Alice worried about everything, howled when she was separated from her parents, and often demanded to sleep in their bed.

Alice had a lot of trouble waking up in the morning despite the fact that she never
wanted to go to bed at night and had trouble falling asleep. She’d get angry when
awakened in the morning and she always had dark circles under her eyes.
Criticism crushed Alice, making her defensive and angry. She complained constantly of
being bored and couldn’t handle waiting. It was hard for her to keep friends because of
her need to control things around her and her tendency to be argumentative. She’d
erupt in a rage when her parents tried to set limits. Alice was irritable much of the time,
and had fast and unexpected changes in her mood throughout the day. Recently, she
seemed to be taking a dark turn, with brooding, cursing, and getting lost in gory graphic
novels.

Alice had seen multiple doctors and multiple counselors. She’d been diagnosed with
ADHD, depression, and an alphabet soup of other labels (ODD, OCD, CD, DMDD**)
each of which almost but didn’t quite fit. Alice had been given a host of stimulants like
Ritalin and Adderall, as well as antidepressants like Zoloft and Prozac, but nothing
seemed to do much good. In fact, sometimes, they even seemed to make things worse,
causing more irritability, agitation, and abrupt mood changes.

Alice’s parents, her doctors, and her counselors were left wondering, what is Alice
suffering from, and how do they help her?

The truth is that Alice’s history shows symptoms of a new disorder, that many
practitioners haven’t heard of yet, which makes it harder to get the right treatment. Alice,
like thousands of other children, suffers from a specific subtype of Juvenile Bipolar Disorder called Thermoregulatory Fear of Harm Mood Disorder, or Fear of Harm for
short. Dr. Demitri Papolos, lead researcher for the Juvenile Bipolar Research Foundation, and the author of the book, The Bipolar Child , explains, “Juvenile Bipolar Disorder and Fear of Harm are major social as well as medical issues.” A study of over 5,000 youth
diagnosed with bipolar disorder suggests that roughly one-third have Fear of Harm.
With an estimated 750,000 kids suffering from bipolar disorder that would mean that
nearly 250,000 children suffer from Fear of Harm . “These children are usually
misdiagnosed, and the typical medication treatments used can make them more
aggressive,” explains Dr. Papolos. This can lead to escalating problems at home, at
school, in social groups, and can even lead to encounters with law enforcement and the
juvenile justice system.

The Breakthrough Discovery

After eight years of research, doctors identified Fear of Harm as a type of bipolar
disorder, which includes symptoms of aggression, extreme anxiety, and intense fear
that harm will come to self or others. But what makes Fear of Harm unique is that it
includes, for the first time, a physical symptom . Among the other symptoms, kids with
Fear of Harm feel hot most of the time, even when their environment isn’t hot. This is a
sign that their bodies can’t regulate their temperature properly. Doctors call this a
“thermoregulatory disturbance”, and it plays a significant role in the development of all the behaviors that go along with Fear of Harm.

This inability to control body temperature also disrupts sleep because with body
temperature rising, when it’s supposed to be getting lower as night falls, kids with Fear
of Harm have problems falling asleep, sleeping peacefully, and getting up in the
morning. Worse, the kids frequently have terrible violent nightmares, and relive seeing
the images whenever they close their eyes. Their brains experience this imagery as if
it’s real, and they develop symptoms of PTSD, including a fight or flight response even
when there isn’t anything threatening happening. This ongoing feeling of fear and
misperception of threats leads to all sorts of other behavioral problems.

How Do We Help?

With the discovery of Fear of Harm researchers knew they had to figure out how to treat
this new illness. Researchers found a medication that was already known to reduce fear
sensitivity, reduce body temperature, and had been shown for years to be safely used in
children. With its fear and temperature reducing effects researchers believe this trusted medication is part of the solution for kids with Fear of Harm. Their findings show that it
can be a safe and effective long term treatment, offering hope for thousands of children
and families.

For Fear of Harm patients once they’ve received the correct diagnosis, and access to the
effective treatment, the change is quick and noticeable. Treating the temperature
dysregulation results in a reduction of manic behaviors, fear, anger, and aggression. It
improves patients’ mood, reduces anxiety, and the behavioral symptoms fade. “For
children and adolescents with Fear of Harm, accurate diagnosis and treatment can be
transformational,” says Dr. Papolos. “I believe there are many, many more children out
there who can benefit.” The bottom line is that those with Fear of Harm can experience
a dramatic change for the better in their lives. As one mother said, “The effects of
treatment have been nothing short of miraculous.”

*To protect patient privacy this patient profile is drawn from multiple real examples originating from
multiple patients.
** ODD, Oppositional Defiant Disorder; OCD, Obsessive Compulsive Disorder; CD, Conduct Disorder;
DMDD, Disruptive Mood Dysregulation Disorder

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