Could ADHD be playing a role here too?

[carina]

Frans (12) was on 150mg Seroquel and asked to drop it to 125 again 3 days ago. But yesterday, he came home from school and he was sitting there at the kitchen table, saying to me I just need time to feel normal again. He was breathing deeply. Apparently the lady in charge of the school bus told him to sit at the back. He hates , for some unknown reason, to sit at the
back. He said he held it all in, but it was difficult. He did not throw a tantrum. He was just trying hard to control himself. I told him to go to the horses and feed them, as that would have a calming effect on him. It did help and he was fine at six. (He comes home at 4:30) Last night I put Seroquel back to 150mg again. We have a rather free hand with Seroquel. Pdoc said one can only reach the right dosage by trial and error. If this carries on And he has too much difficulty, I wonder if I should write a letter. This is not a trained person in charge of the bus. His school mistress is fine and as she knows about his illness and a few things that can be destabilising for him, she always asks first when they are going to do something unusual. I have been wondering if Frans does not have ADHD symptoms too. At times ( regularly) he can get quite hyper. Always touching things and might break something unintentionally. We visited my brother on Saturday. We were only there for about 30 minutes, but I had to send him home, because he just could not leave things in peace. When you tell him about it, he knows and then only realises what he is doing. Carina:-/

[Mayleng]

I don't think it is an ADHD thing as much as a sensory thing. Have you checked out Sensory Integration Dysfunction or SI? It seems he may be seeking sensation.

Also, I would talk to the bus company about not forcing him to the back if it stresses him so much.

[carina]

Yes it could be SID. He does display other symptoms too. Like being very fussy about the "feel" of material on his skin. Or his trousers may not touch his shoes. Looks horrible! He would not wear a specific tshirt, because it does not "feel" good. He would not eat anything unless he knows exactly what it is. Getting him to eat at friends is a nightmare. He won't eat a hamburger unless I made it. At McDonalds or Burger King he would only eat the chicken nuggets or wings and fries. He refuses to touch the meat, becasue a piece of onion might have touched it.
Do you know if they prescribe meds for SID?
Apparently this particular lady only goes with the bus on Monday, Wednesday and Friday afternoons. All the other times every thing is ok. The bus is a schoolbus run by the Commune.
He was in good spirits today when arriving home.
Thanks, Carina

[Mayleng]

Carina, SID cannot be cured with medication but the good news is, it can be cured/helped with Occupational Therapy. I don't know where you live, if you have Occupational Therapists who are familiar with SID.

There is a book by Carol Kranowitz - "Out of Sync Child" that is helpful.

Checkout this link:

www.comeunity.com/disability/sensory_integration/carol-kranowitz.html

One of our members "Texasmom" has a daughter who had SID and was helped tremendously by Occupational Therapy.

Here are some links:

www.sinetwork.org/

www.sensoryint.com/

[ohmama]

Carina,
Here's another thought you may want to consider.. I know that for myself I cannot sit in the back of a bus because of getting motion sickness and there is always a smell of exhaust back there, even if the windows are closed. I was amazed to learn that no one else was aware of this smell but to me it was very strong and affected me. Bipolar people are sensitive to these things and can show upsets when exposed to them. I would make sure the bus company allows your son to sit up front and tell them there are health issues if they protest.

[carina]

I wrote this letter and Frans will give it to give to the buslady if she insists again that he sits at the back. He is a bit sick today, caught a horrible cold, but he did go to school. he does sometimes get sick in the car, but we have not see that lately. Before Seroquel he often had a tantrum about noise when travelling in the car. It is true that bp people can be sensitive to smell ,sound and touch. I have noticed that at numerous times of instability.

"Dear Madam,
Would you please be so kind to let Frans sit in front in the bus where he usually sits? As he is suffering from a neurological disorder, he finds it physically extremely disturbing when sitting in the back of a bus. We can supply you with a doctor’s certificate, should you need it.
His teacher is aware of his neurological disorder.

With kind regards,"
Any changes anybody think I should make please let me know.
Carina

[ohmama]

That sounds good to me. Let us know what happens.

[carina]

He came home all smiles today at 16:25. I gave him the letter at lunch time and he gave it to her. She told him at the next stop to go and sit in the front on his usual seat. He is busy doing homework now. He has a cold, but in spite of it, he was still in good form. It must really have been nerve wracking for him.
Thanks so much for the great response. One little boy is very happy today.
Carina

[ohmama]

I'm so glad to hear that! My bp boy gets very upset with any kind of change too. He gets up and cooks himself breakfast, the same every morning, he has to ride in the same seat all the time in the car, doing school work we always have to do math first, etc. If I change any of this routine he goes out of balance in many ways. I thought maybe that had a connection with his OCD tendency's. Does your son have OCD also?

[carina]

No he does not have OCD. But he is also like that. Always sits in the same chair at the kitchen eating or doing homework. Every morning he eats fried egg sandwich. If he did not his whole day goes haywire. Same seat in the car too, never on the one next to it. Luckily in primary school the teachers only change every second year, because that was also a major issue for him. Won't eat if he has not first prayed. Then he forgets that he prayed and he will pray again. Not that it is a bad thing in principle, but it can be trying on the rest of the family sometimes.

[ohmama]

That's interesting, they have much in common. Is bp your sons only dx? What about the other family members? Do you suspect there are comorbid disorders?

[carina]

He has only been diagnosed with bipolar, but we have been suspecting SID for a long time. His SID is better when stable. Christof (24) has been diagnosed with ADS, but takes no medicine for it, as it is also better when he is stable. The others have not been diagnosed with anything else, although I think my husband also suffers a bit from SID. Luckily Frans has been fine since we upped his Seroquel. I was just thinking about something that has disappeared since being on Seroquel. He used to get completely mad when one of us emptied the post box , before he could when coming home from school. We use to take the important mail out and leave a few unimportant pieces in the mailbox. I noticed yeaterday that most days it was already empty when he arrived, but he just asked if there was any mail for him. We have a parent teacher meeting on Monday evening and I want to speak to her about how he is coping with school at the moment. This is a bad year , as they are preparing to do the public exams on the transfer to high school.

[Beverly]

There was a very good article last month about a study on bipolar patients and routine. I copied and pasted it but did not save the link..sorry. I have seen that my ds is completely off if there is any change in his routine, even a good change like an unexpected snow day!

Study: Daily Routine Helps Bipolar Disorder
By JENNIFER C. YATES, Associated Press Writer
WED SEP 7, 8:22 PMUPDATED 12 HOURS 17 MINUTES AGO
PITTSBURGH - Patients suffering from bipolar disorder who underwent therapy to help them maintain a regular daily routine and cope with stress were able to avoid relapses over a two-year period, a study has found.
The study, published in September's Archives of General Psychiatry, examined a therapy developed by researchers at the University of Pittsburgh School of Medicine.
Using what researchers dubbed interpersonal and social rhythm therapy, patients were taught how to keep to normal sleeping, eating and other daily routines. They also were shown how to anticipate and cope with stress just as a diabetic who would be taught, for example, how to cook and eat differently.
"This is really a disorder characterized by massive disturbances in the body's clock and in all the things the body's clock controls," said Dr. Ellen Frank, lead author of the study. "Their clocks need to be very carefully protected and we need to do everything we can to shore up and protect that fragile clock."
Bipolar disorder, also commonly referred to as manic depression, is a brain disorder in which sufferers experience cycles of mania, depression or mixed states. Treatment for the disorder varies by patient, but often involves some type of medication combined with therapy.
Frank, a professor of psychiatry and psychology at the University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic, said doctors for years have counseled bipolar sufferers about managing their lives but no one had ever systematically put that information together. She said social rhythm therapy does that, and also teaches patients to identify the triggers in their relationships with other people that can cause relapses.
In the study, 175 patients suffering from the most severe form of bipolar disorder were divided into several groups. All the patients were given medication for the disorder, but only some received interpersonal and social rhythm therapy.
The researchers found those who received the therapy were more likely to not have relapses of their illness during a two-year maintenance phase.
Dr. Gail Edelsohn, an associate professor of psychiatry at Thomas Jefferson University Hospital in Philadelphia, said sleep, especially, has a huge effect on those with mood disorders.
"This is a very important study because what's happened is that since we have a variety of medications which are extremely useful, I think the psychosocial interventions were prematurely cast aside," Edelsohn said.
Dr. Suzanne Vogel-Scibilia, president of the National Alliance on Mental Illness, said it's most important that bipolar sufferers have access to care, something that doesn't always happen because of the high costs of health care.