Training Notes

"WHEN ACTING OUT ISN'T ACTING"
OCTOBER 15TH, 2004
IMPORTANT HIGHLIGHTS

Michael Heckman, Executive Director of Blue Harbor, delivered opening statements and introduction. Emphasis on need
for EDUCATION, RESEARCH and ADVOCACY

Greenberg/Bojrab:   What is ADHD? (Associated features, subtypes, and DSM IV criteria)
                      What is Bipolar? (Associated features, subtypes, co-morbidity and DSM IV criteria)
                      What are the differences/similarities between ADHD and bipolar?
                      Presented a video presentation of a patient interview with prior dx ADHD.
                      Information of studies regarding use of medications

                      What I thought was the most interesting:

In children, mania is usually presented with more irritability, anger, and "affective storms"
(rages) than euphoria
A study of 43 BP kids, family member felt that 70% of children presented symptoms prior to
age 5 years and 23% felt that symptoms were "always there". Age of onset prior to age 7.
Instead of weight loss, most children tend to have a slow growth rate
BP in youth: irritability, extreme rapid cycles, "mixed" episodes, chronic/continuous, co-
morbidity is common, family history with bi lineal transmission is very common.
Sleep problems-cycling in p.m., separation anxiety, severe nightmares (boundaries do not
exist)
ADHD may present at school/not home, BP only at home/not school, ADHD both home and
school.
Difference in behaviors at home and not school suggest good parenting since parents taught
child that boundaries do exist in society.
Treatment suggestions: Cognitive/Behavioral, Family & Interpersonal therapies and
Psychoeducation

Open Panel Discussion:   Panelists: Dr. Rosalie Greenberg, Dr. Christopher Bojrab (Psychiatrist)
                               Susan Finn, Janice Gabe (Family Therapist)
                               Robert Merra (Indiana Department of Education)
                              Questions: What should you ask when looking for a professional
                                                 What kind of coping skills for siblings; common to threaten family members
                                                 What are effective punishments
                                                 Ways to approach teachers
                                                 Harm of "wait and see" versus labeling of child
                                                 Bipolar versus Borderline Personality Disorder
                                                 Issues of illness and medication adjustments near teen years
                                                 Problems with therapist/school personnel not believing the parent
                                                 Possible treatment for ADHD
                                                 Advice for BP women in having children
                                                 Excuses of their illness presented by children for behavior
                                                 Is Tourettes a valid excuse for cursing teacher out
                                                 Other neurological conditions that may present as bipolar
                                                 Lithium use in kids
                                                 Do BP males increase predatory sexuality
                                                 Does BP qualify for an IEP
                                                 Strategies for rages
Blue Harbor intends on making this conference available on audio tape. Please check their website regularly to order
a copy if you were unable to attend. Go to Blue Harbor Website