View Full Version : Can Bipolar be misdiagnosed?...My son's experience.


franksmom
11-25-05, 12:15 AM
My question is this..can you be misdiagnosed bipolar and just be ADHD,
My son was diagnosed adhd then later diagnosed bipolar- there is NO family history. He went nuts on antipsycotics. They kept giving him more thinking he needed to stop his wild behavior...BUT the behaviors got worse the higher they went. Once they were stopped the rages and outrageous behaviors stopped.
He is now on a mood stabilizer-Triliptal- which makes him sooo hyper. Sleep meds make him very hyper. Ambien keeps him up ALL night.
Melatonin helps but takes so long ( I think because the Triliptal makes him hyper.)
I am so confused.
What are all these drugs doing to my son- if he is not actually BP?
Now they want to start Focalin. Im ok with that because I always saw the ADHD -BUT Im worried about the increased heart rate if the Triliptal is already making his insides race. And if these meds already keep him up all night what will the added stimulants do?
If anyone has any thoughts I would love to hear them...please.
Susan

Andi
11-27-05, 03:19 PM
Hi Susan, welcome to the forums:)

I don't want to discourage you but bp and adhd are often misdiagnosed and on many occasions comorbid. My initial suggestion would be to consider his symptoms and take in account the medications and the side effects that he has encountered thus far. Remember, not all meds will have the same reaction in each individual. One med does not eliminate the benefits that could be found in a medication that is under the same classification. Keep trying and keep a detailed list of the meds he has taken, the reactions he was having before, during, and after and give this information to his doctors. If you have questions, do NOT hesitate to ask your doctor what is going on. Gather your thoughts and questions before you contact him/her and let them rip. That's what they are there for. If your questions are not thoroughly answered or you feel put off by his/her attitude then I would consider a new doc.

I have personally been through several med changes before and during my formal dx. It took many years before we discovered that antidepressants were not a good idea and believe me, we tried just about all of them. Just as I have tried several stabilizers and antipsychotics. Itís all trial and error unfortunately.

Understand that this is just my advice/opinion. Given the limited info, this is the best I can suggest but I do hope you find the answers you're looking for. Good luck to both of you :)

barbyma
11-27-05, 03:23 PM
Ditto -- what Andi said!

Hang in there. If you, your doctor, and your son are tenacious about figuring this out, you will.

scuro
11-27-05, 05:52 PM
There is a good link right on this board.
http://www.addforums.com/forums/showthread.php?t=19800

MANIA VS. ADHD:

The differentiation of mania from ADHD is difficult. The response or lack of response to stimulant medications is not diagnostically helpful. Elevated mood and grandiosity are the symptoms best able to distinguish between pediatric bipolar disorder and ADHD. With bipolar disorder, hyperactivity may be more episodic. However, ADHD may be the first manifestation of mania and is often comorbid with mania in children. An overwhelming majority of manic youth also have ADHD. Almost one quarter of youth with ADHD meet the criteria for mania. Prepubertal onset bipolar disorder is a nonspecific chronic rapid cycling mixed manic state that may co-occur with ADHD and conduct disorder or have features of ADHD and/or conduct disorder as the initial manifestation. The high rate of comorbidity of ADHD with bipolar disorder may be an age dependent child manifestation that will decrease with age. The onset of bipolar disorder in patients with a history of ADHD is often between 11 and 12 years of age. Many children who develop bipolar disorder develop a depressive disorder first. Of youth with major depression, up to 1/3 go on to develop mania/bipolar disorder.

WHAT IS MANIA IN CHILDREN?

Mania in children is seldom characterized by euphoric mood; the most common mood disturbance is severe irritability with "affective storms" (prolonged and aggressive temper outbursts). In between outbursts, these children are described as persistently irritable or angry. Manic children often have a decreased need for sleep-not insomnia, but an ability to function well on less sleep than normal. These children frequently receive a diagnosis of conduct disorder. Aggressive symptoms may be the primary reason for the high rate of psychiatric hospitalizations in manic children.

SYMPTOMS WHICH DISTINGUISH MANIA FROM ADHD:

Children are incapable of presenting many manifestations of bipolar symptoms described in adults. Studies have shown that five behavioral symptoms in children/early adolescents aid in correctly diagnosing childhood bipolar disorder. These manic symptoms which do not overlap with ADHD are elation, grandiosity, flight of ideas/racing thoughts, a decreased need for sleep, and hypersexuality (in the in absence of sexual abuse or overstimulation). These five symptoms provide the best discrimination of childhood/early onset bipolar patients from uncomplicated ADHD patients. Irritability, hyperactivity, accelerated speech and distractibility are frequent in both pediatric bipolar disorder and ADHD and are not useful in differentiating between the two disorders. Mixed mania (simultaneous mania and depression) is highly prevalent in childhood bipolar disorder.