Bipolar disorder, also known as manic-depressive disorder, can emerge during childhood, adolescence or adulthood. Bipolar disorder is a chronic brain disorder characterized by extreme changes in mood, behavior, thinking and and energy. In a review of data in the Netherlands Twin Registry, 4 to 5 percent of more than 6,000 10-year-olds likely met criteria for bipolar disorder. Among a study group of people with bipolar disorder, half had experienced abuse, suggesting high rates of abuse among the bipolar population, according to 2005 research in "The British Journal of Psychiatry," published by Jessica L. Garno and colleagues.
Background
Four types of bipolar disorder exist. Those who have bipolar I experience mania and depression. Some symptoms of mania include euphoria, racing thoughts, grandiosity, hypersexuality and increased energy. Depression is marked by lack of enjoyment of life, pervasive sadness and changes in sleep, appetite and energy level. People with bipolar II don't experience mania. Between depressions, they experience normal mood or hypomania, characterized by elevated mood and increased energy. Hypomania is not as severe as full-blown mania and doesn't require hospitalization. Bipolar disorder not otherwise specified is diagnosed when serious mood changes occur but it isn't clear which type of bipolar disorder is emerging. Cyclothymia is characterized by recurrent, but less severe, mood swings that still disturb an individual's normal functioning.
Age
The prevalence of bipolar disorder among children and adolescent is likely at least that of the adult population, according to a 1997 study published by Barbara Geller, M.D., and Joan Luby, M.D., in the "Journal of the American Academy of Child and Adolescent Psychiatry." In children, manic symptoms may manifest as believing classes are taught incorrectly, high activity levels prior to sleep and stealing, according to the same study. Hypersexuality symptoms may include masturbation at a young age, excessive masturbation or inappropriate sexual comments. Taking more dares is common. Children may be more likely to experience rapid cycling, or quickly moving from manic symptoms to depressive symptoms.
Research
Severe abuse is associated with a younger age of bipolar disorder onset and higher severity level of manic symptoms in adulthood, according to a 2005 study in "The British Journal of Psychiatry." People with bipolar disorder who experienced abuse as children suffer from more extensive suicidality, rapid cycling symptoms and possibly comorbid substance misuse, according to the same study. In some cases, abuse is suspected in children who display bipolar symptoms but abuse has not occurred. Symptoms of bipolar disorder can be similar to the actions of a child who has been abused.
Considerations
Sometimes, children who are diagnosed with bipolar disorder do not have the disorder. They may have been the victims of sexual abuse and show hypersexuality symptoms but don't actually meet full criteria for bipolar disorder. Language disorders should not be confused with the racing thoughts and speech of bipolar disorder. Attention deficit disorder, anxiety disorders and conduct disorder also share similar symptoms with bipolar disorder and should not be confused with bipolar disorder, although both disorders are often present along with bipolar. Substance abuse can also cause some of the same symptoms as bipolar disorder.
Treatment
Treatment of bipolar disorder in children has not been thoroughly studied. Lithium may be an effective medication, but it may cause cognitive impairment in some children as well as thyroid and kidney side effects. Anticonvulsants, such as valproate and carbamazepine, may be beneficial but are not approved by the Food and Drug Administration. Some children may see a benefit from methylphenidate, but some see a worsening of symptoms. Several antipsychotics, a type of drug including aripipazole and quetiapine, have been approved by the FDA for use in children ages 10 to 17. They may cause weight gain. No FDA-approved medications exist for children under age 10. In addition to medication, treatment plans usually include psychotherapy. Family support groups are also beneficial.
Warning
Even in young children, suicide is a risk and should be taken seriously. If a child talks of wanting to die or wishing he was never born, call for help right away. Take the child to an emergency room or call 911 for an ambulance. If you are alone, call for help from a relative or friend.
References
- "The British Journal of Psychiatry": Impact of Childhood Abuse on the Clinical Course of Bipolar Disorder; Jessica L. Garno et al; 2005.
- "Journal of the American Academy of Child and Adolescent Psychiatry"; Child and Adolescent Bipolar Disorder: A Review of the Past 10 Years; Barbara Geller, M.D. and Joan Luby, M.D.; 1997.
- Child and Adolescent Bipolar Foundation: Allegations of Abuse
- National Alliance on Mental Illness: Facts on Childhood-Onset Bipolar Disorder
- Child & Adolescent Bipolar Foundation: About Pediatric Bipolar Disorder
