normal tantrums or bipolar?

by Jenny
(Massachusetts)

Over the past year, my husband and I have become increasingly concerned about our now 3-year old son. It started when people started noticing that he would not make eye contact, and frequently ignored people besides myself. Other people would comment that his speech seemed a little funny, maybe dramatic or theatrical rather than conversational. He is definitely very high energy, always climbing on things, getting into trouble, he has no fear of anything.


We had him evaluated by infant toddler services, and they noted some social and emotional delays. We made an appointment with a child psychologist, but it is months away, and things seem to be getting better in some ways, and worse in others.

Socially, he seems to be improving somewhat. But now it seems like he is having "episodes" where he is completely out of control. He'll say things like "I want to SMASH you! Or "I want to take my head off!" or "I want to run in the road with cars!". During these times, he is completely shaking with rage, and I can feel his little body just exploding with energy.

He often doesn't seem to understand if he has hurt someone else, including his sister, myself, and our pets. It's almost like he is curious what would happen if he did something like choke the cat.

Writing that down, it seems so terrible, but most of the time, he is a sweet, smart, funny little boy. He loves hugging and cuddling, and often, the way to calm him down is grab him, sit on he couch and read a story.

Many other moms tell me he seems completely normal, and that boys are just different than girls, mature more slowly, and are generally more aggressive. They assure me this is just the terrible threes, and it will pass. But they have never seen one of his terrible episodes.

We do not have a lot of stressful issues in our house. Although we did move about a year ago, it was to my parent's house, a home he was very familiar with and he seemed to take the move in stride. Other than that, my husband and I are in a stable, loving marriage, he has a steady job with lots of time off to spend with us, and I stay at home with the kids. Things are pretty peaceful here, so I do not think the little guy has a lot of external stresses.

I know you can not diagnose online, but can you give me some things to look for to distinguish between a normal temper tantrum and something more? What sort of things should I be looking at to discuss with the child psychologist in the fall? Would you recommend trying to see someone before then?



Hi Jenny. There is a checklist that talks about symptoms on my website. In my opinion, the most important factor here would be your genetic history. Do you have bipolar disorder in your family? DO you have major depressive disorder in your family?

The statements you indicate he makes are definitely indicative of impulse control and anger issues. Although I'm sure that your friends are well meaning, you really need to trust your instincts.

A psychologist will not prescribe medication, and that is the direction you will need to look in if you suspect bipolar disorder. I don't see the benefit in rushing to get him in treatment, unless medication is what you are considering.

Sincerely

Kristen McClure

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