WEDNESDAY, Nov. 3, 2004 (HealthDayNews) -- Leslie Byers calls it her darkest day.
Her 10-year-old daughter, Heather, had woken up "surly and angry," then proceeded to hurl a chair into an entertainment center, smash a floor lamp against the wall and punch her mother in the stomach so hard it knocked her breath away. The episode ended with Byers calling the sheriff, who escorted the girl to a residential treatment center.
By this time, "the first psychiatrist had basically given up and told me the situation was hopeless," recalled Byers, 44, an information technology consultant in Fort Calhoun, Neb. "To be told by the very people we needed help from that we should just walk away, we should just give up, to me, is just an absolute travesty for the child and the family."
Fortunately, others, including both Byers and her husband, Steve, did not give up, and Heather was eventually diagnosed with bipolar disorder, also known as manic depressive illness.
Byers has just written a book about her daughter, and the pseudonym she still uses to identify her is part of its title: Heather's Rage. It is the story of the family's arduous journey from despair, including relinquishing custody of their daughter, to hope.
Bipolar disorder is notoriously difficult to diagnose in young people.
"Clinicians are up against a lot," said Dr. Robert Findling, director of child and adolescent psychiatry at University Hospitals of Cleveland. "First of all, there's the context of developmentally normal. It differs across childhood. Moreover, you are seeing youngsters in multiple settings. What's true for schoolteachers may not be true for parents and may not correspond to the youngster's own inner experience."
While the disease more often manifests itself in young adulthood, it can come on in adolescence and, more rarely, in childhood.
"There's a growing appreciation that early symptoms of bipolarity might actually manifest in the first or second decades of life, although most clinicians would be very wary of diagnosing a 19-month old," Findling said. "But I can tell you from what parents report... moms oftentimes really do know."
Even though Heather's case confounded dozens of experts, her mother suspected very early on that something was wrong.
As Byers describes it, Heather's problems first became apparent when she was just 19 months old, three months after she accidentally overdosed on her mother's iron pills.
Byers noticed a "strange change in behavior." Once "quiet, fun-loving and easygoing," Heather became "anxious, combative, defiant and hard to please" and prone to volatile mood swings and temper tantrums.
The problems escalated as Heather got older. She antagonized other children at day care as well as caretakers at home, was suspended from school countless times and cycled in and out of psychiatrists' offices.
The episodes became increasingly violent as well. Once, Heather kicked a security guard in the face while he was trying to hold her down. Another time she spat in a teacher's face. She also mutilated herself, cutting pieces of flesh from her arm, pulling out her own hair and trying to stab herself in the neck with a ballpoint pen. Her parents were even called to school after she had purposely run into oncoming traffic; she had been pinned to the ground by three large men. Heather was hospitalized six times in less than a year, the first time when she was only nine.
By the time Heather was 10, her parents were running out of options, both medical and financial. The only way to get proper treatment, it seemed, was to give up custody, which is what they did in May 1996.
As awful as that decision was, it did signal a turning point. Heather was finally diagnosed with bipolar disorder, something her mother had long suspected. The diagnosis enabled Heather and her parents to "really take ownership over this," as Byers put it.
Heather, now 19, has responded well to the drug lithium and today is living a relatively "normal" life. She lives at home, has graduated from high school and is working fulltime selling vacuum cleaners door-to-door.
"The raging episodes are extremely opposite to the personality of the individual," Byers explained. "[Heather] is very comfortable with introducing herself and turning a stranger into an acquaintance."
She'll be getting her own place in a few months and plans to start college next year. She also has close friends, some of them friends for nearly a decade.
"She's at a point that she's doing extremely well," Byers said. "This [illness] does not have to define the individual and, while bipolar people can have relapses, you can lead a very productive life once you get the answers, once you get the right diagnosis."
Still, Byers chose to use the pseudonym "Heather" for her daughter because "there is still so much stigma, so much job discrimination, I really was afraid."
More information
For more on bipolar disorder in teens, visit the American Academy of Child & Adolescent Psychiatry.
