ADHD and Bipolar - Bipolar Disorder Message Board

bpmom07 · 09-17-2007, 09:24 AM

Hello all! I am new to this site. I am so glad I found you all!

A little history...My name is Michelle and I have a 13 year old daughter that was diagnosed with ADHD at 5 years old. She was put on Ritalin and then later Concerta for it and it worked well until she was 11. We were only seeing a pcp for her med refills and when the Concerta was no longer working well we switched her to Adderall XR and kept increasing the dose. She continued to get worse instead of better so I finally found a psych at age 12 and she was diagnosed with Bipolar 1 as well.

The psych never changed or stopped the Adderall, just added in Abilify, Lamictal, and Trazadone. After a year of this she still continued to get worse and I ended up putting her into the hospital. It turns out that the Adderall was making her manic and the rages she was having was also a result. They took her off the Adderall and took her off the Abilify and Trazadone, increased her Lamictal and added in Seroquel. Her Bipolar is now under control, but her ADHD isn't!

I am scared to put her back on stimulants since they were making her Bipolar worse, but I need something that will get her ADHD under control since now she's having all kinds of problems in school and her grades are horrible. Does anyone here have any ideas of what I can try with her that can get both disorders stable without setting the other one off?

TIA!
Michelle

goody2shuz · 09-17-2007, 10:42 AM

Hi Michelle

I am somewhat in the same boat as you having 2 daughters a 16 year old diagnosed a year ago with BP NOS/ADD Inattentive Type as well as a 19 year old diagnosed ADD/Mood Disorder NOS at one of Dr. Amen's clinics a few weeks ago with the use of SPECT Imaging.

From my understanding and findings most pdocs feel it is important to get the BP under control before even addressing the ADD because the symptoms of the two overlap and many times the ADD symptoms are taken care of as well. In my case my 16 year old has been stabilized for about 4 months right now on Lamictal and Seroquel. She had 4 hospitalizations within a year and we had been through the mill in that time. Prior to her diagnosis she was treated with Concerta and antidepressants which only worstened her condition but thankfully allowed for her to properly diagnosed much like your daughter. My daughter thankfully does well in school and even though she exhibits the lack of concentration and distractibility we feel that it isn't significant enough to add an ADD med which may upset her overall stabiity. If her grades were suffering we might be more inclined to do so but both the pdoc and ourselves seem to think that adding a stimulant wouldn't be in her best interest at this time. We will re-evaluate the situation if things worsten but for now are happy with our newfound stability.

Now as far as my other daughter....the comprehensive evaluation and SPECT Imaging done at the AMEN Clinic showed much more ADD involvement with hot spots in the area of her brain that controls moods as well. They suggested that she would benefit most by putting her on an anticonvulsant such as Lamictal and once at a therapeutic level if she still showed problems with concentration or getting stuck with a particular idea that we try her on the Daytrana patch. He suggested this because you can take it off and regulate it's effect so that the sleep isn't affected which is a big problem with the other meds and we all know how important sleep is for our kids with BP.

So even the AMEN clinic seems to support the belief that the moods must be stabilized before the ADD symptoms are addressed and re-evaluated after doing so. My older daughter is in her second year of college and is not quite yet up to a therapeutic level of the Lamictal but she too has had no problems maintaining grades. However, she has had a problem with using alcohol and weed more than we would like since the age of 14 and both the pdoc and ourselves feel that it is more due to the impulsiveness of the ADD/Mood Disorder as well as some self medicating on her part and with the proper meds that should improve as well.

So....we are in the same situation, so to speak...do we medicate for the ADD knowing that there is a possibility of threatening the stability of the BP???? I would suggest that you talk it out with your pdoc and come up with a plan that will be least likely to upset your daughter's overall stability and perhaps start slowly and keep a careful watch on her response to treating the ADD if that is what you decide to do.

Good luck and please keep us posted with how things go. There is another mom here, Lor, who is going through the same situation with her son. I am sure that you will be hearing from her as well as many others here.

So a BIG welcome to you & I look forward to seeing more of you here.

(((((HUGS)))))) ~ Goody

bpmom07 · 09-17-2007, 06:47 PM

Thanks for the reply. Yes, her pdoc is wanting to see if what I'm seeing is still bp or adhd and sent a adhd checklist for her teachers to fill out. They haven't returned them yet.

I think I spoke too soon about her BP being under control. She is depressed tonight and crying over something that happened 4 years ago. Anyone have any advice on how to get her through this?

goody2shuz · 09-17-2007, 06:59 PM

Hi again, Michelle. When she is depressed and like that it will help to just hold her and let her know that you are there and that today everything seems bad but tomorrow is another day and that she won't always be feeling this bad. She needs to hear your calm voice that is reassurring and offers her hope that what she is feeling won't last forever, that you are there for her in the good times and bad. Ask her if there is anything that you can do to make her feel better.

If she gets any worse you may want to give the pdoc a call. Perhaps he will be able to suggest an increase in one of her meds. Usually the Lamictal works well for the depression and mood swings. Has anything happened in the past day or two that could have triggered this??? I know that with the seasonal changes our kids could get a little thrown off. There is sometimes a breakthrough of seasonal depression in the fall/winter months and a breakthrough mania that happens in the early to late spring. This occurred with my daughter but it was too soon to tell whether there was a true seasonal component to her Bipolar since she wasn't quite stabilized yet. This year will allow us to get a better picture since she has been stabilized for the past 4-5 months.

I hope this helps and that your daughter is feeling better soon.

((((HUGS)))) ~ Goody

jules3 · 09-17-2007, 07:07 PM

Hi my son is in the same boat as your daughter only hes older..hes 21 and suffers mostly form depression..i know he has some kind of add, but he can easily go the other way and be hyper and stay up for no kiddin days at a time..so we dont even go there with those meds. i agrree with goody, the bp has to be under control with the right meds and she needs to be stable awhile before you do anything about the add. i swear ,its horrible to see tham depressed. and girls..wher, i can only imagine, throw in some hormones and it must be a nightmare..