But the good news is that therapy does do wonders. In fact, I would say that medication should never be given without therapy. I asked a bipolar teen who struggled with depression most of his life (including suicide attempts) and now is amazingly well what he thought was the most important thing that helped him. Without hesitating, he said that the drugs did help but it was the therapy that had the most impact.

The other thing that my neighbor nurse and I have observed is that some of our kids who have been diagnosed as bipolar/ADHD/OCD/etc. and who have been difficult to treat actually have some comorbid and undiagnosed autism/Asbergers. These are the kids who seem to have a hard time at school and in social setting because they can’t understand the social dynamics enough to try to hide their disorder (most bipolar kids can “hold it together” until they get home and then unleash all their emotions and problems). And autism makes therapy a little harder, but even more important.

I know how exhausted you are. I have a 6 yr old son who was just officially diagnosed by a therapist a bipolar, even tho I diagnosed him myself last year after doing much research on the web and at the bookstore. It does sound like your son has juvenile bipolar disorder and maybe a few other issues like anxiety that are totally genetic (there is high comorbidity between bipolar disorder and other problems like ADD, ADHD, OCD, etc. It sounds like his early life may have made his problems worse (and even introduced a few new problems). So, thank God you came into his life. Whenever I start to feel down about having a bipolar child, I try to think positively that at least we have identified the problem and we can help my son learn good coping skills to help him navigate the rocky, stressful shoals of his adult world, and that will increase the chances of him having a decent life.

I highly recommend this website of the The Juvenile Bipolar Research Foundation to everyone who suspects that their child may be bipolar: http://www.bpchildresearch.org/. The JBRF is the first charitable organization solely dedicated to the support of research for the study of early-onset bipolar disorder. The website provides the latest research on juvenile BPD and even has an online questionnaire that can tell you if your child definitely has juvenile bipolar disorder. Not only is it critical to get an accurate diagnosis, but it is critical to get ALL the comorbid disorders diagnosed accurately because, as you have probably been experiencing, medications that treat some problems can make the bipolar disorder symptoms worse.

Also buy the book that Demitri F. and Janice Papolos wrote the called “The Bipolar Child.” Actually, buy a few copies so you can give a copy of it, along with a copy of the filled out questionnaire, to your son’s therapists and doctors who haven’t read it. Evidently, it is a groundbreaking book because many therapists don’t even know that the symptoms of BPD in children are different than those of adults, and that there is such a huge overlap of other disorders.

Good luck with everything.

-Chris