Bipolar In Children
A Brief Guide to Bipolar in Children
In the mid-1990s, bipolar disorder in children was thought to be exceedingly rare. Since that time the number of diagnoses has increased dramatically. There are thought to be nearly 800,000 children and teenagers with bipolar in the United States at present. The staggering increase in the number of children diagnosed and the use of medications that previously had only been used in adult cases has made this an area of some controversy in the psychiatric community.
Also called early-onset bipolar disorder, childhood bipolar was often misdiagnosed as Attention Deficit Hyperactivity Disorder (ADHD). Some of the same difficulties with hyperactivity, irritability, and distractibility occur in both disorders. Other behaviors such as flight of ideas, decreased sleep, hypersexuality, and grandiose behaviors are rare in ADHD but common in bipolar disorder. Flight of ideas is characterized by rapid and illogic changes in topic during conversation. Grandiose behaviors include both thinking they can perform superhuman feats and that they are above or untouched by societal rules. Other symptoms include having a very short temper, excessive silliness that is out of context with the situation, risk taking behaviors, and thinking or talking about death or suicide.
Bipolar in children has rapid mood swings unlike the adult disorder. Adults with bipolar may experience the manic or depressive state for weeks, months, or years. Children can cycle through these phases in a day. This is one of the primary differences between the two types. All children have frequent mood changes, but these are much more intense and often cause problems for the child at home, at school, and in other environments.
There are no definitive physical tests for diagnosing bipolar disorder. A doctor will diagnose a child based on behaviors. Bipolar is more common in families with a history of depression, bipolar disorder, and alcoholism, but also occurs in children without these family histories. Medications in conjunction with therapy are used to treat the symptoms of the disorder. There is no current cure for bipolar, but medications can keep the symptoms under control. Treatments work best when ongoing rather than stopping and starting. Children need to be watched closely for possible side effects and medications adjusted when necessary.
The manual that both doctors and insurance companies use when diagnosing psychiatric disorders is the Diagnostic and Statistical Manual (DSM) by the American Psychiatric Association. Its most recent addition, DSM-IV, is currently up for revision. The new edition is set for release in 2013. Some significant changes may occur in the new edition, revising disorders that affect children including Asperger’s Syndrome, binge eating, cutting and self-mutilation, and childhood bipolar.
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