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Bipolar at 5?

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By Dorothy O'Donnell

Medicated children

One afternoon while Sadie was in school, I watched The Medicated Child, a Frontline documentary about the huge rise in the number of children being diagnosed with bipolar disorder, and the corresponding increase in treatment with powerful psychiatric drugs intended for adults. The film featured Dr. Kiki Chan, a leading researcher in pediatric bipolar disorder at Stanford University, who believes bipolar disorder has always existed in children. He echoed what Dr. Olson told us about kindling and the urgency of controlling symptoms early, before the disorder becomes firmly established.

But all I could focus on were the children — a little boy who raged like a trapped wild animal, or the teenager whose face twitched uncontrollably from the assortment of drugs he'd been on since he was Sadie’s age. I felt like I was watching my future unfold.

Glancing up at the kitchen clock, I realized it was past time to pick up Sadie at school. I grabbed my purse off the counter and fished around for my keys. As I yanked them out, I noticed a corner of the prescription from Dr. Olson sticking out from my wallet. I dug out the wrinkled square of blue paper, crumpled it into a ball, and tossed it in the trashcan under the sink. I knew I wouldn’t be using it. We wouldn’t be going back to Dr. Olson.

One step forward…

Kirsten sounded warm and caring on the phone. I liked her even more when we met in her cozy office in a renovated Victorian in San Francisco. Sadie loved her new child psychologist. At the first appointment, my daughter’s face lit up when Kirsten showed her cabinets and drawers filled with toys and art supplies.

Twice a week, I strapped Sadie into her car seat and zipped across the Golden Gate Bridge to Kirsten’s office. With a summer’s worth of sessions under her belt, Sadie started first grade on a more even keel.

Most mornings, she donned her pink Super Sadie cape and skipped ahead of me to her classroom.

“Why are you wearing that thing?” a scowling little boy asked her one day.

“I’m Super Sadie!” she announced, ignoring the twitters of other kids.

I’d almost lulled myself into believing that therapy was working when I received an email from her teacher. Again it was the same story: Sadie had trouble focusing, no trouble disrupting class. She kept rolling her eyes back into her head, giggling for no reason, and pulling her hair.

For parents of kids with mental health issues, school is often their first reality check. Suddenly, your child is being evaluated from the perspective of the world outside your immediate family. Suddenly, the behavior that you’ve reassured yourself is within the realm of normalcy doesn’t look so normal anymore. At first, I’d resisted seeing what the teachers saw in my daughter’s behavior. Now that her symptoms had become more obvious, I felt only gratitude.

Sadie's teacher and I agreed that Sadie should start seeing the school counselor on a regular basis. Still, Sadie’s behavior continued to deteriorate. She complained that she didn’t have any friends and didn’t want to go to school anymore because she was “too stupid.” She talked about wanting to hurt other kids or herself. When a girl accidentally pushed her in P.E. one day, she flew into a rage and threatened to “slap her in the face and kill her.”

Kirsten had also become a target of Sadie’s venom. Every time we drove across the bridge to see the therapist she once adored, it was a battle. She pummeled the back of my seat and threatened to jump out of the car as I struggled to keep us from careening into oncoming traffic. “I hate that stupid baby doctor,” she screamed “I’m going to kill her!”

At Kirsten’s office, it took the two of us to wrestle Sadie inside, kicking and shrieking.

Your mountain is waiting

One night, as we snuggled under her daisy-strewn quilt reading, Oh, The Places You’ll Go, Sadie’s lower lip started to quiver in a way that was becoming all too familiar.

“I don’t want to be on this planet anymore, Mama,” she choked in between sobs. “I think I’d be happier in heaven.”

I let the book drop to the floor and pulled her close, burying my face in her hair. I tried to soothe her but no matter what I said, or how tightly I held on, it felt like my little girl was slipping away.

When she finally drifted off to sleep, I crept into my room and climbed into bed. My mind bounced between my fears for Sadie to the mothers on the pediatric bipolar forum. With a pang of shame, I remembered how quick I’d been to judge them. I finally understood how it felt to be in their shoes. Like them, I was so desperate to ease my child’s pain, I was willing to try anything.

A new dance

A few days later, about eight months after Sadie had begun therapy, Jim and I met with Kirsten. No fan of medicating young children, she explained that there were some — like Sadie — who were dealing with such intense, scary thoughts, they needed medication to get stable enough to even benefit from therapy. On the back of a business card, she scribbled the name of a psychiatrist known for his careful approach to treating children. “He really helped turn things around for a little boy I work with who reminds me of Sadie,” she said. While cooking dinner that evening, I told Sadie about the new doctor who might give her some medicine to help her feel better. She leaped up from her chair at the kitchen table where she’d been coloring and hopped around the room.

“Will it fix my brain and stop me from being bad?” she asked, as excited as if I’d announced we were going to Disneyland.

I scooped her up in my arms, images churning through my mind. The jerks and tics of the boy in the Frontline documentary. Sadie downing a rainbow of pills each morning, her quirky spirit flat-lined by medication, her eyes dull and vacant. God, what am I doing? I heard her laughter ricocheting through our house the way it used to. I saw the long, solitary afternoons and weekends I scrambled to fill with projects suddenly packed with the play dates and birthday party invitations she craved. I even let myself imagine her walking across a sun-dappled college campus with a group of friends.

Sadie looked up at me, waiting for an answer. As we reeled around the kitchen together in a clumsy dance, I wished I could tell her what she wanted to hear. But I could only say what I knew. I didn’t know anything for sure. The only way we’d ever find out was to give it a try.

Video: Sadie, now 11, tells her own story.

Dorothy O’Donnell has written about travel, health and business for a variety of publications. Her essays on motherhood have been featured in the Marin Independent Journal, Mothering and on KQED radio. She is working on a memoir about raising her daughter.