Diagnosing a Child with Mental Illness

The moment my 12-year-old son ran out the front door, I locked it. The temperature that evening was 17 degrees. Bob was wearing basketball shorts, a tank top and no shoes. Earlier he was playing with knives and making threats. My mind struggled as he banged on the door begging me to let him in. Finally, I unlocked the back door to the basement and told him to go around the house. He slept downstairs (behind a locked door) while my family slept safely upstairs. The next day Bob was diagnosed with bipolar disorder.

Diagnosing Bipolar Mania in a Child

When we got to the psychiatrist's office, I explained how Bob responded to the fluoxetine (Prozac) he took for 35 days. First the depression lifted. No more lethargy, irritability, apathy or threats of harm. Bob's attitude toward school and friends improved and his grades climbed back up. After a few weeks he was joyful and social. He even started talking a lot and singing in the car. He made his younger sister giggle with his silliness. His confidence was building. He boasted he was smarter than most kids, played better basketball than anyone on the team and was pretty much the best at everything. But then the vice principal called about Bob's escalating bad behavior at school. Suddenly my shy, quiet, goody two shoes kid was in trouble for disrespect, bullying and reckless acts. Worse, the vice principal said Bob didn't seem to care about the consequences.

What Mania Looks Like in an Adolescent

The psychiatrist said, "He has bipolar disorder." Then he scribbled on his prescription pad. He said the new medication would stop all the manic behaviors.

Shocked but relieved, we went to the pharmacist and then home. Thirty minutes after taking risperidone (Risperdal), Bob's face looked relaxed, less agitated. I asked how he felt. He said, "normal." I exhaled.

You Don't Know What You Don't Know

I was glad to have an explanation for Bob's puzzling behavior. Each year his teacher said, "I'd like to get Bob to come out of his shell." Later in the year she said,"I'd like to get Bob back in his shell." I didn't know Bob had a mental illness with a name.

I was thrilled to learn Bob's mental illness was treatable. I hoped medication, therapy, routine and substance avoidance would rid Bob of his symptoms. That has not been the case. In fact, Bob got worse, much worse, before he got better. Even now Bob is symptomatic every day. Still, having the diagnosis gives us a launching point for professional, medical treatment.

Fortunately, I know a lot more about bipolar disorder today than I did that dark, cold night when I locked Bob out of the house. In retrospect, Bob was very ill and should have been hospitalized. Now when I see the warning signs of mania, I call the doctor.

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