By Jacki Wood ~ written for a college assignment in 2010
Tears roll down his cheeks like steady raindrops sliding down a window during a spring thunderstorm.
“I HATE YOU, DAD, I HATE YOU,” he yells from behind his closed bedroom door.
Hunter’s tears mix with the mess on his face and he wipes it with his shirtsleeve, leaving streaks of it across his cheek. He coughs and lets out one last wail before trying to compose himself.
He sniffs hard, wipes his face again and licks his dry lips.
“Mom,” he whimpers, knowing I’m standing outside his door. “Can I come out now?”
This is not a toddler temper tantrum. This is the winding down after a rage, after the shoving of his sister, the throwing of furniture, the growling and yelling and screaming and flailing.
This is 11-year-old Hunter who lives with bipolar disorder, one of an estimated 10 percent of children who deal with serious emotional and mental disorders, according to the US Surgeon General.
Bipolar is a brain disorder that causes unusual changes in mood, from the lowest of lows to the highest of highs, and can also be known as manic-depressive illness or manic depression.
In children, it is sometimes confused with attention deficit hyperactivity disorder because of the many similar symptoms when they are manic, according to the National Alliance for Mental Illness. The difference, though, includes elated mood, grandiose behaviors, flight of ideas, extreme changes in behavior and energy levels and decreased need for sleep. Then there is the depressive and even suicidal opposite side of the disorder.
During mania, children and teens can “feel very happy or act silly in a way that’s unusual, have a very short temper, talk really fast about a lot of different things, have trouble sleeping but not feel tired, have trouble staying focused, talk and think about sex more often and do risky things.”
During depressive episodes, they can “feel very sad, complain about pain a lot, sleep too little or too much, feel guilty and worthless, eat too little or too much, have little energy and no interest in fun activities and think about death or suicide.”
Other symptoms can include impulsive behavior, psychotic symptoms like delusions, hallucinations, and disorganized thinking and cognitive disturbances.
Mere minutes from his raging, things seem to have changed inside Hunter’s brain as I sit with him on his bedroom floor. He’s laughing, smiling and showing the dimple that dots his right cheek as he describes his latest car design to me. His fiery red hair seems a softer orange now. He drags out a sketch pad with curled edges and begins drawing.
And just like that, all seems to be well again.
At least for a few moments.
One of the biggest differences between children and adults with bipolar disorder is that an adult can go for weeks or months before they cycle from high to low or vice versa. With children, though, they can have multiple cycles during a single day. It’s really a roller coaster of emotions on a daily basis, from giddy highs down to depressive lows. Children and teens with bipolar disorder may also have mixed episodes that have both manic and depressive symptoms.
In the past several years, I’ve done plenty of reading and studying up on the illness, trying to figure out how best to raise Hunter and how to teach him to deal with it all. Most of the time I feel lucky that his symptoms aren’t as serious as others who I read about. Still, as he grows and gets older, I’m concerned how the illness will change and affect him in other more serious ways.
“My brain works differently than other people’s brains,” Hunter said. “Sometimes I go all crazy.”
Crazy, for Hunter, means he feels mad, sad, scared and even sometimes confused.
And then there’s the opposite of those feelings.
“Sometimes when I feel good, I think I can do anything,” he said.
That translates into him feeling that sometimes he is smarter than his teacher at school or his classmates, who don’t like it when he gets overly excited or yells out all the answers in class. It can also mean that he feels he knows better or more than his parents.
That’s not all that different than other kids, but it can be a little more difficult with him because of the other symptoms he experiences.
A couple of hours have passed since Hunter’s blowup with his dad. He is still in his room but has moved from drawing the car to building it using K’nex that litter his carpeted floor. The incident that led to him screaming his hatred toward his dad was about one of his Saturday chores – vacuuming the family room floor.
Saturdays are tough for Hunter. After breakfast, the chores begin. On his list for the day was to clean his bedroom, put his clean clothes away, clean the upstairs bathroom and vacuum the family room floor.
A reasonable amount of time for his younger sister to do the same chores is usually two hours or less.
But Hunter says he hates to work and drags it out nearly the entire day, even though he has been reminded that once his chores are completed he can do whatever he likes until bedtime.
“I don’t really like to do work,” he said. “I just want to get it done, but most of the time I don’t want to do it all.”
His seven-year-old sister completes her comparable chores well before lunchtime and is off to ride her bike and play outside with the dog.
By 11:30, Hunter has yet to complete even one of the tasks. He’s in the family room now, where he should be vacuuming. But instead of the cleaning, he’s sprawled out on the floor flipping through a car magazine, completely enthralled.
He goes all out for the things he enjoys and I love that about him. But I also believe he needs to learn the value of work, regardless of his illness.
His dad enters the room and quietly reminds him of his chores.
Hunter begins with whining and complaining about all the work he has to do. Then he starts looking for excuses. He’s hungry. He’s tired. His foot hurts. He’s thirsty. His head hurts.
He soon moves to crying. Then screaming. Then all-out raging returns. And finally, his dad must drag him off to his room so he can calm down and not hurt anything or anyone else.
“I told my dad I hate him because I didn’t like him when I was really angry,” Hunter said. “I don’t want to cry, but sometimes I feel like I can’t control it.”
The crying comes with the lows but can change without notice to euphoric highs. And when the mania hits, so do the ideas and the feeling he can do or be anything.
“I have lots of ideas of things I want to do,” he said, talking about his future. “I am excited when I feel good. I want to be an inventor or an engineer or an architect or a chef.”
He wants to build the biggest mall in the world. He wants to design the fastest racecar. He wants to own the best bakery in the country.
Everything is a superlative with him. It has to be the biggest or the fastest or the best.
While many of his classmates are busy playing video games, watching TV, playing sports or hanging out with each other, Hunter is setting goals, making plans and creating new ideas to help people and change the world.
Those grandiose ideas are typical of others with bipolar. The goals and ideas aren’t necessarily a bad thing, but not being able to accomplish them all, right now and with great success, is a difficult concept for Hunter to grasp. He wants it all. And he wants it all right now.
The dichotomy of the disorder seems to be seen in all aspects of his life, especially at school, where he attends Tri-County in Jamesport.
He likes math and excels in it, his fifth grade teacher Connie Critten said, although his grade card doesn’t always show it.
“Hunter has very good mental math skills and enjoys helping other students who are struggling with math,” she said. “He is usually patient with his classmates while helping them. But he doesn’t like doing homework and his scores are generally lower because he doesn’t finish his work.”
While receiving the highest MAP test in math in his class, his grades are consistently Cs in the subject.
“I don’t like doing homework,” he said, “because I don’t like work.”
We’ve tried many different ideas to help with this – things we’ve read from other parents and things from both his school counselor and his clinical counselor – without a whole lot of success.
More serious than his academic performance, however, is the way the disorder affects his behavior at school.
When Hunter is at his best, he is compassionate, caring and has a positive and uplifting attitude, his resource room instructor Debbie LaFerney said.
“He has a contagious smile and loves to please his peers,” she said. “Hunter knows where he wants to be in the future with his behavior, with school and with his career. He has a creative and imaginative mind and is always thinking about some invention he is going to work on.”
But being at his best – kind, imaginative, helpful – can change quickly, his school counselor LeAnna Wilcox said. He can be happy one minute and crying or in a rage the next.
“His mood swings could be associated with a ticking time bomb; you never know when they are going to go off,” she said. “When he gets upset, he tends to totally shut down. He becomes agitated and logic does not take place.”
Whatever the reason, his explosions disrupt the classroom and sometimes even the school.
“Hunter sometimes becomes very aggressive, throwing chairs, yelling or pushing other students,” Critten said. “He has been known to cause physical harm to others. And his crying can disrupt our classroom and the entire elementary building.”
He also appears to have a high anxiety level most of the time, she said, because he has so many goals he wants to achieve.
“He is afraid he will mess up or that his peers are looking at him and judging him,” she said. “Then he has an outburst as a way of protecting himself.”
Hunter walks out of his bedroom, the red blotches that dotted his face from his excessive crying have begun to disappear and his orange freckles shine once again. I offer him a hug and he presents both his newly constructed car and the drawing from his book.
And then as if nothing has happened, he begins telling me about his latest idea of making a more fuel-efficient car.
As bad as it was on this particular Saturday morning, it has been much worse.
We feel fortunate to have found help in recent years through the North Central Missouri Mental Health Center in Trenton where Hunter has received new medications, counseling and support.
He currently takes three mood stabilizer prescription drugs: Abilify, which he has been on since he was first diagnosed, Strattera and Lamictal.
“I don’t like to take my medicine,” Hunter said. “But my mom keeps telling me it helps me be better.”
In addition to the medication, he visits a psychiatrist every three months, meets with a clinical counselor each month and receives visits from a caseworker both at home and at school.
Hunter’s eyes light up as he describes the components of his new car idea. His words fly out of his mouth, one right after the other, faster than I can keep up with. I smile and sigh to myself. So many ideas – too many ideas. Hunter copies my gentle smile with a wide, toothy genuine grin of his own.
When he has finished explaining the idea, he shrugs, a little embarrassed and then waits, seeking approval. I reach out and give him that approval with another hug and smile.
I think it’s time to apologize to dad, I whisper to him.
Hesitant, he plops his car and sketch pad on his desk of overflowing ideas, papers, pads, cars and creations. He strolls out of the room, head down, and quietly calls out for his dad who is in the kitchen.
“Did you finish vacuuming the family room,” his dad asks, after Hunter had apologized for his actions.
“Yes,” he lies, with a blank stare on his face, trying not to make any moves to show his deceit.
It doesn’t matter. We all know he’s lying. Lately, most everything coming out of his mouth seems to be a lie. That’s an exaggeration, of course, but we’re tired and we don’t know what to do about it. There’s other deceitful behavior, like sneaking food from the kitchen during the night and stealing money from my wallet.
Consequences don’t seem to matter much to Hunter. And logic is lost on him most of the time.
There are so many facets to bipolar, and it seems when we figure out how to deal with one thing, something else pops up.
The lying is also something his caseworker Terri Westover has seen with Hunter when she visits him at school.
“One of the main things I’ve noticed lately about Hunter is his easiness in not being truthful,” she said. “I always talk to teachers before or after I talk to him about whatever the current incident is and the stories are usually quite different. Part of it is probably him minimalizing what actually took place. I don’t think he’s necessarily being conniving with his untruthfulness, but it keeps him in an alternate reality. He gets quite angry when confronted, but that’s what we’ve been working on at school and at home, bringing him back to reality.”
Hunter sulks back to the family room, this time without the dramatics. He seems to be too exhausted for another outburst. He grabs the vacuum, turns it on and roughly and quickly pushes it back and forth around the couch, TV and the magazine that’s still lying wide open on the floor. A few toys also dot the floor, some of which he threw in his earlier anger. There’s also the chair he knocked over in his rage.
I walk in and sit on the couch. He turns off the vacuum when he sees me. I encourage him, telling him I know he can do it and do it well. His dimple resurfaces with his smile as he picks up the toys, the magazine and the chair – and he finishes the vacuuming.
He really is a great kid, but it’s so hard to know if what we are doing is right with him or for him. It’s also hard because it feels like a lot of people don’t see the good in him with his dramatic changes in mood. I feel a lot of judgmental stares from others who get annoyed by his behavior, like I’m being a bad parent or no parent at all. We’ve made lots of mistakes with him, but it’s really frustrating when others don’t give him a chance or enough time to show who he is when he’s at his best.
So we just keep taking one day at a time. Some days are good, some are more of a struggle.
But even with the struggles and the mistakes, we feel like we’ve come a long way since he was first diagnosed.
“It’s difficult for me to describe the difference between the past couple of years and how it was in the beginning,” his dad says. “It’s like night and day.”
While Hunter knows bipolar disorder is something that will affect him his entire life, he is grateful for the help he is receiving.
“I’m a little afraid of my future because of bipolar,” he said. “But I know my family loves me even when my brain is crazy.”
(note from 2015: while we were blessed with wonderful mental healthcare resources and services when we lived near Jamesport back in 2010, we haven’t been so lucky where we live now. Due to the lack of resources here, we’ve had to make some major changes in dealing with Hunter’s illness. So we face new challenges while we continue to take one day at a time with him. Lack of adequate mental healthcare services affects thousands of people across the country. I encourage you to contact your legislator in support of mental healthcare and not be afraid to talk about mental illness.)