Friday, March 19, 2010
1 : excitement manifested by mental and physical hyperactivity, disorganization of behavior, and elevation of mood; specifically : the manic phase of bipolar disorder
2 a : excessive or unreasonable enthusiasm —often used in combination b : the object of such enthusiasm
The mind is such a fragile thing. It can be influenced by many factors. For my children there are biological predispositions, environmental factors, developmental complications, prenatal substance exposure and trauma. When a parent brings a baby, or child, into their home, they bring with them many hopes and dreams. We dream about what our child will accomplish. We dream about what part of us they will inherit or take from us. We always think of this in terms of positive influences, and rarely do we try to anticipate the negative factors.
I suppose some would say that I knew what I was getting myself into when I adopted my children. After all, when you go through a public adoption the children are more likely to have been taken from their biological parents rather than relinquished. As a social worker I have often been in the position to offer a child for placement to an individual, or couple. I have sat with them and discussed all the possibilities, and what this particular child might have difficulty with. At that point the prospective parent must make an informed decision about placement. Of course what really is an informed decision? For myself it was a decision to accept and love my children with whatever they bring with them. It was with the hope, and desire, to give them many positive experiences and opportunities. This is no different than any parent, irregardless of how they came to be parents.
When I adopted my daughter there appeared to be little risk. She was a healthy baby girl. I knew that she came from a parent with some very significant problems, but that was not a factor for me. I trusted fate, and welcomed her into my life. When my first son arrived things were quite different. He was 18 months, as opposed to my daughters arrival at 6 months. He was very ill looking, jaundice and anemic. He had been severely neglected, both prenatally and through infancy. He possessed no stranger anxiety, and he quickly exhibited the signs of an attachment disorder. From the first time I brought him home I knew something was wrong, but he was family. He was my daughter's biological sibling, and we wanted to love him whole heartily. When I say we, I mean myself, my 5 year old daughter, and my cousin who was living with me at the time. With my oldest son I thought I was making an informed decision, but looking back I really didn't know what I was taking on. His behavioral problems began day one.
Throughout the years I have often times been told by others that nobody could have done for my son what I was attempting to do. People would often say he was lucky to have me. In my modest way, I would say I was lucky to have him. Life at home quickly became very complicated. By age 5 he began needing psychiatric hospitalization for his extreme episodes of rage and cycling moods. He was what people would call a difficult child, but he was also a very loving child.
By the time my youngest child arrived on the scene our family's day to day life was already very complicated. I initially said that I was not in the position to raise a third child, but would be interested in our being a part of his life. As the weeks went by I decided I needed to let my two children know of the birth of this other sibling. I spoke to them about his birth. I let them know that he was born with some significant substances in his system, which could affect his behavior as well. We spent a lot of time discussing the pros and cons, and what we as a family would gain by welcoming him into our family, and what we would need to sacrifice.
In the end I decided that I would adopt him. He joined our family at 3 months of age. He was a adorable baby, and my daughter was a wonderful big sister. Although he had his complications at birth, I chose to be optimistic. As he grew it was quite clear that he was a very bright child, yet he was also a very hyperactive child. By the time kindergarten came he was far too much for the teacher, and school, to handle. I had him assessed for ADHD, and made the choice to try medication after much therapy. At that time I had taken a leave of absence to be with him full time in the classroom. I did this for a couple of months. That first day on the medication we walked into the classroom, he sat down on the rug with his classmates, and listened intently. When questions were asked he raised his hand. When called upon, he knew the answers. He smiled. I smiled. The teacher smiled.
It would be a nice story if I ended it at that, but that wouldn't be the real deal. From that year to the present, he has remained in therapy. He has been on several different types of medication, as he doesn't seem to last too long on any given one. After a few years his doctor and I realized that he had significant emotional challenges every winter. It was like clockwork. Soon it began to be a more serious problem. In time he asked his doctor if he could try the same medication as his older brother. He wasn't liking how he felt about himself, or how his days at school were going. This was last year, when he was 10 years old. We agreed to try the new medication, and once again the change was like night and day. He was suddenly improving his relationships at school, excelling in his studies and was very well liked by all. It was also around this time that we began to see some serious mood shifts. This cycling moods were much more pronounced before he began to new medication, and decreased dramatically afterward.
At the beginning of this school year my son was dealing with his step father dying, his father being quite preoccupied with his terminally ill spouse, his sister and brother's own challenges, and yet was getting all A's and B's in his first quarter in middle school. I was frankly in shock. Who knew that he would manage all of this so well. Two months ago as winter descended upon us, so did his mood shift. Last weekend I recognized a look in his eyes that I had not seen in quite some time. Although this look was familiar, I told myself not to worry, and just be patient with him. On Monday he was having a difficult morning, so I kept him home a little later than usual, then carefully transitioned him to school. It was that afternoon that he became aggressive with his teacher, and was given a 3 day suspension. That same afternoon in therapy I was made to see that which I didn't want to admit. He was in the beginning of a manic episode. This past week has been extremely challenging. He has been rapidly cycling from one moment to the next. Yet through it all he has completed all of the classwork and homework sent home with him. Today when he asked what he could do, meaning he wanted to play with his Playstation, I said why don't you work on your science project. All I was looking for was a small amount of progress, yet he sat there at the computer for a full hour, and completed his whole research paper. He will now return to school ahead of the class.
Earlier in the week my son's mood was more on the angry and agitated side. Today he was in the more typical manic mode, with being very hyper and quite overly animated. For the rest of us, it has taken a different way of coping throughout the evening. He told me earlier that he thinks that we should maybe go back to a prior medication because he doesn't like how he is feeling. As I sat here writing this post he came knocking at my bedroom door. To be honest, the last person I wanted to see on the other side of the door was him. I opened the door, and he looked exhausted. He asked if he could sleep in my bed. He said that he was very tired, and knew that in his own room he would never feel calm. He laid down right here beside me, and has been asleep the entire time I have been typing.
I remember yesterday afternoon when he was going from anger to euphoria in very rapid cycles. He stopped at one moment and looked up at me and said, "I miss Mike." Then he was off again. Hearing him say that yesterday, and having him come to my room knowing what he needed were both signs that he is on the mend. I can see that this manic episode will likely begin to give way to his more typical behavior. And believe me, his typical is not necessarily a walk in the park, but it is what we know.
Below is some information for those who may find themselves challenged by a loved one who suffers from a mood disorder. You might just read it, and put it in your back pocket for later use.
I no longer have my husband Michael here to support and encourage me during these difficult times, but I have all of you.
What are the signs of a manic episode?
-Abnormal happiness (euphoria).
-Extreme irritability or silliness.
-Long-lasting or intense outbursts or tantrums.
-Unrealistic feelings of self-importance (delusions of grandeur).
-Intense energy levels maintained for a long period of time.
-A decreased need for sleep.
-Increased talkativeness that is difficult to interrupt.
-Racing thoughts and distractibility—attention constantly moving from one thing to the next.
-An intense focus on sexual thoughts, feelings, or behaviors (hypersexuality); use of explicit sexual language.
-An intense focus on reaching a goal.
-Dangerous or reckless behavior. For example, a young child may think he or she can fly and jump off a roof. A teen may drive too fast, spend money unwisely, or have unprotected sex.
-Extreme behavior that causes problems on the job, at school, in social situations, or at home.
-Symptoms of psychosis (detachment from reality), such as hearing voices or being paranoid.
How do I help my child manage a manic episode?
Maintain a stable sleep pattern.
Maintain a regular daily routine.
Set realistic goals.
Avoid alcohol and illegal drugs.
Get help from family and friends.
Reduce stress at home and at school or work.
Learn to recognize the early warning signs of a new manic episode