However, living with someone who actually has Bipolar Disorder is anything but a joke. Our youngest daughter, Kimmie, has been diagnosed with BD and we live with the effects every day. We've always known something wasn't quite right, but just assumed it was a result of all the trauma she experienced in her first three years before she came to us. The hope was that with lots and lots of therapy and love, she would overcome all the abuse and neglect she suffered and would get to be a nice, normal little girl. Sadly, that's not been the case.
Don't get me wrong, the trauma, abuse, and neglect have had a very serious and long lasting effect on her psyche, but there is more going on with her than that. We have an official clinical diagnosis of Bipolar Disorder with Psychosis as well as ADHD for her. Unfortunately, she is not one of the "soft" bipolar cases, as her doctor calls them. She has an extreme case. The way he described it was something like this: Think about people with asthma. Some of them have it under control and only need an inhaler after they've been exercising or are sick. Others have it so bad that they are in the hospital every week. Kimmie is on the end of in the hospital every week, and with as severe as some of her symptoms are, she may actually end up there.
She is allergic to the two medications that give the best results and allow for the most control over the symptoms, so we live day to day trying to find the right combination of other medications, the right dosages, the right words to help her through her day, the right ways for us to react when she just can't control herself, the best way for us to all survive the day.
She does get some good days, even great ones. She can be the most loving, caring, awesome little girl in the world. She is extremely smart and loves to read, especially about bugs and other creepy crawlers. (What is it with my kids and bugs???) She remembers almost everything she reads and can tell you about things in great detail. She has a very active imagination and her fantasy worlds are extravagant. She can come up with some amazing stories. On the flip side of that, she can come up with some amazing lies and excuses. She once had her entire class believing we were moving elsewhere and would have to fly on a plane to get there. I found this out when a note came home wishing her well and asking her to keep in touch and to enjoy the plane ride. Sigh.
Looking back, the signs started when she was barely 4. She hit her sister in the face with a doll and told us it was because the doll told her to do it. She said the doll told her that her sister didn't love her and she had to hurt her. Not your typical four-year-old's reasoning there, is it? We had already been dealing with her extreme outbursts of aggression and being out of control whenever she got mad. I can remember times when it took me, Todd, and Sissy holding her down to keep her from seriously hurting herself or someone else. She would hit, kick, bite, punch, head butt, scratch, pinch, scream at the top of her lungs,and try to bang her head as hard as possible against objects such as her dresser or the headboard. She almost broke my jaw with a head butt once and almost broke Amanda's arm when she shoved it against the dresser. She is preternaturally strong when she is in one of her rages. It was awful.
We would try everything we could think of to get her to calm down, but absolutely nothing would work. She would just have to rage on until she literally wore herself out. As she got a little older, she would tell us, "My head won't let me calm down!" We didn't fully understand it then, nor do we now, but we believe those were the first manifestations of her psychosis/hallucinations. Once she had completely worn herself out, she would sleep for a couple of hours and then wake up as if nothing had happened. Sometimes, she wouldn't remember any of it, but we'll never forget having to watch her suffer through it all.
Because she's Bipolar, she sometimes sees and hears things that no one else can. Sometimes it's nice things like fairies and pretty lights, other times it's scary voices telling her to do bad things. It's always a bit disturbing and scary for her, though, no matter what.
Her last round of great medication stopped working sometime in November. She had three full months of full blown mania. Her body and mind never shut down. Not for a minute. She wasn't sleeping. She wasn't eating. She lost weight. She was all over the place. She was scattered. She constantly talked 90 miles a minute, even in her sleep, when she actually did sleep. She would sometimes fall asleep at her normal bedtime, but would wake up in the middle of the night and stay awake for hours, aimlessly wandering the house. Her ADHD medication wasn't helping at all because her mania wasn't under control, so her doctor stopped that. She went from looking like a healthy little girl to a meth addict in those three months. It was horrible watching her health deteriorate, knowing that nothing we were doing was helping.
She was losing friends at school because she couldn't be still or quiet and was constantly bothering her classmates. Her teacher is an amazing lady who understands what Kimmie is going through and has worked with us to help her succeed in the classroom. I cannot give enough praise to Mrs. Best for all she has done for Kimmie and for us. She tried to explain to the kids, in terms they could understand, that Kimmie has an illness that keeps her from behaving sometimes, but that doesn't mean she's not a good person. She doesn't mean to be loud and bouncy, but she can't help it. That helped some, but kids are kids and they don't always care what the reason is, they just want their friends to be "normal."
At home, she can be very compliant, happy, helpful, upbeat, and occasionally, even quiet. She can also be argumentative, angry, defiant, depressed, loud, obnoxious, aggressive, and just downright mean. We never know which Kimmie we're going to get. She's just as comfortable yelling at us as she is giving a hug. Her disorder makes her think that she is going to be a famous singer and have millions of fans and all the money in the world. It also makes her think that no one loves her, that everyone is out to get her, that she doesn't deserve to have a family. That's the paranoia part of it. It's heartbreaking to have your seven year old tell you that she knows you don't love her and don't want her to be a part of your family. There are no words or actions that can change her mind when that's where her head is. During those times, she wholeheartedly believes what she's saying. This paranoia is one of the reasons people with BD are 20-30% more likely to die by suicide than the average population. I've seen some studies that suggest this number is closer to 60% higher. Either way, the statistics are frightening.
Over the past two years, we've worked more closely with her psychiatrist than we ever thought was possible. He's worked us in for emergency appointments, been on call 24/7 for emergencies, has read and reread her medical history so many times he can probably recite it by heart, all to try and find a way to help our little girl.
We've had some medications that worked beautifully for her. She was completely in balance and got to be a regular kid. She sat still in class, had perfect grades, was happy and smiling, loved to dance and sing, and just be normal. Unfortunately, these seem to only work for 3-6 months for her and then they stop working. Completely and utterly fail to do anything for her. At that point, it's back to the drawing board to see what we can do next. We thought we'd found the answer with Lithium a few months back. We were seeing a great reduction in her manic symptoms and she was eating regularly. It looked like we'd finally found something that would be a long term medication for her.
Then, one day after school, I noticed her slurring her speech. Over the next hour, she went from normal speech to completely incomprehensible babbling. We were at the ER for several hours while they ran tests and did blood work. The results were not good. She is allergic to Lithium. The effects only lasted a couple of hours, but those few hours were some of the scariest we've ever had as parents. We tried a different medication that can sometimes produce the same great symptom control. No go. She's allergic to that one, too. On top of that, her thyroid isn't working properly, so she's on a medication for that as well. Sadly, this is all too common in people with BD.
She's currently on two medications that have worked well in the past, but aren't doing so great right now. She just had blood drawn on Friday and we are anxiously awaiting the results on Monday so that we can see what the next step for her will be. The aggression is coming back full force and is now manifesting itself at school, a place where she's never shown aggression before. Once again, the ball game is changing and no one quite knows what the new rules are.
If you want to learn more about Bipolar Disorder, you can check out these websites:
http://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml
http://www.webmd.com/depression/guide/bipolar-disorder-manic-depression
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