BIPOLAR DISEASE IN CHILDREN AND YOUNG ADOLESCENTS

By Priya Modi and Kojo Koranteng and Aarushi Sharma

What is Bipolar?

• Manic – depressive disorder • Causes extreme mood swings that include

emotional highs and lows • Disruptive, long term condition

Symptoms

• Vary from person to person • The Diagnostic and Statistical Manual of

Mental Disorders – lists criteria for diagnosing bipolar

• Bipolar I - at least one manic episode, preceded or followed by hypomanic or major depressive episodes

• Bipolar II – at least one major depressive episode lasting a least 2 weeks and at least one hypomanic manic episode lasting at least 4 days

• Cyclothymic disorder – At least 2 years or 1 year in children and young adolescents and having numerous periods of hypomania symptoms.

• Other types – Bipolar related to other conditions such as Cushing’s syndrome, MS, stroke

For manic and hypomanic episodes, 3 or more of the following symptoms have to be present:

• Inflated self – esteem • Decreased need for sleep, insomnia • Unusual talkativeness • Racing thoughts • Distractibility • Increased agitation, restlessness • Doing unusual things with painful consequences • Depressed mood, feeling sad • Reduced interest or feeling no pleasure • Weight loss, weight gain (in children failure to gain weight)• Fatigue • Recurrent thoughts of death or suicide

• Symptoms often come and then disappear in children

• Not always the case therefore hard to diagnose child with bipolar

• Children with bipolar frequently diagnosed with other mental conditions

• Most prominent signs in children and young adolescents are unusual mood swings

Causes:

• Biological: physical changes in brain • Neurotransmitters: imbalance • Inherited traits:

Risk factors:

• First degree relative: parent or sibling • Periods of high stress • Drug or alcohol abuse • Major life changes, such as death of a family

member or other traumatic experinces

Conditions often in association with bipolar

• Anxiety disorders • Post traumatic stress disorder • Attention – deficit/ hyperactivity disorder • Addiction or substance abuse • Physical health problems – such as heart

disease, thyroid problems or obesity

Treatment

• Currently no treatment for bipolar disease • But medications and psychotherapy people are helped

to overcome episodes • Doctor has to do a ‘baseline’ assessment • Mood stabilizers – such as lithium first choice (also

used in children older than 12) • Anticonvulsant - used to treat seizures and sometimes

mood stabilizers• Atypical Antipsychotics • Anti depressants

Psychotherapy

• Cognitive behavioral therapy – helps young people with bipolar to learn how to change harmful or negative thoughts

• Family focused therapy – enhances family coping strategies

• Interpersonal and social rhythm therapy – helps children and teens improve their relationship with others and manage their daily routines

• Psychoeducation – teaches young people about illness and treatment. This helps to recognise signs of impending relapse

references

• http://www.mayoclinic.org/diseases-conditions/bipolar-disorder/basics/definition/con-20027544

• http://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

• http://www.webmd.com/bipolar-disorder/mental-health-bipolar-disorder

• https://en.wikipedia.org/wiki/Bipolar_disorder