Saturday, December 17, 2005

Bipolar and Autism as Billy Ray Experiences It

Bipolar is basically mood swings from high to low. It is cyclic with big highs (mania) and desperate lows (depression). Thus bipolar is often referred to as manic/depression as well. Some folks who experience this have what is called rapid cycling. Billy Ray can be calm one minute and then manic the next. He doesn’t experience as much depressive state.

It is interesting that Griffin’s Mom wrote in her blog a few days about bipolar because I have been doing internet research on Bipolar because it has been suggested by the psychiatrist that the out of control behavior Billy Ray is experiencing maybe a worsening of his bipolar. I have been told there is a link between bipolar and autism and I am hearing of more children who have both diagnoses. Thus have been trying to understand where one comes in and the other one comes in.

I don’t talk as much about Billy Ray’s experience with bipolar. Maybe that is because it has been controlled with medication a lot of the time since his diagnosis. There are things that occur in Bipolar that could also be symptoms of Autism or ADHD.

When he was seven, he had already been diagnosed with ADHD and was using stimulants for that. We had experienced a family trauma. My late husband had been in the hospital for two months with lung problems. A few weeks after his return home he drove the little Mazada pickup that was special between father and son to observe the highway construction project he had been working on before his hospitalization. An 18 wheeler pushed a car across the median into Raymond and he was back in the hospital. The combination of Dad being back in the hospital and their little truck being totaled set in motion Billy Ray’s first manic episode. The psychiatrist explained that bipolar can be brought out younger than it normally would if there is some sort of trauma.

It was clearly different than what he had exhibited with ADHD. He was literally a wild man and incredibly strong. The developmental pediatrician sent us to a pediatric psychiatrist. It didn’t take long for the psychiatrist to make the diagnosis of bipolar. Once we had established that he was able to control it with meds for a number of years. Billy Ray had not been diagnosed with Autism at that point though I now understand that he had symptoms of mild autism I didn’t recognize then.

I wanted to find links for you which would explain how bipolar manifests in an Autistic child. That was difficult to find. I did find a MSN group site Bipolar and Autism. The beginning of it is fairly detailed and a bit hard to read, however, when you get to “Mania” it has specifics about mania in an Autistic child might. It is not clear who this group is so I am not going to quote it as authority. Here’s the link, you can decide for yourself.

Here is how Billy Ray experiences hyperactivity and mania (which can be combined but aren’t necessarily):

Hyperactivity: A basic inability to sit still or remain focused on anything. It includes bouncing up and down in place or running and throwing behaviors. Note that some of these behaviors are also a part of mania as we experience it. The main difference is the degree of excitement involved. Hyperactivity can quickly escalate into mania for Billy Ray.

Mania: Similar to the mania in adults with bipolar disorder (sense of being invincible, no impulse control, sleep issues, irritability, etc.), but it also includes the following:

  • Hitting, kicking, pushing.

  • General silliness that is out of control.

  • Running from us, both outside or taking off across the room to grab something.

  • Throwing things down the stairwell or just aimlessly across the room. This can be anything he sees sitting on the kitchen counter, clothes from his hamper, his shoes, garbage, etc., particularly something that is out of its normal place. We had to take his wastebasket out of his room because it seemed he couldn’t stand even small amounts of trash in it. Now he is beginning to do the same with kitchen garbage.

That old question of where is this coming from is a constant source of wondering for me. I pray a lot and review his journals repeatedly to try to figure how to handle each new challenge. In Billy Ray’s case, I have basically come to understand that Autism responds to the programs and schedules that I have learned works for him. For the most part when he is not responding to things that have worked in the past, we have tried to adapt and communicate with him and he is still manic it is most likely coming from bipolar and we need to call the psychiatrist. Usually the only thing that has worked for bipolar in Billy Ray is medication no matter how much I would prefer to avoid it.

Billy Ray recently started on a new medication. He is not perfect but he sure is better (sigh).

I would love to hear from others of you who have children with the dual diagnosis of Bipolar and Autism especially if they also have Down Syndrome.

Until Monday,
Peggy Lou Morgan

No comments:

Post a Comment