Bipolar disorder, also known as manic-depressive disorder, affects more than 2 million American adults. This condition was once thought to occur only rarely in children. However, it is now clear that this is not the case. According to the American Academy of Child and Adolescent Psychiatry, up to 1.1 million children and adolescents in the United States may have bipolar disorder.
20% of all bipolar patients have their first episode during adolescence and 16% of youth in child psychiatry clinics probably have bipolar disorder. The peak age of onset is between 15 and 19 years of age.
Bipolar disorder is grossly under diagnosed. Only 1/3 of adult patients with bipolar disorder ever receive a formal diagnosis. Only 1/3 of those diagnosed receive treatment, and only a fraction of those receiving treatment are receiving optimal treatment.
In children, the diagnosis is even harder to make. Bipolar disorder is more difficult to recognize in children for a number of reasons. First, the symptomatic criteria in children are not well established. Also, the symptoms can resemble or co-occur along with other common childhood mental disorders. In addition, symptoms of bipolar disorder may easily be confused with the normal labile emotions and behaviors found commonly in children and adolescents.
19% of ADHD children also have bipolar disorder.
Subtypes
Psychiatrists have divided bipolar disorder into a number of subtypes. This division is helpful for diagnosing and treating the disorder.
Bipolar 1:
This is the classic manic-depressive disorder. Patients with this subtype have full-blown episodes of both mania and depression.
Bipolar II:
In bipolar 2 disorder, patients still have depression, but the symptoms of mania are not as severe. These patients have what is called hypomania. The symptoms are similar to mania, but without the delusions and hallucinations that may accompany full mania. In adolescence, hypomania appears as a markedly elevated or irritable mood accompanied by increased physical and mental energy.
Cyclothymia:
This disorder is characterized by definite mood swings, but without full mania or depression.
Bipolar Disorder NOS (Not Otherwise Specified):
This is a catch all diagnosis given when it is not clear which type of bipolar disorder is emerging.
Mixed States Bipolar Disorder:
There is something called mixed states bipolar disorder that is important to understand. This comes in two types, mixed bipolar disorder and rapid cycling bipolar disorder.
Mixed bipolar disorder is characterized by simultaneous manic and depressive symptoms. In rapid cycling bipolar disorder the patient experiences frequent switches from depression to mania/hypomania and back.
These mixed states are found in bipolar 1, bipolar 2, and cyclothymic disorders. Children and adolescents often have mixed bipolar disorder. These mixed states are often associated with thyroid abnormalities. They do not respond well to lithium, the standard treatment for bipolar disorders.
Symptoms
Bipolar disorder is characterized by an alternating pattern of emotional highs (mania) and lows (depression). The intensity of the signs and symptoms varies. Bipolar disorder can range from a mild condition to a severe condition. Normal people regularly have mood swings, but in bipolar disorder, these changes interfere with daily function. The symptoms of bipolar disorder depend upon which stage of the disorder the person is experiencing.
Manic symptoms include:
Increased energy, activity and restlessness
An excessively euphoric mood
Severe changes in mood—either extremely irritable or overly silly and
elated
Overly-inflated self-esteem grandiosity
Increased energy
Decreased need for sleep
Rapid speech and increased talking
Distractibility
Poor judgment
Increased goal-directed activity or physical agitation
Increase in risky behavior
Depressive symptoms include:
Persistent sad or irritable mood
Loss of interest in activities once enjoyed
Significant change in appetite or body weight
Difficulty sleeping or oversleeping
Physical agitation or slowing
Loss of energy
Feelings of worthlessness or inappropriate guilt
Difficulty concentrating
Recurrent thoughts of death or suicide
Agitation and irritability
Between the episodes, the person has periods of relative or complete wellness.
Anthony Kane, MD is a physician and international lecturer.
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» left by Anonymous (2 years 46 days ago.)
very helpful...as recently having been told a family member may fit this diagnosis. There is much to learn to facilitate recovery. Thank you very much. Respond to this comment
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Article added to SearchWarp.com on Monday, December 27, 2004 View other articles written by Anthony Kane MD(3,083)
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