Bipolar on ritalin??

[Heavenly]

My friend's daughter is 4 and I am almost positive she is bipolar. I am bipolar myself so I know the signs well. I have talked to my friend about it and even lent her the book the Bipolar Child but she is too afraid to mention it to her doctor. Her husbands side of the family has a history of mental illness and she is is adopted so she doesn't know (my friend is adopted, not her daughter). Some of the problems they are having are extreme, destructive rages, threatening to burn down the house, threatening to choke someone, threatening suicide, running away (she left the house and was halfway down the street while her mom was in the shower and thank God it was my DH who found her - we live on the same street) with no idea why it was wrong. There are many, many other symptoms as well. Anyways my friend has taken her to a psychiatrist but they said probably ADHD and put her on ritalin. She has been on it for only one day and my friend says she is talking a mile a minute and switching subjects every 3 seconds and cutting herself and everyone else off when talking. She is bouncing all over the place and can't sleep (as of 10 pm tonight) because she is so wired. I remember reading that that could happen to a bipolar child put on ritalin but I can't find anything documentation of that right now. I told my friend again (I was just talking to her) that it sounds like she has gone manic and to keep a journal of it, which she is going to do. I told her to mention the possibility of bipolar to the psychiatrist but she is the type that doesn't question doctors so I don't think she will. Any information on the effect of ritalin on bipolar children?

[MotheringMe]

Are you suggesting that a four year old is bipolar?

[Heavenly]

Yes I am. Bipolar is not just a disease for adults. Here is a website for info if you have not heard of it. www.bpkids.org. There are women on this site whose young children have bipolar. I myself have had it my whole life and my parents could see signs of it from 3 years of age. Now back to my question - anyone have experience with this?

[DocsNemesis]

I do. I have done a lot of research into this because my ADHD kid probably has bipolar.
In a child without ADHD, yes, the ritalin will result in manic episodes-though this is really true in any child who takes it without ADHD. They will get wired because it is, in all truth, like speed. In my sons case, this does not happen. Instead his hyperactivity is reduced, but it helps nothing else and doesnt even seem to help that as well as it should. Also, in children who have both ADHD and bipolar, if the dose of ritalin (or Adderall in my sons case) is too high it will result in extremely aggressive behavior-ie my son strangleing a little girl at his school for singing a song he didnt like. Not good!
My ds has a lot of those same symptoms-running away, fearlessness, horrid tantrums that result in all his toys being broken and holes in the walls, hitting, he steals (he has very little impulse control in general), among other things. Minor little things will set him off, majorly.
The major difference between adults with bp and kids is that while adults often have long cycles-ie depressive for months, manic for several weeks, back to depressive, etc-kids cycle very rapidly, often several times a day. My ds does this, no doubt.One minute he is screaming and having a full out tantrum and the next he is completely calm and happy, acting like nothing ever happened. He also cycles with hunger-he will go days without eating a bite and then gorge for a day or two. He also hordes food-taking it and then just hiding it because he doesnt actually feel like eating (which is odd since we let him eat pretty much whenever he asks).
I would suggest they find a good child psychiatrist, one that it is up to date on the latest info. Even a not so good psychiatrist would agree that if she actually had ADHD the meds would not be causing that kind of behavior (although it can cause sleep issues). I know that we have had a hard time since my ds does get some help from his Adderall, but luckily he has a very good doctor. The treatment for bipolar in kids is generally either Depakote, Topamax, Neurontin, or this other one that I always forget the name of . Anyway, all of those meds are also antisiezure meds...for some reason they work, which has made a lot of docs say hmmm, maybe the bipolar is actually a siezure disorder. Anyway, in my sons case this would make sense-he actually has epilepsy. Also, they said that certain siezures are known to look like bipolar/adhd-those in the temperal lobe. So it might be a good idea for them to try and get her an EEG. My sons have always been abnormal, but I dont know if its ever abnormal with just bipolar. Anyway, I hope this helps!!