QUESTION:
Dear Dr. Heller,
I was wondering if you could assist me with a situation. I am a fourth grade teacher. One of my students has recently been going through some changes. I just say, “It’s probably just a phase.” But his mother is quite concerned. She calls me often, and I do not know the answers to her questions. She asks me, “What is wrong with my boy?”, and I do not know. He is a loveable boy. Recently he has been lying at home and at school a little. He said a swear word and then insists that he did not. This kind of thing is going on at his home also. He does something that is unlike him or inappropriate, and then he denies the actions. Also he has been very quiet with his classmates. His handwriting is getting sloppier and sloppier. His grades are declining fast, and he was an A/B student. Also, over the weekend, he ripped out half of his eyebrow. What could this be? Nerves? A phase? Please e-mail me with any conclusions or thoughts.
Thank you.
ANSWER:
Ripping out half of one’s eyebrow is not a phase. The most likely diagnosis is childhood onset bipolar disorder. http://pks.947.myftpupload.com/BiPlrKid.htm shows the questions I ask when trying to make a diagnosis. The book “The Bipolar Child” by Dr. Papolos is invaluable. There may be other diagnoses going on, but childhood onset bipolar is the most concerning possibility.