genea I did not realize that a person having bipolar would have physical signs and symptoms as well as emotional/cognitive symptoms.
    It does make me want to scream though. If it can change itself up like this, then CHANGE BACK.

  11. We are dealing with the same thing here. S is only 5 so they have labeled him as having a General Mood Disorder but we all know it's Bipolar. I haven't noticed the pupils dilating, but his voice gets very high and loud, his face is flushed and he has ZERO impulse control. He laughs hysterically over nothing, sometimes for 20-30 minutes straight. He tries to tell jokes and be funny but he just isn't except to himself. He also doesn't sleep as much during the manic times, and his sleep is filled with vocal outbursts and lots of movements. And the worst thing? He never shuts up. He talks non-stop in that high-pitched loud screechy voice, babbling on and on about nothing. Most of it doesn't even make sense. It is exhausting but it only lasts a few days usually.

  12. I can't imagine how hard that is, although we have had some of the manic behavior at times. Ours is usually from an ADHD med change (as in now). I was sick last week and the husband gave our 6 yr old her new dose of meds later on the weekend and she was still up at 10am. She didn't sleep in either.

    You are a good mommy to be there with her through the hard times.


  13. Yep, that's bipolar all right. One of my BILs has it and when he's manic he's Mister Big Fun, witty, expansive and up for almost anything. It's as if he's high on free cocaine.
    I think that's why Genea is so agreeable and pleasant to be with when she's on an upswing; she's feeling very, very happy.


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