Bipolar Teen

Mark-

The diagnoses is in - he's got bipolar. This is what we thought all along based on the info on your site and your emails. Do you know how this is treated?

Thanks,

F.

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Hi F.,

Once the diagnosis of bipolar disorder is made, the treatment of children and adolescents is based mainly on experience with adults, since as yet there is very limited data on the efficacy and safety of mood stabilizing medications in youth.

The essential treatment for this disorder in adults involves the use of appropriate doses of mood stabilizers, most typically lithium and/or valproate, which are often very effective for controlling mania and preventing recurrences of manic and depressive episodes.

Research on the effectiveness of these and other medications in children and adolescents with bipolar disorder is ongoing. In addition, studies are investigating various forms of psychotherapy, including cognitive-behavioral therapy, to complement medication treatment for this illness in young people.

Lithium is a naturally occurring substance. As a medication, lithium reduces chemicals in the body that cause excitation or mania. Lithium is used to treat manic episodes of manic-depressive illness. Lithium helps to prevent and control symptoms of mania such as hyperactivity, rushed speech, poor judgment, reduced need for sleep, aggression, and anger.

Valproate is also an excellent mood stabilizer and is superior to lithium for mixed, chronic, or atypical forms of bipolar disorder in children. It has also been successfully used to treat aggression in patients with FXS and in children with autism.

Good luck - stay in touch,

Mark
Online Parent Support

SUCCESS is sooooo sweet...

Just wanted to let you know about my success last night. J___ met at a little Italian restaurant me for dinner last night since we were the only two home. Nice dinner, some nice talk - college lacrosse recruiting, Christmas, etc. As we were leaving the restaurant to get into our separate cars he asked to go to the soccer game. I said no and that it was not open for discussion. I told him if he went I would take the car away for 3 days. He tried to call my bluff and said that never works due to inconvenience. I told him my good friend had agreed to help me since my husband is traveling so much. Of course he began to argue - even pulled the "that girl I really like is gonna be there!" routine. I kept a slight smile on my face (no scowling!) and repeated myself several times. He continued to negotiate and all I said was no and I am not going to argue. He threatened, told me I was acting like a robot, said this is b....it - all the things you know he was going to do. I laughed at some of his antics to make it lighter but firmly held my ground. We stayed in that parking lot "discussing" for 22 minutes. (i would have left sooner but since I intended to FIRMLY hold my ground I needed to wait it out.) He left in a huff and threatened. We went in opposite directions and when I got home (probably 2 minutes after he did) his car was in the garage and he was watching TV. I came in and made a BIG deal about his cooperation - intentionally acting like an over the top fool so he would laugh.

SUCCESS is sooooo sweet.
THANK YOU!!!!!!!!!!

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Kudos for a job well done!!

Bear in mind there will be more episodes like this one. Be consistent. Hunker-down for the long haul.

Mark

Online Parent Support

Transportation Issue

Love this product. It is as if someone sat in our house for three days and watched what was going on in order to write it! Job well done.

I agree with everything you have said, but I am stuck re: consequences. My husband works in a different city so he leaves Sun nite and returns Fri nite. Our 17 year old son has a car - we thought to make our lives easier. He is responsible for taking his sister to school, getting himself home from sports practices and running an occasional errand. I work full time, have little to no flexibility during the day and have two younger children who also have activities.

We did take the car away for one week and it was crazy. My younger ones were left waiting for me while I picked up Mr. 17 and then he started to get rides from friends and was showing up even later - they went to McDonalds, to someone's house, etc. When I told him not to do that he said, "I'm not the one driving. I have no control. So & so had to take Johnny home, go to the mall to pick up his new shoes, etc, etc, etc.".

You may ask what we did before he had the car. At that time none, of the kids had cars so parents carpooled. Now, since most kids have cars, there is no carpooling available.

The CAR is the greatest consequence we could impose. Especially since most of our fights are around his "excessive" use of freedom and disregard for curfews. But how do I make it work for ME!

Thank you,

K.

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It sounds like a compromise may be the best route to go.

On one hand, the car is your son's most valuable item, thus making it a great tool to use during consequences -- on the other hand, your life is easier when he's able to drive.

How about a partial consequence?

That is, whenever you would ordinarily like to confiscate his car for discipline purposes, is it feasible to simply put just enough gas in the vehicle for him to take sister to school, get to sports practice and run an errand - but no further? This will take a bit of calculation on your part (i.e., estimating mileage here and there). On those occasions when he abuses the partial consequence (i.e., makes a few extra stops along the way), I think you have to inconvenience yourself and park his car (1 - 3 days).

If this is not feasible, let me know and we'll come up with plan B.

Mark

My Out-of-Control Teen

Bipolar?!

I am seriously considering buying your book and online course. However, I am a single parent of extremely limited means and want to ask you a question first.

My 14 year old son Toby just fell asleep after being awake for more than 24 hours. Is this a possible symptom of bipolar disorder? I doubt it is the first time he has done this, but it is the first time I have verified it beyond doubt, or perhaps that I have believed him.

When he was a baby and toddler I don't recall him ever sleeping more than two hours at a time. I used to lock all the doors,turn off all the lights, take a sleeping pill myself, and bury myself under a pillow so I could sleep. He seems to be having a resurgence of this in adolescence. And, he has become quite hostile when I attempt to discipline him re schoolwork.

Yes, he definitely has phases of extreme irritability, hates rules & teachers, is highly intelligent, has had depressive phases, has been suicidal.

I am currently homeschooling with a charter school. I have definitely tried everything in the school department and am increasingly tempted to give up and send him back to his Dad and the juvenile justice system where his half-brothers were when I met them.

His father and paternal grandma are alcoholic, his mother, aunt, maternal grandma have all been diagnosed with Anxiety Disorder, his maternal grandpa was alcoholic and had an IQ of 176. I believe there is a relative somewhere on Mom's side who committed suicide. No one in my family of origin has ever been diagnosed with bipolar disorder altho a couple of my father's best friends were.

My son and I have both experienced counseling and schooling that were completely useless.

I personally have experienced counseling, schooling, and psychotropic medication that were quite useful, but my son refuses to discuss this.

I would appreciate your comments.

Thank you

A.W.

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Re: Is this a possible symptom of bipolar disorder?

Possibly. Sleep can be disturbed by mood disorders, PTSD, substance abuse, ADHD, and anxiety. Many children have sleep problems. Examples include:

· Bedwetting
· Difficulty falling asleep
· Feeling sleepy during the day
· Frequent awakening during the night
· Having nightmares
· Talking during sleep
· Teeth grinding and clenching
· Waking early
· Waking up crying

Many childhood sleep problems are related to poor sleep habits or to anxiety about going to bed and falling asleep. Persistent sleep problems may also be symptoms of emotional difficulties.

Nightmares are relatively common during childhood. The child often remembers nightmares, which usually involve major threats to the child's well-being. For some children nightmares are serious, frequent, and interfere with restful sleep.

A range of treatments is available for sleep disorders. Fortunately, as they mature, children usually get over common sleep problems as well as the more serious sleep disorders (parasomnias). However, parents with ongoing concerns should contact their pediatrician or directly seek consultation with a child and adolescent psychiatrist.

Online Parent Support

OPS Newsletter

I enjoy your newsletter and use the information provided. I have had some good results with the tools. I thought I would still be receiving the newsletter for one year and would like to do so. Please advise. Thank you, L.J.

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Hi L.,

You can re- subscribe on the home page (subscriptions automatically terminate after one year). The newsletter is still free. CLICK HERE to go to the home page. Look for the sign-up box that reads: I want to receive weekly newsletters from Online Parent Support (under the chat room).

There you will also find a link to the newsletter archive and can get caught up on all the past issues you may have missed.

Thank you,
Mark

My 14-year-old daughter...

Dear Mark,

I'm writing again about my 14-year-old daughter. I have really tried to follow your plan to the best of my ability but unfortunately my husband and I are not on the same page. He has gotten a whole lot better but will often overlook things to prevent any conflict or explosive behavior or retaliation. I cannot speak for him but I remain firm on my issues and even when he does back me up she does not cooperate. Consequences do nothing for her. We cannot force her to do anything such as go to her room, take a shower, etc. nothing too difficult to comply with. I feel we have lost control of our home to this girl. We have had her in counseling for the last few years and family counseling for the last six months and things seem to be getting worse with the total defiance. She really hasn't done any raging since August but the tension in our house is almost unbearable. I have actually considered leaving; there is only so much I can take.

We have considered boarding schools but many of them require her to want to go there and ask for some sort of writing sample on the application, which she does not cooperate with. She is very bright and very athletic and that is why we have considered regular boarding schools. I have also looked into specialty boarding schools and they are very expensive although she does not have to agree to go there. While I was on your website I seen a listing for boarding schools and many are the same as the ones I have seen. What I would like to know from you is if you have any recommendations for the schools. Are there some in which you've had more positive feedback than others?

She has never been a problem at school mainly at home. She wants everyone at school to think the best of her but is totally disrespectful to her parents and immediate family. She puts on a show for the extended family. No one has any idea what we live with every day. I know this sounds like we are giving up or letting someone else take over but this has been going on for the last four years and we all need a break. We adopted her when she was little and she is our responsibility and we are not ignoring that or throwing her away but nothing we do seems to work, and that is why we are searching for the best possible solution for all concerned.

Any suggestions or recommendations you can give would be greatly appreciated.

Thank-you,

Frustrated

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I think the best help I can be to you at this time is to provide you with a checklist of sorts.

Let's trouble shoot...

Below is a summary of all the assignments I gave you in My Out-of-Control Teen eBook. If parents do not implement most of these assignments, it is often the "kiss of failure." For example, the transmission in your car has hundreds of parts, but if just one little tiny part is not working -- the whole transmission does not work. The same is true with this "parent program." Omit just one strategy, and the whole plan runs the risk of failing.

1. Are you asking your daughter at least one question each day that cannot be answered with a simple "yes" or a "no" to demonstrate that you are interested in what is going on in her life? (page 20 of the printable version of eBook)

2. Are you saying to her "I love you" everyday and expecting nothing in return? (page 20)

3. Are you eating dinner together at least one evening each week -- either at home or out? (page 20)

4. Do you use "The Art of Saying Yes" whenever your answer is yes? (page 25)

5. Do you use "The The Art of Saying - and Sticking With - No" whenever your answer is no? (page 25)

6. Do you catch her in the act of doing something right at least once each day? (page 25)

7. Do you use the "When You Want Something From Your Kid" approach as needed? (page 31)

8. Do you give her at least one chore each day? (page 31)

9. Do you find something fun to do with her each week? (page 54)

10. Do you use the "I noticed ...I felt ...Listen" approach when something unexpected pops-up? (bottom of page 50)

11. When you are undecided about what to say or do in any particular situation, are you asking yourself the following question: "Will this promote the development of self-reliance in my daughter, or will this inhibit the development of self-reliance?"

If it is supportive of self-reliance, say it or do it. If it is not supportive, don't!

12. Is she EARNING ALL of her stuff and freedom? (see "Self-Reliance Cycle" - page 19)

If you answered "no" to any of the above, you are missing some important pieces to the puzzle. Most parents DO miss a few pieces initially -- you can't be expected to remember everything! But don't get frustrated and give up. We must be willing to hang in there for the long haul.

I'm talking about refinement here. Refinement is a necessary tool to use in order to truly be successful with these parenting strategies.

HERE IS THE GOOD NEWS: Parents who refine are, on average, 95% - 100% successful at getting the parent-child difficulties reduced in intensity and severity (i.e., the problems are easily managed).

The same can be true in your case. Don’t give up just yet. Please continue to refine by emailing me as needed over the next few months. Refinement is a process, not a one-time event.

Mark

Online Parent Support

My Out-of-Control Teens

Hi D.,

Please look for these arrows below: ==>

Hi Mark: A lot has happened since my last email about 5 weeks ago. Our son B, 15, was arrested for battery on a school official on November 2nd. (He threw a piece of candy at a teacher from a distance at lunch time horsing around.) He was arrested for battery on a school official and the teacher dropped the charges but he mouthed off to the cop and resisted arrest without violence. He is in the juvenile system and as of today in a diversion program. As a result for this recent offense, he was up for expulsion but in lieu of that is assigned to an internet-based alternative school. He is very capable, making poor choices and hanging out with the wrong crowd.

==> This is a good thing. Most of my juvenile clients do very well in alternative school. The classroom is usually smaller and they get more one-on-one attention. His latest "Buddy" is an Afro-American 15 year old who is already a FATHER!! He is a foster child, living with six other foster kids with a single adult male. He has been going there all too often, against my wishes. Walks out of the house without permission, lies about his whereabouts and takes public transportation hither and yon. He got picked up by the police for sleeping on a girl's doorstep with the one mentioned above, they were both warned and let go.

==> If he leaves without permission, go to probation and file a runaway complaint. He was drug tested this morning. Negative except for a trace of marijuana and he admitted trying it three months ago. He is non-compliant at home, makes threats and breaks things to manipulate. All of this will be coming to an end.

==> Call the police and file a report whenever he destroys property. This gives your son’s PO more ammunition in court. Our daughter, A, 17, I found out today skipped school all day on Friday. I also found out today with a little research from a deputy, that her boyfriend is 21 and has his own apartment. Her Father signed a car loan for her on October 20th and now that she has wheels, it is harder to control her. She is grounded for a week and will lose driving privileges if she violates those terms. Her grades are great and she has maintained a job for over two years that she likes. I was going to have her battery charges on me dropped, but with her recent antics, we are going ahead. She has skipped other days too and forged her Father's signature on a note to get out of school.

==> I’m glad to hear you are not dropping the charges. I am hoping that they will both hit rock bottom and we will see some changes. They both have so much going for them, attractive, bright and I have already done their pre-paid college programs. They are making destructive choices. If Bart violates the diversion he will go through the court system and be on probation. All up to him. Any feedback appreciated...Thank you!

==> Well …as ugly as circumstances are right now, you’re doing what you should be (i.e., allowing natural consequences to take effect). Mark

MyOutofControlTeen.com