Kentucky Partnership for Families and Children

Bipolar Disorder, once known as manic-depression is a serious but treatable condition. Bipolar disorder causes extreme changes in mood, energy, thinking and behavior, and affects over 2 million adults. Research has shown that it can run in families, and more research is being done to find links between bipolar disorder and chemical changes in the brain.

Being bipolar means that a person swings between periods of mania, or being “up”, and periods of depression, “down”. When the person is “up” they may feel hyperactive, have delusions of grandeur, lack good judgment, may be easily distracted or irritated, and may not sleep. When the person is “down” they may feel worthless, helpless, and hopeless, lose or gain weight, sleep more than usual but still feel tired all the time, and may think about death or attempt suicide. The length of each phase will vary, and there’s no way to tell when each phase will begin or end.

IN CHILDREN AND YOUNG ADOLESCENTS

It was only very recently that bipolar was diagnosed in young children; a diagnosis was more common in adolescence and adulthood. It is estimated that about three quarters of a million American children and adolescents struggle with bipolar, but most are undiagnosed. Bipolar is very difficult to detect in prepubescent youth. When the children are “up” their symptoms are similar to that of ADHD, when they’re “down”, symptoms are more closely related to Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD). The age for those children who are diagnosed is getting younger, some children even display signs of bipolar in their infancy. Children who are diagnosed with the disorder at a young age have a greater chance of being negatively affected for longer periods of time than do those that were diagnosed at a later age. It leaves them at risk for school failure, substance abuse, and suicide. One of the major differences between children and adults affected is that children do not have periods of wellness. There’s no “baseline” for them, and they have manic and depressive episodes simultaneously. Children who are diagnosed prior to puberty seem to have the most difficulty with the disorder.

IN OLDER ADOLESCENTS AND YOUNG ADULTS

Many adolescents do experience a “baseline” period of wellness. These periods of wellness occur in three different forms:

• Bipolar II - episodes of hypomania occur between recurrent periods of depression. This is marked by elevated or irritable mood accompanied by increased physical and mental energy. This can be a period of great creativity
• Cyclothymia - this form causes less severe, but very definite mood swings
• Bipolar Disorder Not Otherwise Specified - this diagnosis is made when neither of the two above are clear

For some adolescents, a loss or other traumatic event may trigger the first episode of depression or mania. Later episodes may occur independently of stress, or stress may cause the episode to worsen. In girls, the onset of the menstrual cycle may trigger the illness and symptoms often vary in severity with the monthly cycle. Many adolescents and young adults try to control their mood swings with alcohol and other illegal substances. If this happens, both the bipolar and the substance abuse will need to be treated separately.

Without treatment, the episodes will most likely worsen with each recurrence. Studies have shown that after the first symptoms appear, there is usually a 10 year lag before treatment begins.

FOR PARENTS

If you feel your child may suffer from Bipolar Disorder, the best thing for you to do is get a diagnosis as soon as possible. Remember, no one can diagnose your child with bipolar except his or her physician, a psychologist or psychiatrist. Be open and honest about your child’s diagnosis, and be sure to get proper treatment for him or her. Side effects of improperly or untreated bipolar are the development of personality disorders such as:

• Narcissistic
• Antisocial
• Borderline Personality Disorder, and/or
• A worsening of the disorder due to incorrect medications.

A good start to getting your child properly diagnosed is to start taking daily notes of your child’s mood, behavior, sleep patterns, unusual events, and statements by the child. Be sure to share these notes with the doctor in the beginning and even right before each session with the doctor treating your child. A good evaluation will take the doctor at least two appointments and may include a detailed family history. A parent support group may prove valuable for your own mental health needs.

FOR TEACHERS

It is possible for a student diagnosed with bipolar to, for at least some of the time, be in a regular education classroom. If you’re a teacher with a child with any disability in your classroom, be sure to do your research about the disability, and be flexible and creative when teaching and working with him or her. Share your knowledge with other school staff members, too. They may need the information later.

An open line of communication between you and the child, and you and the child’s parents is essential. And excellent resource for teachers with students with disabilities is at the bottom of the resource section in the next column. KPFC is also a great resource for parents and teachers!