Thursday, August 29, 2013

Veterans of a Different Kind

Tonight I got a touching letter from another mom who happened to find my blog by searching for “Dr. Jekyll and Mr. Hyde.” By the way, based on my blog feed information, parents often find me through this exact word search every week. It’s reassuring to realize that I’m not alone.

Like most letters I receive, I was moved to tears and inspired to keep writing, it reminds me of why I do this blogging thing. I started several years ago after one really bad night of rages, I was desperate to vent and escape out of isolation. Several years later, I find myself still writing, but with purpose now.

I want to reach you, all those parents who are searching for answers and looking for connection. I am so much stronger today because of all of you, because of your stories, your advice and simply for being by my side during the worst of times and for cheering me on during the best of times.

In the letter I received today, this mom brilliantly put into words what this experience is like, she said:

“I think I just needed to reach out because I am aching right now, and it was mind-blowing to find out someone else is dealing with the Exact. Same. Things. It broke my heart. It was also something akin to what I suspect it is like for veterans of foreign wars, meeting someone else who understands the particular hell they have gone through. Does that make any sense?”

Does that ever make sense! It’s true, we’re fighting battles in a foreign land, one that our own parents have never seen and one that friends can’t even relate to, yet here we are, with battle scars, some more fresh than others, but we’re connected. We know each other’s story without ever having to say a word.

It’s together that we’ll get through this.

Wednesday, August 28, 2013

New Brain Scan to Diagnosis Bipolar Disorder

This week Medical News Today shared a report from the British Journal of Psychiatry about a new brain scan that uses blood flow patterns to determine if a person has bipolar disorder. They were able to accurately identity which person had bipolar disorder and which ones had unipolar depression during a depressive episode 81% of the time.

This is great news! It puts us another step closer to accurately diagnosing individuals with bipolar disorder, allowing for appropriate treatment even faster. Being that the disorder takes an average of 10 years to diagnosis, many people suffer much longer than they should with many facing serious setbacks as they’re treated with the wrong medication and therapies.

As for kids with bipolar disorder, this is huge because not only do children’s mental illness symptoms present themselves differently than adults, the kids themselves aren’t always able to articulate what they’re experiencing until they’re much older. This makes making a correct diagnosis even tougher. A scan like this would not only help the child get the correct treatment early on, but it would bring peace of mind to the parents who are questioning if they’re doing what’s best for their child.

Also keep in mind the kindling theory, the longer an illness goes untreated, the worse the illness gets. A scan like this would not only improve lives, but who knows, maybe it would prevent illness altogether.

Hang on folks, we have good things coming...

* * *

Medical News Today
Article Date: 25 Aug 2013 - 0:00 PDT
Written by Honor Whiteman
Brain scans to diagnose bipolar disorder

Sunday, August 25, 2013

“I’m Moving Out!”

Well we survived the first week of school, everyone’s a little cranky at the end of the day, but we’re getting by. By Saturday night my youngest had had enough of his family and declared, “That’s it, I’m moving out to get away from you people!” This is after he showed me a Magna Doodle with the words “I hate you!” written on it, all because it was time for bed and he couldn’t stay up late to watch a movie.

I wasn’t surprised by his antics, since he’s pretty extreme with his reactions, it’s either “The best day ever,” or “The worst day of my life!” What I wasn’t prepared for was his follow through on Saturday night.

Shortly after declaring he was moving out, he came downstairs with a pile of neatly folded clothes, 5 pairs of jeans and 5 t-shirts to be exact and his iPod of course. I didn’t have the heart to point out that he was missing his iPod charger. With a look of distain he marched into the room, carrying his folded clothes and announced, “I’m leaving here forever!” Then out the back door he went into the night.

Honestly, I had to try hard not to giggle because it was all so darn cute, he was the first of my boys to “move out” and his performance was admirable. Before he left I asked him a few questions to consider such as, “Where will you go in the dark of night?” To which he responded, “I’m going somewhere far way from here!” Then I asked what he was going to eat while he was on his own. This question stumped him and after some deep thought he said, “I’ll become survivor man!”

After about 10 minutes of living on his own (in our backyard), he came back inside and into my arms, crying saying that he couldn’t tell me a lie and that he loved me and was not really moving away.

What a relief, I would really miss that little guy!

Tuesday, August 20, 2013

The Most Wonderful Time of the Year

It’s that time again, the most wonderful time of the year, Back-to-school time! That’s right, in 11 hours my boys will be back in school, it’s almost like Christmas, I’m too excited to sleep!

Ok, maybe I’m exaggerating, but if you’re reading my blog, I don’t think I need to explain how difficult summer can be for parents like us and how we have great anticipation for the day when our kids are back to class, back to routine and if we’re honest, back to a little peace and quite for us. Can I hear an amen?

On a more reflective note, today my oldest son reminded me of how far he’s come. He brought me his yearbook from 6th grade and from 5th grade. As he opened his 5th grade yearbook he said, “Look mom, it’s when I use to be lonely.” Slowly he flipped through an entire yearbook showing me empty pages with no signatures from friends. Then he proudly opened up last year’s yearbook from 6th grade and flipped through the pages and showed me pages of signatures. I smiled and asked him, “What do you think happened?” He said, “I got social, I got better.”

I wanted to share this with those parents who are currently hanging on by a string, who see no end to their pain and their child’s struggles. For the handful that wrote me this week, I’m thinking of you as I write this, I hope to encourage you that things do get better. In 5th grade my son paced the schoolyard by himself every recess, he was living with depression and finding it hard to function each day. But we’ve come a long way since then and I hope to encourage you that you will too. Hang in there moms and dads, things do get better.

Sunday, August 18, 2013

Inspiration from Steve Jobs

This weekend I took my oldest son to see the movie Jobs. This was after my son saw the preview and declared, “I have to see that movie!” followed by his book selections at the library about Steve Jobs. As some of you may have learned over the years of following my blog, my oldest loves to create. We like to think of him as our little MacGyver, able to invent something with string and tape alone. Add an old electronic device and a screw driver and he’s entertained for hours as he dismantles it and tries to put it back together. His greatest joy is building things. So of course we had to see the movie so he could learn more about a man who has changed the world. Yes Steve Jobs was a complicated man, a genius, an innovator and a difficult person to work for and live with. Yet, I believe he still made the world a better place. A final quote at the end of the movie gave me goosebumps and put a smile on my son’s face a mile wide:
Here’s to the crazy ones. The misfits. The rebels. The troublemakers. The round pegs in the square holes. The ones who see things differently. They’re not fond of rules. And they have no respect for the status quo. You can quote them, disagree with them, glorify or vilify them. About the only thing you can’t do is ignore them. Because they change things. They push the human race forward. And while some may see them as the crazy ones, we see genius. Because the people who are crazy enough to think they can change the world are the ones who do. —Steve Jobs
My son recognized himself in this quote and felt not only validated, but inspired.

After the movie we headed straight to the bookstore to look for books on building circuit boards. My son’s passion for building was lit on fire, I don’t think he’s stopped smiling since we walked out of the theater. As he said, “I wish I could get my hands on a circuit board right now!”

I encouraged him, “Then you need to pursue this. I told him that God has blessed him with the ability to create things and that he should do just that.”

I’m excited to see what he’ll do, because I know that God will use him in wonderful ways...

Friday, August 16, 2013

Letting Go & Holding On

Earlier this year I was asked to write an article for a small parenting magazine sharing my experience as a mother raising a child with mental illness. I was torn as to whether or not to do it, first because I’m not a writer and something about writing for a magazine felt a little too fancy for my skills and also I was afraid of negative feedback. But after some prayer and thoughtful consideration with my husband, I decided to do it because deep down, I feel like God can use our story to help others. Here is what I wrote:

* * *

Letting Go & Holding On
By Anonymous Mom

I never thought motherhood would look like this. I’m sure most moms would nod their head in agreement, but I really thought I was prepared. I read “What to Expect When You’re Expecting” from cover to cover along with any other book I could get my hands on. I talked to new moms and very experienced moms. I was going into motherhood with my eyes wide open, but nothing prepared me for raising a child with mental illness.

What started as mild symptoms and strong-willed behavior turned into violent rages and thoughts of suicide—from a child who was only 7 years old. We watched our once joyful son turn inward and cry out for help because the “bad side” of his brain was taking over the “good side.” And like a horror movie, I’ve held my son as he tried to take cover from visions of monsters that terrorized him and rapid mood swings that made him feel out of control. How does a mother prepare for this? 

As my son’s illness took over, we watched his life crumble. He was no longer invited to birthday parties, and the friends he did have vanished as the mothers got wind that he was seeing a psychiatrist. As one of his best friends explained, “I can no longer play with you because my mommy said you might hurt me someday!” As you can imagine, this crushed him. How does a mother’s love mend this wound?

As a family, we learned for the first time about the stigma associated with mental illness. What those mothers didn’t understand is that those with mental illness are statistically more likely to become a victim than to hurt others. We have witnessed this first-hand with the bullying our son has faced.

As a mother, I faced my own stigma. I’m the “evil mother” who medicates her child. I know that the other mothers judge me and assume that I’m a bad parent. They also assume that changing his diet, giving him fish oil or eliminating video games would heal his symptoms, but we tried all that and then some. Just as a parent chooses to medicate their child for a heart problem, we chose to medicate our son for a brain problem. 

This decision has saved our son’s life. After only a short time on a bipolar medication, our son felt joy for the first time in years. Everyone who knew him could see the change. It was like a weight was lifted off him and the child we lost so many years ago returned. 

Unfortunately this progress doesn’t make it any easier on us. We know that medications have side effects and we’re constantly weighing the risks versus the rewards. How does a mother do this?

In addition to judgments I also face ridicule for my son’s symptoms, which are often misunderstood as being behaviors of a bad kid. There have been many times when my son’s illness triggered impulsive behavior that to the outside world looked unruly. As a result, I get rude looks or hear whispers under the breath from those who have no idea of what we’re dealing with or how hard we’re trying to help our son. If people only knew how much their glaring eyes hurt me. It honestly feels like being kicked when I’m already down. How does a mother cope with that?

Our son’s illness is not cured. It will be a lifelong battle and maintaining his stability is a fragile balancing act. Simple events like a school dance or a family outing can result in unspeakable symptoms. We find our lives becoming very isolated; instead of after school sports and play dates, we spend our time in regular therapy sessions. Our attempts to create fun family experiences often end with tears and regrets. These events leave my husband and me feeling overwhelmed and defeated, not to mention the impact they have on our younger children.

This is not the life we envisioned for our dear son or our family. I never imagined that there would be so much pain and that I would watch those I love suffer daily. In response, I’m learning to parent in new ways and to love even bigger. I’m learning to let go of all expectations, and as a result I’m finding joy in the small things.

Achievements that may appear insignificant to others are victories to us, such as the time our son wore blue jeans for the first time in 5 years. It was a triumph over sensory issues that made it hard for him to fit in with his peers. 

Then there was the family dinner where we were surrounded by our children’s giggles and great conversations. Tears of joy rolled off my face as I clung to a moment that I never wanted to end. Those are the moments that get me through the tough times.

Just this month our youngest son was also diagnosed with a mental illness. Though it has shattered our hearts, we’re holding onto our belief that God will get us through this as well. I truly believe that God can take this bad stuff and make something good out of it. 

But before I can experience the good, I have to let go of my former visions of motherhood and embrace what lies before me. As I look at my two boys, I see depression and anxiety, but I also see their amazing courage and resilience. In my third child, who is free of illness, I’ve witnessed remarkable forgiveness and compassion. In my husband, I’ve witnessed strength and dedication when many men would have left. Though heartbreak surrounds me, I see love at its finest. How could a mother not embrace that!

So I’ve chosen to let go of all expectations and hold onto hope that one day my children will thrive and we’ll look back on this time and see something remarkable, even if it’s something I never imagined.

Tuesday, August 13, 2013

More Research Finds Connections Between Autism, Depression & Schizophrenia

I thought you might be interested in another study that’s finding common genetic ground between mental illnesses once thought to be distictly different. (link below):
The latest data suggests that seemingly disparate symptoms — patients with bipolar experience extreme mood swings, while people with schizophrenia often suffer from delusions and paranoia — may not necessarily derive from different genes, but rather from different timing of exposures to risk factors, such as toxins or infectious disease during pregnancy, or early life trauma...
...“We thought these were completely distinct diseases,” says Bruce Cuthbert, director of the division of adult translational research and treatment development at NIMH, explaining that the idea of a distinction between bipolar and schizophrenia has been a core part of psychiatry for over a century. But now, he says, “We’re gradually seeing that these are, in fact, highly related conditions and only appear different from the surface symptoms.”

Pretty interesting stuff huh! This may explain why one family member may have autism and another have bipolar disorder, it’s the same genes, just turned on differently. This research may be the key to finding the right kind of treatment, or better yet, finding out how to prevent the onset of disease where a family history hints its presence. Stay tuned folks, they’re on to something...
Common Genetic Ground Found for Depression, Schizophrenia, Autism:

Health & Family
By Maria Szalavitz
Aug. 12, 2013

Sunday, August 11, 2013

9th Annual Mood Disorders Day in Stanford

Last month I attended the 9th Annual Mood Disorders Day in Stanford, here are a few highlights I thought you might me interested in. Please keep in mind that these are my interpretations of the information presented. For more complete information, I recommend you check out the following link which takes you to Stanford’s website where they have video and in some cases, slides posted for each of the presentations.

Stanford 2013 Presentations:

* * *

Pediatric Mood Disorders Notes:

Presented by Kiki Chang, MD, Stanford

Depression is often the first symptom of Bipolar Disorder in kids.
Bipolar starts with depression not mania.
1/2–2/3 of bipolar patients are labeled with bipolar BEFORE 18 years of age.
This is not an illness that begins in adulthood, it’s being diagnosed much earlier.

Rates of major depression in kids:
Preschool: 0.3%
Prepubertal: 1.8%
Adolescents: 4.7-8.9%

Children in preschool with depression have a higher family history of Bipolar Disorder. Bipolar switch rates in children with Major Depressive Disorder is 30%, adolescents 20%.

Symptoms of Depression:
• Somatic (Head/stomach ache)
• School refusal/separation anxiety
• Poor school performance
• Preoccupation with death or morbid themes
• New behavioral problems
( I have seen all of these symptoms in my two boys)

How depression is different in younger kids from older kids:

• More somatic/behavioral problems
• “I wish I were dead”
• Boredom
(Depression in kids does NOT look the same as in adults)

• Acutely poor school performance
• Substance use
• Sleep/appetite changes
• Dangerous behavior/suicidal ideation

Age of onset of Bipolar Disorder:
14% Childhood (<12 years)
19% Late Adulthood (>30 years)
32% Early Adulthood (19–29 years)
36% Adolescents ( 13–18 years)

Notice the largest group are those between 13–18 years old.

kids can have short manic episodes, like 4 hours long, not days like adults. These episodes can be bipolar, a large percentage of them do get “full” Bipolar.

Comorbid Disorders with Bipolar Disorder in children and adolescents:

ADHD 49–87%
Substance abuse 8–39%
OCD 44%
Panic 19–26%
General Anxeity Disorder 19%
Social Anxiety 40%
Oppositional Defiant Disorder 75%
Conduct Disorder 12–41%

Have you heard of PANDAS yet?
If your child’s symptoms were sudden and acute, you need to look into this!

This is acute onset of OCD, irritability, behavioral problems. Tics present in over 50% of cases. Other possible symptoms: frequent urination, dysgraphia, anorexia, sensory sensitivity, and cognitive impairment. Basically your kid was fine one day, they got an infection and what followed was a drastic and sudden change in your child’s behavior. Some of these kids are being diagnosed with bipolar disorder, but they do not have BP, but instead have a condition that was brought on by an illness such as Strep A infection. These kids typically don’t respond to psych meds. These cases are treated with short term medication like an antibiotic and these kids get better. If this fits your kid, contact Kiki Chang at Stanford, he’s currently doing research on this.

Currently Stanford’s research is looking into inflammation in the brain and it’s connection with Bipolar Disorder, depression, mania, anxiety, and even autism. They hope to find some answers on this path to explain the increase of all these illnesses in children.

* * *

Psychotherapy Notes:

Presented by: Fennifer Nam, PhD, Stanford University

The best treatment option for mood disorders is medication with therapy. When therapy is included, there are less days of depression and less hospitalization in patients.

There are different types of therapy. Such as:
1. Psycoeducation: Therapy that focuses on learning about the illness and how to manage it.

2. Cognitive Behavioral Therapy (CBT): Learn about what you’re thinking. What are your wrong thoughts that lead to bad actions. You work on recognizing wrong thoughts and work towards changing them.

3. Family Therapy: The entire family is in therapy together. This is important because patients do well when surrounded by support.

4. Dialectical Therapy (DBT): This is where you learn life skills. Pain will happen, here’s where you develop skills to cope.

* * *

Alcohol/Substance Abuse Notes:

Anna Lembke, MD, Stanford Addiction Medicine Program

Those with mood disorders have higher rates of substance abuse.

U.S. Population with Alcoholism = 15%
Bipolar Patients with Alcoholism = 75%

Most speculate that this is because those with bipolar disorder self-medicate.

Mood issues are worse if you use substances. Pot use in early teens creates a greater risk of having psychosis later in life.

There is a third element to this, the disease of addiction, if this runs in the family, risks are greater. You need to treat both mood disorder and addiction behaviors, you can’t treat both under one illness. For example, you can’t treat a person’s bipolar illness in a 12-step program, and you can’t treat their alcoholism in a psych ward. They need to be treated separately.

* * *

Visit the Stanford presentation page for more presentations not reviewed above:

Thursday, August 8, 2013

Overcoming Fears and The Slender Man

My family and I just returned from an amazing vacation at the ocean. We played, we danced, we swam and surprisingly, my oldest conquered his fear of The Slender Man.

This story is quite impressive and I saved it just for you. But I have to start at the beginning, the week leading up to our trip. It all started with a darn viral YouTube video about a fictional character named The Slender Man. This mythical creature apparently lives in the woods to stalk, abduct, or traumatize children. He’s described as an unnaturally tall man with no face, wearing a black suit. He’s considered the first great myth of the web. Honestly, just writing about him now creeps me out!

Well apparently my son saw this YouTube video and quickly turned it off at the beginning. Unfortunately, the damage was already done and once bedtime arose, his anxiety was at an all time high. For several days he dreaded bedtime with the same reaction: anxiety, trouble sleeping and mom lying by his side until he was finally asleep.

Flash forward to our vacation at the ocean and our son realizes that our beach house is not only near the ocean, but surrounded by woods, which he’s certain contains The Slender Man. On the first day there, I heard my son talking through his anxiety, especially on our hike through the wooded area, then out of nowhere, he declares, “I need to conquer my fear and the only way to do it is to walk through the woods at night!”

Impressed with his proactive solution to overcoming his fears, my husband and I agreed that we would assist him with this, but I think neither of us thought he would actually do it. 

Boy were we wrong.

As we approached the beach house after a day of playing in the waves, my oldest reminded us, “I can still walk through the woods tonight, right? I want to go to the “scary wooded” area, it’s the only way I can get over this fear.”

Surprised, my husband chimed in, “Sure, I’ll take you.”

At this moment, I was relieved to be off the hook, because honestly, there was no way I was comfortable going into the scary part of the woods at night!

So off they went, with a flash light and a determination to overcome The Slender Man.

As they approached the “scary wooded area” my husband confessed feeling apprehensive, “It was pretty scary at night, my head was “Blair Witching”, I would’ve never done it on my own!” 

Just so you can get the picture, the scary wooded area is a path surrounded by large trees blown over by the ocean wind, over the years the trees formed somewhat of a tunnel, thick with branches that hovered and blocked out the night sky. Along the way, people had drawn faces with charcoal on the exposed stumps, there were easily over 20 faces drawn into the woods (see photo above).

As my son walked through the woods he methodically focused on the scary thoughts that had occupied his mind, such as how The Slender Man can reach his long arms and abduct you from the trees. Through this process, he was able to address his fears head on.

Once they got to the end of the path my husband offered a different route on the way home to avoid the woods on the way back, but my son declined and said that he needed to go through it again. And he did.

Afterwards he explained how scary it was, but he said, “I didn’t want to do it, I NEEDED to do it!”

WOW! I was so impressed and so damn proud of him!

We used this unique opportunity to share with our son that what he did would serve him well for his entire life, that there would be many things in his life that he wouldn’t want to do, but that he would need to do. Having done this tonight, he proved not only to us, but to himself that he is capable of conquering his fears.

When I told him how proud I was of his courage, he said, “I wasn’t brave, I was really scared doing that.”

I replied, “No dear, doing something that scares you is the definition of bravery!”

Man do I love this kid!

* * *

I’m happy to report, that from that night on, my son has gone right to sleep with no more anxiety. His plan was a huge success!

The Slender Man (In case you’re curious):