The latest in the saga of Oksana....we finally have an answer

Sometimes I wish this blog was private.  I'd love to be able to type out every little detail here because I know it would be therapeutic but I can't.  Still, I'm sharing far more here than on Facebook where I've been completely silent on the subject.  Somehow sharing this with the handful of people who actually read this is a lot easier than posting it for hundreds of people to see.

I've alluded to the fact that Oksana was very challenging this summer.  Actually "very challenging" doesn't begin to describe what we have been through.  Now I'll pick up where I left off......I guess it was the first days of school.  I mentioned that the psychiatrist got us in on Monday.  Our appointment was after yet another nightmare day of school.  We were the last appointment of the day.  By the time we left there the lights were out and the doors were locked.  In the past I had debated leaving our psychiatrist.  On Monday I was SO glad we didn't.  She was wonderful to our family.  She sat and listened to me spew what had happened over the summer and at the start of school.  She told me to tell her EVERYTHING because she didn't want me leaving her office feeling as if I had not been heard.  She asked how I was doing, which was so refreshing since many doctors just focus on your child.  She listened to all of my questions and fears and never said "Oh that won't happen" or "You don't know what will happen in the future".  Instead she gave me an answer or suggestion to each thing I was worried about no matter how ridiculous.  I think I was with her for about 45 minutes.  In the  meantime Larry was in the lobby with the girls.  At that time she already knew what was going on with Oksana but it was time to bring her in.

Oksana came bounding into the room.  She got a teddy bear off of the shelf and sat on the couch.  She squeezed the bear, bounced on the couch, rattled on about various things, etc.  The psychiatrist started asking her questions "Oksana, how are you?  What did you have for dinner tonight?  How is school?  Who is your teacher?  You are doing such a great job pooping on the potty!  Do you get angry sometimes?  Tell me what makes you angry."  As Oksana talked, the psychiatrist pointed things out to me.

"Erin when you look at her right now what do you see?" 

"Ummm...should I see something?"

"She is very elated at this point" (a nice way of saying the child is so hyper she is bouncing through the roof)

"Oh, yeah. That's Oksana."

"No.  This is worse than I've ever seen her.  This is not normal for Oksana and certainly not for an 8 year old girl.  Do you hear how she is talking to me?  That is called compressed speech."

During Oksana's conversation with her about the recent events at school I honestly was creeped out.  As I watched her the psychiatrist turned to me and said "What do you see as you watch her talk to me about this?"

"She is getting joy from it.  She is smiling while she talks about what she did."

Disturbing, because what she did was very violent.

There was so much more to this appointment.  I'm really just giving  you the highlights to help you understand how our psychiatrist worked with us to make the diagnosis.  It is one that Larry and I have been suspecting all summer.  We've done our research.  We knew she fit so it didn't come as a shock to us but it's still not what a parent wants to hear.

Oksana has early onset bipolar disorder.

Early onset means that it is very likely genetic.  It manifests itself differently than bipolar in adults.  The mood swings are more frequent and the depressive part tends to come out as aggression rather than depression.

She was in a manic phase in the office.  Once we understood what that really is we could point out clear times throughout the summer when she was manic.  Times that we looked at each other and said "What is up with her?!"  Early onset bipolar is often misdiagnosed as ADHD because of this manic phase.

What seems to have happened is that at some point while Oksana was on Risperdal the bipolar disorder set in but it was masked by the Risperdal.  Seroquel is not as strong of a medication as Risperdal so when we started to pull off of the Risperdal and move onto the Seroquel we got to see what was hiding underneath.  The Seroquel just wasn't sufficient to hide it.  It was bad enough at home but when we changed everything on her and sent her to school everything got kicked up a notch....or 50 notches....because she just couldn't cope with it.  The doctor decided to try keeping her on Seroquel because it has a component that reduces drooling, and then add a small amount of Risperdal back in since Risperdal was so effective in the first place.  On the way home we got our prescriptions and had them in her before bed that night.

The next morning we could already see a difference.  She had much better days at school and we saw a difference at home too.  She still struggles, but the behaviors come much less frequently and they are more easily controlled.  We will go back in a month to reevaluate.

We have a behavior therapist from the Center for Autism Education coming to meet us on Tuesday and we are in the works with a number of organizations and mental health centers to get our family help.  We believe that if all of this had happened in a couple of years when she was bigger and stronger she would have been dangerous and ended up hospitalized.  We are preparing now to either avoid that, or at least know what to do in the event that she would need inpatient care. 

While I am very sorry this all had to happen, Larry and I are very relieved that our family is now getting support.  We aren't doing this alone anymore.