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how do you discipline a bipolar child?

8K views 23 replies 15 participants last post by  izzygrn 
#1 ·
Seriously...how do you do it? I feel like I've worried so much about consistancy that all I ever do is ride him and nitpick and overcorrect. I'm so afraid that if I ignore the negative and praise the positive, the ignoring of the negative will be seen as tacit approval (he has a touch of narcissism and acts like he is the king of the world and can do no wrong and anyone who criticizes him is an unworthy idiot).

But then I keep reading blogs and articles and such that say that when it's obviously the disorder making them act "disobediently" you should just let it go because it truly is beyond their control.

If I start to refrain from gentle correction when ds uses a nasty tone of voice with me, or shoulder checks me into the wall, or starts breaking stuff up in his room, am I teaching him that those things are socially acceptable? Where do I draw the line and give a consequence?

He is 9yo and extremely intelligent, if that matters.

TIA!
 
#2 ·
Quote:
Originally Posted by blessedwithboys View Post
But then I keep reading blogs and articles and such that say that when it's obviously the disorder making them act "disobediently" you should just let it go because it truly is beyond their control.
I think it is about balance, and I wonder if some of those articles are talking more about punishment than about gentle correction and re-direction. I don't think children should be punished because I don't think it's helpful, however, I do think that your efforts to gently teach your son how to treat other people are well advised.

Ultimately, if your son doesn't learn to control his behavior, he has no future. I do believe that bi-polar people can, with help, develop self control. There are some bi-polar moms her on Mothering, and at least one mom has mentioned that her DH is bi-polar. It is possible for some one with this disorder to learn to behave appropriately toward other people. It may be harder. It may require medications, but it can happen.

Is your son in counseling? My DD's issues are different, but when she was going through a very difficult phase and was seeing a counselor every week, the counselor and I would talk for a couple of minutes at the beginning of the session and she would help trouble shoot the specific kinds of issues we were seeing. We could talk about what worked and what didn't. It was EXTREMELY helpful to me to have that kind of specific input from an expert who knew my DD well about how to address DDs behavior.
 
#3 ·
Along with bi-polar, Erica has OCD and social anxiety. When she was out of control, she was sent to her room away from the family. It's not as harsh as it sounds as that was what she needed and wanted even if she wasn't capable of realizing it during one of her episodes. It gave her time to regain her self-control and usually resulted in a nap. When she woke up, she was more in control and able to interact with others. And it was always open ended; she could join us when she had control and felt ready to face people again. Another thing I did was to keep life almost rigid for her. Any deviation from what she was expecting triggered anxiety which resulted in a melt down (her manic episodes were violent anger). She required order and surprises, even good surprises like stopping for a treat on the way home from school, meant chaos. Discipline (not a synonym for punishment) was very consistent. There was no letting things go the first time. And I let go of things that weren't really important and concentrated on the important, long term for life things. Throwing/hitting stuffed animals, pillows, and her bed was ok. Breaking things was not. She needed to let out the violence, she went to her room and pounded her pillow. She could use words to let us know how she felt and we helped her find the words. To other people, she came across as being very disrespectful but they didn't know the whole story. Because of the social anxiety, Erica was usually very well behaved in public; she saved everything up for at home where it was safe. We also home schooled until she could cope with the classroom and she went to school when she felt she was ready.
 
#4 ·
I found discipline to be one of my most challenging issues raising a bipolar (bipolar, ADHD, tourettes, ODD) child. He is now 18. Nothing normal worked. I would take these parenting classes or read a new book, or beg for advice from friends and eventually his doctors. It was so hard for me to judge what was his diagnosis's verses he was was just being cheeky.

It is tricky. Because the regular stuff doesn't work. And patience is often at a premium. I think, looking back, one of the biggest ways I failed my son was with structure. He need lots of it. He was not flexible. And he had the meltdowns to prove it.

If you have the time, contact http://www.nami.org/ . Or the http://www.bpkids.org/?gclid=COyMtfubp6sCFccaQgodS3zc1A . That second link has some great articles and such.

I think you hit the nail on the head. There is such a struggle between not wanting to let things go because sometimes their behavior is so, so offensive. And it seems wrong to just do nothing about it. But sometimes you have to just walk away and say "nothing I do or say in this moment will change the disease or my kids thinking."

As a mom to many, and my oldest being the one with Bi-polar, I have had to "let him get away" with stuff that would never fly from other kids. And it feels wrong somehow. And the other kids think it's unfair. And it did feel that way, a lot. But you must choose your battles.

Hang in there. :)
 
#5 ·
BP's are overly sensitive to criticism. The approach can not be in any way considered finger pointing. Somethings need to be danced around but not let go. Lots of praise with gentle reminders of why something really isn't ok. Once they start freaking out and breaking things... leave them alone. Let them get it out of their system.
 
#6 ·
If you don't learn how to help your 9 year old get under control what are you going to do when he is a teen?!!

I was lucky that my bipolar son was my 3rd son and I was an experienced single mom. I knew I had to use effective parenting skills because by the time they were 10 they were bigger than me and they outnumbered me. You do not excuse bad behavior because "it's the disease." That teaches the child to do that the rest of their life. You do not be gentle with a son. With the behaviors you are describing he may not be on the right meds or he may need counseling or both.

You use many of the same authoritative parenting skills you use with other kids you just have to do it more. You have to watch them all the time like they are 2 year olds in case they decide they can fly and jump off a balcony. You have to say what you mean and mean what you say. Avoid punishment because it doesn't teach good behavior and it doesn't work.
 
#7 ·
Yes, of course there must be consequences to bad behavior/choices. But trying to discipline when they are in the middle of a rage attack or other type of melt down is pointless. In that moment the goal should be to keep everybody safe, including them. I think Imacerka said it very well.

And sometimes you have to do tough love. But with the bipolar child what works will always be changing and evolving. What worked last month might not be effective today.
 
#8 ·
Quote:
Originally Posted by foreverinbluejeans View Post

If you don't learn how to help your 9 year old get under control what are you going to do when he is a teen?!!
Why do you suppose the OP posted her question to begin with?!!

The title of this thread is a question: how do you discipline a bipolar child? The original poster is requesting help to learn just exactly that, how to help her child. So your sarcastic tone, emphasized by extra exclamation points, was completely off-putting. I don't know about the OP, but I didn't absorb anything you wrote after your introductory sentence.

When reading a post by a mama who is distressed and asking for help or just sympathy, it is really, REALLY important for a person to read the post carefully, so that their advice isn't redundant and therefore completely useless, and so that their tone isn't contemptuous of the human being on the other side of the computer who is asking for help.
 
#9 ·
I'm not going to bash you. I just wanted to say that maybe you find your way affective maybe it works for your family. However there are degrees of BP's... some hate that they lash out the way they do and feel guilt. Knowing what they did was wrong and feeling guilt is enough punishment in my book. The whole point of discipline is to help them understand that there are appropriate ways to handle things and inappropriate ways to handle them. You can't "GOOD MOM" the "disease" right out of them. If I could do that I would "GOOD WIFE" the "disease" right out of my husband.

BP's are hypersensitive, they need help learning to deal with their emotions. They know things are not right. They don't need to be hounded and treated as if they are untrusted. The first thing the OP needs to do is figure out his triggers. What sets him off. Once she can do that she can then try to eliminate them. Or keep them to a minimum. That will help with the outbursts.

Quote:
Originally Posted by foreverinbluejeans View Post

If you don't learn how to help your 9 year old get under control what are you going to do when he is a teen?!!

I was lucky that my bipolar son was my 3rd son and I was an experienced single mom. I knew I had to use effective parenting skills because by the time they were 10 they were bigger than me and they outnumbered me. You do not excuse bad behavior because "it's the disease." That teaches the child to do that the rest of their life. You do not be gentle with a son. With the behaviors you are describing he may not be on the right meds or he may need counseling or both.

You use many of the same authoritative parenting skills you use with other kids you just have to do it more. You have to watch them all the time like they are 2 year olds in case they decide they can fly and jump off a balcony. You have to say what you mean and mean what you say. Avoid punishment because it doesn't teach good behavior and it doesn't work.
 
#10 ·
How we discipline our bipolar son depends on his stability level, his triggers, etc. When he is mostly stable, doing well then we will discipline him for things and hold him to a higher standard (we discipline by sending to room and also removing privileges). When he is unstable we don't hold him to the same standard in what he says and does as we would with a "normal" child. We know that it is the disease causing it and we just try as hard as we can to remove all potential triggers and keep him as calm as possible. He hasn't had a rage in a long time but when he did he would always feel extreme guilt afterwards and sob hysterically and we certainly weren't going to give him extra punishment of any type after that.

On another note - are you sure he's on the correct med combo? I know it is really hard to stabilize kids and sometimes you have to tweak the meds. I believe that you should expect stability and if he doesn't have it you need to try something else. My son is on a med combo that has him stable. There are still minor issues and we will always have to deal issues but he is stable and living a fairly normal (and calm) life. Talk to your doctor and see what they think about that.
 
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#11 ·
My son has Aspergers and when I first found out, I used this as an 'explanation' for his every behaviour. But I soon realised, or should I say had abruptly pointed out to me by a friend who dares honesty over politeness, that I would indeed just breed an arrogant little so and so that nobody would ever tolerate.

I prefer positive praise and try this most of the time. However, sometimes, regardless of us having whatever condition, we need to be told that how we treat others is unacceptable. If what he does upsets you, you need to tell him and remove something from him he holds dear (not something to dear though, like his fave item, then he will have no reason not to misbehave) but there has to be a consequence to actions, because as much as we adore our child and can forgive them, nobody else will.

If they want any chance in this world of making friends, we have to show them how to treat others...regardless of their condition.

Sorry guys if I sound harsh, but I have learnt excusing and cotton woolling does not help them, and we are their parents, killing them softly will not do.

I am sure you are an ace mum and doing fab...after all you realise you are blessedwithboys :D
 
#12 ·
Thanks to everyone who has posted. I've been away from this thread because I decided to just sort of check out of this topic for a bit. Ds was on meds but they obviously weren't working and so his ARNP sent him to her supervising Md who summed him in 5 minutes: Total Brat. And me? Neurotic Mother. He took ds off his meds, ds is rapid-cycling, totally irritable, and extremely destructive. So now I'm back to square one looking for a care-provider.

FWIW, I asked the ARNP and she told me I was absolutely dead-on to be right on top of him all the time, never budging an inch when he acted up. So I kept on keeping on. The dr. saw me doing just what his nurse told me to do and called me an "OCD helicopter control freak". Maybe I'll try a female pdoc next time around, in an effort to avoid misogyny.

And ds has been in weekly therapy for nearly 18 months, with no improvement. His new therapist is also a behavior analyst who thinks all he needs is a rigid to-the-minute schedule. I sense it's about to get much worse around here!
 
#13 ·
Holy cow! What kind of MD was he?? Was he a child psychiatrist? Was he even a regular psychiatrist? Or was he just some general practitioner? I'm sorry you (and your child, for pity's sake) didn't get any useful help.

Bipolar disorder is notoriously difficult to medicate in children, so it's not surprising his medication didn't work. Time to try a different medication. And a different doctor, no doubt!

Many hugs to you. You've got a challenging job, but your son is lucky to have you!
 
#14 ·
Quote:
Originally Posted by blessedwithboys View Post

FWIW, I asked the ARNP and she told me I was absolutely dead-on to be right on top of him all the time, never budging an inch when he acted up. So I kept on keeping on. The dr. saw me doing just what his nurse told me to do and called me an "OCD helicopter control freak". Maybe I'll try a female pdoc next time around, in an effort to avoid misogyny.
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#15 ·
They always call us mums something, overprotective, over controlling, under disciplining, maybe it is because we get passed from so called ,specialist' to so called 'specialist', all of them telling us what to do, and contradicting the other... F**k them and trust you :D
 
#17 ·
I recommend the book The Explosive Child if you haven't seen it already.

http://www.amazon.com/s/ref=nb_sb_ss_i_7_4/192-1555769-0836039?url=search-alias%3Dstripbooks&field-keywords=explosive+child&sprefix=expl

Not for the parenting strategies as much as the over arching attitude that children will do well if they can, and the real cause of most misbehavior with our kids is lagging skills. Not simplistic skills like politeness or saying please, but the executive function to cope with a change of plans or disappointment for example. This outlook changes the whole dynamics of parenting special needs kids, particularly with mental health issues and autism spectrum, and is explained much better in the book than I can here.
 
#18 ·
This was child psychiatrist.

I read The Explosive Child a few years ago when I thought ds was jsut plain ol' run of the mill difficult. I might re-read it but for now I'm reading a book from the director of a pediatric mood disorder clinic at U of IL or some such school. She's really speaking to me and I think I'm going to see about getting ds an appt there. Today he raged for over 2 hours straight over being bored and not liking any of the activity suggestions I made.
 
#19 ·
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I am seriously at my wits end with my 11 year old who is bipolar. He fights and fights to get his way when he is grounded and has things taken away from him and then he picks on his 8 year old autistic brother. He is super mean to me and my partner, and is making life so hard for everyone in the house! He has been in residential treatment already and it didn't seem to help. HE ALWAYS says he has nothing to do even tho he has a tablet, MP3 player, a cell phone, and an xbox, and he never wants to stay home with the family, and I have heard the words I hate you so much that I actually believe him. What can I do? I am at a loss. He has Tss worker and a mobile therapist, but it isn't helping at all.
 
#20 ·
Grounding and taking things are forms of authoritarian parenting. Authoritatian parenting has lots of negative consequences in all children, it is an especially ineffective form of parenting with children/teens with bipolar disorder. Under the best of situations it fails to promote good behavior. What it does with typical kids is make them resent their parents, lie and behave worse. It can drive them to hate their home/parents/family, especially chrildren with bipolar disorder. Imagine how you would feel if someone grounded you or took your things away.

There may be parenting classes in your community that aren't based on authoritarian parenting.
 
#21 ·
Wow, my last post here was three years ago and boy have things ever changed!

We found a new doc and new therapist and they are/were fantastic! I say "were" because ds was recently discharged by the therapist. She came weekly for 24 solid months and got him farther along than any other one he'd seen before. In fact, she got him as far as he could possibly go at this point in his life and development. She called him out on all his crap and he loved her. I am forever indebted to her!

Also about 2 years ago, we found an amazing pdoc. She is a diminutive Asian lady but is a total pit bull on the inside, and I mean that in the most admiring way possible! She sees right into and through ds. She takes close to 30-45 minutes at a time with him and speaks softly and gently but her words go deeply into his heart. In a good way! He will share a deep personal thought or feeling and she will remember how he answered the same question 3 months before and ask him why his answer changed, or why it stayed the same. She listens and never interrupts and truly cares.

Because she is such a good listener and never rushes us in and out, she has been able to tailor his meds perfectly. I know it's controversial, but I have come to believe that people with psych illness NEED meds. We eat a clean traditional diet. We don't fill the house with environmental toxins. Ds attends an eco-friendly school. He is unvaxed and has never had antibx in all his 12 years of life. The kid is super healthy physically, there is nothing environmental causing his symptoms. He just inherited broken brain chemistry from his dad. And the meds rebalance that chemistry. Yes, it's a science experiment conducted on a child, but in this case the child is totally on board. Once we got him stable, he felt SO MUCH BETTER he actually stood up to his dad (paranoia causes him to reject psych treatment for himself and he doesn't want it for ds either) when I wasn't around to say that he wants to stay on the meds.

No more rapid cycling mood swings, no more violence or suicidal ideation. No more rages. The worst now is akathesia that kept him from falling asleep before midnight, but we've just switched the time of day he takes his meds and after two days there is a vast improvement.

Some would say I drug my child to control him. I don't care. Ds is FINALLY having some kind of decent quality of life. I know puberty can throw it all out of whack again, but I trust his doctor to see him through it. Things have been great lately. We couldn't be happier.
 
#22 ·
I'm glad he's doing so much better, we never managed to get my BP1, ADHD, ODD kid stable on meds. It's when we went natural things improved and I don't care what anyone says, pyroluria and methylation problems are very real and made our life hell before treatment. Food intolerances were also causing severe aggression issues. Just this past year at 13 dd was dx'd with high functioning autism which explained why years of therapy didn't work. Her therapists now have been doing wonders with her. Different paths work for different kids.
 
#24 · (Edited)
I plan to go back and read each and every response. I am a child psychologist and I have a daughter with bipolar disorder. No amount of training prepared me for how scared I would be or how, despite my education and training, I read into every tear as oh no she is heading for a Major Depressive episode! or every time she is excited I wonder if she is starting to get increased psycho motor activity and question if she is hypomanic. It is fear. Out of pure love and terror for her and what her life will be like in the future I have lost it a time or two. I absolutely have shame and guilt since I tell myself I should know better. The thing is, we are moms who love our children so we are allowed to get all wonky from time to time and lose it.

To answer how do I discipline? Well, it varies. I ignore the grandiosity and keep a log. She is sometimes crass and is not her normal self. I suck it up and say, "We do not say balls and nuts and if you say it at school you will encounter consequences." Then I name possible consequences. I state it not because I expect her to stop right away but so she has some frame of reference this is not acceptable. I keep repeating myself in a neutral way. I do not get so bent out. I allow her space to be grandiose, hypo-manic and sometimes mood in-congruent. You know those times. Those are when our children are laughing but say they are sad. Or are sad but insist they are happy. That freaks me out more than anything.

When she hits herself or attempts to pull out her hair I hold her and sing. Rock her. I do a lot of prevention work and it has saved me tons of frustration. We have a very organized home, we have a good sleep hygiene schedule, we have a routine. We are not rigid but flexible. I also have team work. I can't stand lows and depressive phases. The whiney and the cries just get to me. My husband takes those. I take the times when she bounces off the walls. I can do that. We made our house safe and we have safe rooms to let her just be in those times.

We talk. My husband and I evaluate often if something was off or if it was typical behavior. We don't punish right away and delay a consequence if we are not sure. We simply say, "I am not sure what this is right now and so we have to revisit this." We talk to our daughter nightly. We give her information she can handle about her body and brain. She gives us input and feels comforted knowing why this goes on. She rapid cycles in a day so it gets hard for her.

We are lucky. She does not rage or tantrum. She her ups and downs are there but I have seen worse. Her anxiety, social issues, learning issues, and depressive episodes can be very very very scary. She has more depressive episodes than anything. How do we discipline? We use more of a philosophy than consequences. We think about it, the three of us, as a team. There are no hard and fast rules on this.

My heart goes out to you because I can actually feel your concern. What will they be when they grow up? How will they manage this? I could go on and on because we do so much during our routines. We exercise every single day with heavy exercise. We do a very strict healthy diet. Nothing radical. Just simple non processed foods. I have the same questions, how do other people do this? I think also I am most thankful for a doctor who has her medications just right. We are seriously lucky we caught it very very early and have the best doctors in our area. She has the best in my opinion and it shows. Some may question why we do medication but I can tell you when your child wants to die....medication is a life line and necessity not "just an option."
 
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