Bipolar disorder, also called manic-depressive disorder, is a psychiatric illness characterized by mood swings, extreme emotions, sleep disturbances and unpredictable behavior. It is most commonly diagnosed in young adults, with a mean age at diagnosis of 25 years. Nevertheless, it is a common disorder in children as well. Known as "early onset bipolar disorder," the childhood form of the disease is characterized by more severe symptoms than those usually seen in adults.
Both forms of the disease are treatable. As a rule, outcomes are better when treatment is started as soon as possible after symptoms appear.
What is bipolar disorder?
Bipolar disorder is a serious brain disorder. People who suffer from bipolar disorder experience extreme emotional states that vary unpredictably from severe depression to an agitated, excitable so-called "manic" state. The illness is divided into four major categories according to the severity of symptoms and the frequency with which they occur. The most severe form of the disease, Bipolar I Disorder is characterized by severe episodes of mania that last a minimum of seven days, usually alternating with periods of depression that may last as long as two weeks. Bipolar II disorder and other less severe forms of the illness are marked by "hypomania" -- less extreme manic behavior -- alternating at irregular intervals with depression, which is often severe. Many people with mild bipolar disorder are incorrectly treated for depression, often with poor results.
What causes bipolar disorder?
While the exact cause of bipolar disorder is unknown, it is believed to be a result of the confluence of a number of biological, physical and environmental factors. Although the disorder is not hereditary, it does tend to run in families. Children who have a parent or sibling with bipolar disorder are four to six times more likely to develop the disease than those who do not. Other contributing factors include childhood trauma and severe psychological stress. Children who suffer from anxiety disorders are more likely to develop bipolar disorder later in life.
The incidence of bipolar disorder in children and adults has increased dramatically in recent years, but by far the largest increase has occurred in children. According to the National Institute of Mental Health, nearly 40 times more children were diagnosed with bipolar disorder in 2012 than in the any of the preceding 5 years. This statistic may be misleading, however, reflecting a more aggressive approach to diagnosing mental illness -- especially in children -- rather than any actual increase in the prevalence of the disease.
What are the symptoms of bipolar disorder?
The symptoms of bipolar disorder vary, but the hallmark symptoms are mania, or extreme excitability, alternating with periods of sadness or withdrawal. Children with bipolar disorder may appear very sad for no apparent reason. They may cry a great deal; have difficulty making friends or express thoughts of suicide or a pre-occupation with death. Other behavioral signs of bipolar disorder include:
Complaints of non-specific health issues, like stomach aches or fatigue
Problems concentrating
Failing grades
Agitation, trouble sitting still or extremely high energy
Difficulty sleeping
Nightmares
Excessive, incessant talking
Extreme irritability, getting into fights with siblings or peers
Increased interest in sex
Increase in high-risk behaviors - speeding, shoplifting, or other run-ins with law enforcement
Alcohol and/or drug abuse
Of course, all of these behaviors can occur in normal pre-pubescent children and teens, which is why bipolar disorder in children is difficult to diagnose. The severity of the moods and the suddenness of changes may be the only clue that something serious is wrong.
How is Bipolar Disorder Diagnosed?
The diagnosis of bipolar disorder is based on a number of factors, including family history, recent symptoms, and a physical exam. While there is no blood test or other diagnostic test for the disorder, your doctor will first examine your child and do a number of laboratory tests to rule out any physical cause for his symptoms. If none are present, he will refer you and your child for a psychological exam.
Bipolar disorder can masquerade as any number of psychiatric and neurological illnesses, including schizophrenia, major depressive disorder (unipolar depression,) post-traumatic stress disorder (PTSD) and attention deficit hyperactivity disorder (ADHD), to name just a few. Physical problems, such as brain tumors and metabolic disorders like diabetes can cause similar symptoms as well. Nevertheless, a pediatric psychiatrist will undoubtedly be able to provide you with both a diagnosis and a plan for treating your child.
How is bipolar disorder treated?
There are many available treatments for early onset bipolar disorder, but early intervention is the most important factor in controlling the disease. Successful treatment usually involves a combination of medication and psychotherapy, which has been shown to be much more effective than medication alone. The mood stabilizer lithium and the atypical anti-psychotic medicines resperidone and aripiprazole are the only medicines currently approved for use in children with this disorder, although effective new treatments are introduced every day. Antidepressants,like fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft) usually are not recommended for children and adolescents, since they greatly increase the risk of suicide or suicidal thoughts.
Early onset bipolar disorder is a serious mental illness, but with early intervention and treatment your child can lead a long and happy life. Contact your physician if you suspect your child may have this or any other psychiatric disorder. You also can obtain additional information and resources by visiting National Institute for Mental Health.
No comments:
Post a Comment