This is a very difficult subject for a parent to talk about. In our everyday world when a child acts out we think: they need to be "gounded" or "here comes a time out."

We can see the behavior escalating and we know when they are about to force the issues. It is in these repeat lows and highs that we learn. Sometimes a behavior is occurring not because a child chooses to misbehave but rather it is part of a pattern to an illness.

This is why continued therapy is always a good idea if you have a child with behavior issues. A trained eye can observe the actions of the child and help you and the child to understand them. Most of the time this is when a medication might be suggested to help the child maintain in school and to be as normal as possible.

My daughter April is a perfect example. For so long she just acted like Jekyl and Hyde. One moment she was the sweetest little, blue eyed, blonde on earth. Then the next moment you would expect her head to spin and through for sure any moment she would levitate off the floor.

The therapist at the agency we were adopting through taught us how to restrain her. She would get out of control and she would harm herself or others.

We would get calls from school and she would be missing. No one could find her anywhere. So of course I went to the school and we would do a search and most of the time she would be hiding in a clothes closet or under some table in a classroom where she did not belong.

She didn't begin acting out in school until about third grade. It just happened that this was her first experience with a male teacher also.

April had lived a traumatic life. She was four years old and ran out into the street in front of a Social Worker's car and that is how the kids came into care.

She had always blamed herself. But there were other reasons also. The family had no food and the parents were both high and unable to manage the children. The smallest child was 11 months old and she was drinking beer in her bottle.

However all that April knew was her siblings said it was her fault. So she carried the inner blame. This little one suffered from depression. She did not seem to care about anything. Not toys, food or cartoons.

I quickly noticed that she would wipe feces on her bed sheets and down her walls. Often she would use the bathroom wall instead of toilet paper. She also had a very difficult time waking up and she would wet her bed. I didn't allow any of this to bother me. I simply talked to her worker and her therapist about it.

About the second evening she was in our home, I walked in to the bathroom after knocking on the door, to bring the girls in some fresh towels. When I turned around I saw April's little butt and her leg. She was a running sore. I smiled and said oh wow honey how did you get that rash. She told me that it has been there for a couple months and won't go away.

When I approached the worker on it the next day, I was amazed that the worker knew about it but did not pass the information on to me. The worker said oh the other foster mom said the doctor told her it would not go away it is A typical skin.

With in one week of good hygiene and keeping it clean and putting some desitin on it, it began to clear up. I took her to the doctor and the doctor told me that it was simply from neglect to keep the child clean.

It was only a few short weeks and the rash had gone away. I taught April to use toilet paper and she stopped using the walls to get "Yuckies" as she called them off her fingers.

However we still noticed that the bed sheets would have finer streaks down them. I washed her sheets daily and taught her to pull the sheet and top plastic off in the middle of the night if she woke up wet. I would double sheet her bed and double the plastic so she would be comfortable and could stay dry at night if she had a mishap.

It wasn't until much later that we saw April just become unable to control her temper and actions. When she was twelve she got into a school fight. Two girls jumped her on the bus and she finally fought back. One of the girls got her arm broken in the process of the fight and the next thing we knew we were in court. They had turned all the blame on April and as a foster/adoptive child they let her take the full fall. April was taken and placed out of state in a youth home for teen offenders. It was an 8 month program.

We had been told it was a place where she could receive up to date therapy and she would complete the program in six to eight months.

This is where April was first introduced to medicine. They sedated her and kept her so drugged up that she couldn't communicate well.

So our first experience with medication was very negative. I will later talk about the time April spent in lock down and how we fought to get her back.

Right now I want to focus on medication. When April came home to us we got her into a wonderful doctor and therapist. They worked with us to help us make sure April was on the correct medications and on the right dose. We went through about two months before we seemed to get it right so April could stay awake and function in school and have a somewhat normal life.

I wish I had only known about these medications sooner in life with April. I wish someone had said your daughter has ODD (Oppositional Defiant Disorder) and Explosive Disorder and Oh by the way she is Bipolar too.

We knew she had always been defiant. We also knew it only took something small to set her off on a rampage of distruction. But we didn't even know what Bipolar was.

We saw April blossom when she took the medications. It was so strange. She would become this wonderful normal child and then she would refuse to take the medications and in a few days she became a monster again.

It was not a chosen behavior but one rather that depended on her medications, so we had to begin to monitor her and make sure she took them.

We learned each day what was and was not a chosen behavior, so our discipline had to change also to accommodate for behaviors that she really couldn't control.

I would highly recommend that if your child is on a medication that you monitor how and when the child takes the medication, even if they are teenagers.

April is now 16 and ready to be 17. She gives us issue after issue and life is never boring with her around.

I look forward to sharing more about life with April in future blogs. I sincerely have compassion for bipolar children and their families.