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06 Jul 2011

ODD/ Bipolar
Hi, doc.....we are really going through a difficult time with my son, aged 8yr old....At the moment he has been diagnosed with possible ODD and anxiety dysorder. He has been put on helped but he has side-effecs...I''m starting to wonder if my son is not suffering from early onset bipolar because of this swings between extream anger outbursts and crying, guilt feelings. I''m trying to reed up more on bipolar in kids but it''s very clinical....Could you maybe shed some light on how young kids with BD present in''real life''? there any comparison with ODD or what differentiate the 2 from each other? Thanx
Answer 457 views

01 Jan 0001

Tofranil is a really old drug, been around for years, but because it is also useful in enuresis ( bed-wetting ) there's been a lot of experience in using it in children. Side-effects, in most drugs, are most noticeable and annoying in the early weeks as one's system gets used to the presence of the drug.
There has not been much experience in dealing with Bipolar Disorder in kids, and I'd think the diagnosis is still somewhat controversial. Such a diagnosis must NEVER EVER be made or treated first by a GP, and should be based on a caeful assessment by a child psychiatrist.
In children as in adults, an anxiety disorder shows itself in an excessive amount of anxiety either arising without any apparent reason, or out of proportion to any apparent reason.
By ODD ( also not a widely used abbreviation ) I suppose your shrink is meaning Oppositional Defiant Disorder. And if you google it, there are many good descriptions in detail available on-line. Then you mention BD, which some use for Borderline ( a personality disorder, but really not something one diagnoses in kids ) and others use for Bipolar Disorder, in which there are major mood swings between depression and unreasonable elation, not rapidly back and forth within an hour, but over days and weeks.
The symptoms you describe sound a complex mixture in terms of possibly fitting a umber of different diagnoses, including a distressed but essentially normal kid.
The issues you raise are too complex to discuss satisfactorily here. But if these diagnoses were made by a GP, or even by a paediatrician, as they have not had sufficiently detailed training in making such diagnoses or treating them, ensure that the boy is seen and assessed by a good local child psychiatrist, maybe at one of the nearest medical schools.
If this is who HAS assessed and diagnosed the boy, then it was his/her absolute professional duty to discuss the details of these diagnoses, their treatment and implications, with you in detail, and to have made sure you understood the complexities. If this was not done, go back and ask for it to be done properly, because so much depends on the precise details of why the shrink made these diagnoses and treatment suggestions in this particular boy.
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