I Win

The first helpful diagnosis we got for Max was pediatric bipolar disorder, but it didn't come from any of Max's doctors; it came from my doctor, Fred. In June, when Max was starting at Prospects, I was trying to take care of my basic needs by actually having a physical. I was wiped out. I was an emotional wreck, I'd developed asthma that required three different medications, and any free time I had, I spent wandering around our house. I'd go upstairs, looking for a book I wanted to read. I'd fold some laundry, then turn on the TV, and spend an hour watching an episode of NCIS that I'd already seen. Then I'd wander downstairs and stand in front of the refrigerator, staring for minutes at a time, and finally gulping something down without noticing it at all.

I dragged myself to my internist, patting myself on the back. Fred and I talked for a while about my physical health, he did a thorough physical exam, and then we talked again in his office about the other stuff. He knew Max had some issues, but, like us, didn't really know what they were. He asked if Max had a diagnosis. I took a deep breath, "I don't know...he seems to meet criteria for everything, ADHD, mood disorder, anxiety, oppositional defiant disorder. I don't know." Fred calmly said, "He may have pediatric bipolar disorder. A lot of kids do, and it's really underdiagnosed".

I finally had something I could google. Pediatric bipolar disorder. Which let me not only to the terrific book by Papalos (The Bipolar Child), but also to the Child and Adolescent Bipolar Foundation, where I found a whole community of people like me with kids like Max. I read Bipolar Child in a night, and went to my next meeting with Dr. E.

"Max has bipolar disorder Why do you keep saying 'mood disorder'?", I was furious. By not calling it by a name that meant anything, she held all the power. But with a real name to it, I could do something, read something, help myself. Dr. E responded carefully, bright-eyed and smiling, "Well, let's just call it a mood disorder. We don't need to label him."

A common excuse, the "labeling". It's bull, really, because labels are an important part of communication. Dave once pointed this out to me, "There's this thing outside that I drive. It's made of metal, and it has four wheels. I don't want to label it and call it a car, but it gets me where I'm going." The real issue with labeling is that many of these health professionals don't actually believe in this disorder.

Doctors like Dr. E. suffer from a terrible liberal bias which prevents them from seeing mental illnesses for the biological disorders that they are. Dr. E's clientele is mostly poor, black or hispanic. They are under-privileged by every definition. They are often referred by their school district for their acting out in a public school that just doesn't know what else to do. Dr. E. sees their situations as so painful, she grants them such latitude because they lack social, community, and family support. Their parents are mostly single mothers who work incredibly hard just to keep their families' heads above water, and Dr. E. knows that this has an effect on children. So she imagines that if she can hook those families up with community support and some "parenting skills", the kids will improve and not be so problematic. She's right about some of this: these kids would benefit from better nutrition, more time to play and be kids in a safe space, and from a cadre of adults around them who can guide them to good decision making. But that doesn't mean that they don't also have mental illness with a biological basis. She doesn't want to label them because maybe in a different environment, they could do better. And they're labeled enough, these kids, right?

So what does she do with me? I'm a member of a close-knit Jewish community. I have the support of my synagogue, my kids have 2 sets of local grandparents whom they see all the time, my husband and I have a close marriage untouched by alcoholism, infidelity, or financial stresses. But my kid is among the sickest of these kids, and that shakes her belief system.
So she just blames me, anyway. I give in too easily, or I'm emotionally distant, or both. She confidently states that I have anxiety, which is like telling a four-hundred pound woman that she has a weight problem. I do have anxiety. I have a kid who bites me, and throws things at me while I'm driving. He takes off his seat belt and tries to take his younger brother's seat belt off, too. Every day at 3 PM, he becomes completely uncontrollable, running around in circles, chanting nonsense words, like "api-ceca-gabi" or saying the same word over and over for half an hour. So, yes, I had anxiety. But Max was causing it, not suffering from it.

From then on, from the moment that Dr. E. denied that Max has pediatric bipolar disorder, I knew he had it. I was downright smug about it, in fact. This was something that I could control, research, advocate for. I wished there was a damn ribbon to put on my car, because I suddenly KNEW that this was not a parenting problem.