Should My 4 Yr. Old Be Tested
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Q:  Should My 4 Yr. Old Be Tested

Hi Dr.

I have a child who has had problems since birth, and I have recently come to the conclusion that it could possibly be bipolar disorder.  Briana has had problems sleeping since the day she was born.  She would sleep less than 8 hours total per day as a newborn.  She now sleeps about 7 hrs/day at four years old.  As an infant and toddler, she experienced severe separation anxiety, which seems to be one of the signs.  She does not respond well to change, which I do not know is relevant.  When my husband leaves for a business trip, she has fits daily, temper tantrums and crying fits that she cannot stop (at least according to her).  She seems to enjoy being angry and sad, and cannot ask the most innocent question without a whine or an angry tone of voice.  She hits, pinches, and bites me and her father when she is angry, though she is disciplined for it almost every single time.  I'm sure there are other things I could mention that are not coming to mind right now.  She does not have a short attention span, so I cannot blame ADHD for her actions.  I know I am not the perfect parent, but I used to be a teacher, and I have had a lot of experience with other children, including some with bipolar disorder, ADHD, autism, and other disorders.  I realize that it is different when it is your own child, but I can't imagine I am entirely to blame for her behavior.  I don't have any medical insurance for her presently, but will be getting some soon.  I would just like some advice.  Do you think I should have her tested once she is covered?  Do most insurance companies cover such testing?  Do the symptoms sound like they could possibly be bipolar disorder?  I am at my wit's end with raising her, and find that I am now losing my patience with her, and I am known for my patience with children.  I have never had a problem with losing it with any child.  I need help.|
Thank you for at least listening,

Dear Ms. P' -- 
As an adult psychiatrist I fear I'm of little use here, mostly because I feel there might be some resources out there to help you but I can't put you on to them based on my own experience.  Perhaps her pediatrician, or asking for a consultation diagnostically from a child and adolescent psychiatrist, if those doc's in your area are not taking new patients.  There's a wonderful site on bipolar disorder in kids you may have already found, called , if you conclude that bipolar may be part of the explanation for what's going on. 

Dr. Phelps

Published December, 2001


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