Treating Bipolar Disorder
I cringe when the telephone rings, that it will disturb Robert or set him off into a rampage that can linger all day.
—Mother of a bipolar child
Robert is a bipolar child. His family’s day is dictated by his wild mood swings. His parents’ nerves are brittle. They walk on eggshells, praying that something they do or say doesn’t set off another rage.
“Imagine trying to keep two six-year-old girls and a puppy silent until Robert is ready, worrying that one cry or bark will set him off, slamming doors, kicking things, threatening someone,” says his mother. “I cannot control everything.”
Robert’s family sought help from IJR’s Pediatric Mood Disorder Clinic.
“With pediatric bipolar disorder, some parents, sadly, feel they need to divorce their kids,” says Dr. Mani Pavuluri, director of the clinic. “They come to our clinic at wit’s end.”
With Drs. Amy West and Julie Carbray, Pavuluri directs the Pediatric Mood Disorder Clinic, one of the specialty clinics within IJR. Pavuluri and her colleagues are among the first to use brain imaging technology to map how bipolar disorder affects the brain in children and how bipolar children differ from bipolar adults.
“We’re finding, for example, that kids with bipolar disorder have an overactive amygdala, the part of the brain that guides basic reaction to facial recognition and other social cues. They also have an underactive prefrontal cortex, the part of the brain that controls how you respond to those impulses.”
Armed with this knowledge, Pavuluri and her colleagues have developed a drug and therapy regime, called RAINBOW therapy, that allows psychiatrists to better tailor interventions to each individual child. The therapy approach takes away the punishment aspect and emphasis on behavioral control common to many therapies. Instead, it focuses on a compassionate model that works on a child’s strengths, and teaches parents positive responses, coping skills, and how to take care of themselves.
“We help these kids be the bright and sparkly kids they can be,” says Pavuluri. “It’s heady work to be on the cutting edge of treatment for this sometimes devastating disorder. The parents are often held hostage by their children. We hope to give them their freedom.” After working with IJR, Robert’s mother would agree. For the first time in a long time, she can stop holding her breath.