Friday, August 10, 2012

A Reason for Hope

Today is my final post about the 8th Annual Mood Disorders Education Day. I saved my most exciting experience for the end. This year I heard through Stanford staff that Kiki Chang was going to be leading the breakout session for the children’s discussion. When I heard that, I was so excited to attend because I’ve always wanted the opportunity to ask Dr. Chang questions face to face. Dr. Chang founded The Stanford Pediatric Bipolar Disorders Program in 1997 and a few years ago I saw him on an old episode of Frontline called The Medicated Child and was very interested in what he had to say.

(Please note that this is my interpretation of the information presented.)

You can imagine my disappointment when I attended the breakout session and there was no Dr. Chang. Instead, another person answered questions. Unlike previous years, this discussion felt more like a sharing time where we were asked to share our stories along with our questions. I appreciated everyone’s participation and there were some great questions from the group, but the information wasn’t as new as previous years. As the session came to an end, my friend and I hung out a little longer to ask a few more questions and to get to know one of the other parents attending, then to my complete surprise, Dr. Kiki Chang came wandering in after working where he was teased by staff for not being there sooner. Then to our good fortune, Dr. Chang volunteered to hang out with us for a bit to answer any questions that the three of us still had.

(Yes, I was giddy with excitement, I just love good surprises!)

During our discussion Dr. Chang wanted to share a new interest in mood issues caused by a strep infection that his team is getting into. It’s called PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) or as they now refer to it as PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) because they now believe it may be more than strep bacteria causing the illness.

Dr. Chang has witness first hand kids that have bipolar-like symptoms with psychosis that required being admitted, then later be treated with a course of antibiotics for the PANS and respond to treatment. To think that some children who are experiencing the debilitating symptoms of a serious mood disorder can be cured by a course of antibiotics is amazing! Now this doesn’t mean that all kids that have mood issues are experiencing PANS, but for a group of them, this is life changing news. Dr. Chang pointed out that to consider if a child has PANS, they must have developed all their symptoms at once, it is an acute sudden onset of symptoms, which would typically have symptoms of tics and OCD. For example, your child is happy, social and performs well, then suddenly, they are obsessive with OCD qualities, experiencing tics, having mood issues, anxiety etc. all at once, the child changes overnight. Dr, Chang shared that they’re starting a new study soon so if you’re interested you may want to contact Stanford.

One of the questions I was most anticipating asking Dr. Chang was, “Is it possible for a child who has bipolar symptoms, who with medication, therapy and a developing brain grows up to not have bipolar disorder as an adult? Essentially, the course of the illness is changed due to early intervention?”

Dr. Chang responded with “YES!” He explained that they have seen it in their own studies with kids who were put on Lithium as a child for bipolar symptoms and as they grew up they were able to come off their medication. He did believe that the early intervention helped these kids and he pointed out that in all cases of this happening, the kids were taking Lithium, which is known for it’s neuro-protective qualities. He did mention that some kids may still have some challenges, but joked, “don’t we all!”

Now if that isn’t a reason for hope, I don’t know what is.

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More from Dr. Kiki Chang:
Please note that these interviews were done in 2007-2008 and may not include the latest research.

Kiki Chang interview on Frontline in 2007 in the episode The Medicated Child:

The Medicated Child Frequently Asked Questions answered by Kiki Chang posted in 2008:

Chat with Kiki Chang and The Balanced Mind Foundation in 2008:


  1. Tear of Joy, or should I say Hope!


  2. How exciting that you got to ask him some questions. The PANS stuff is interesting as well. A family at our church has a son that experienced behavior changes from a strep infection that went unnoticed for a while (due to allergies) But he had some longer term effects from it--it wasn't just a course of antibiotics and he was better. I also think that this boy had some ADHD type issues before his illness.

    The other issue this family has had with it was a complete lack of understanding about it--schools and other officials just don't believe it is something that can happen.