JULY2002

What is Bipolar Disorder and is it as prevalent with young children and adolescents as with adults?

Bipolar Disorder, also called manic depressive illness, is a serious emotional disturbance affecting between 0.4 and 1.6% of the general population. Episodes of mania alternate with periods of depression. It is usually seen for the first time in young adults but can be seen in adolescents. It is relatively rare among young children. This illness can affect anyone. However, there is increased evidence that a familial component might play a role in the development of a bipolar disorder. If one or both parents have manic-depressive illness, the chances are significantly greater that their children will develop the disorder. Psychosocial factors can also have a major impact on the development of this disorder. Severe stressors - abuse, difficult family relationships, extreme poverty - are other factors which have been implicated.

The manic symptoms MAY include:

•  Severe changes in mood compared to others of the same age and background--either unusually happy or silly, or very irritable.

• Unrealistic highs in self-esteem--for example, feeling especially connected to God or having grandiose ideas.

• Great energy increase; ability to go with little or no sleep for days without feeling tired. Increased talking--talking too much, too fast, changing topics too quickly, unable to be interrupted; having disconnected and racing thoughts.

• Distractibility--attention moves constantly from one thing to the next.

• High risk-taking behavior, such as jumping off a roof with the belief that this will not cause injury; frequent unprotected sexual intercourse; reckless driving, poor judgment.

The depressive symptoms MAY include:

• Persistent sadness; frequent crying; depression.

• Loss of enjoyment in favorite activities.

• Frequent complaints of physical illnesses such as headaches or stomachaches.

• Low energy level, poor concentration, boredom.

• Major change in eating or sleeping patterns, such as oversleeping or overeating.

Some of these signs are similar to those that occur in teenagers with other problems, such as drug abuse, delinquency, attention-deficit hyperactivity disorder, or even schizophrenia. The diagnosis can only be made with careful observation over an extended period of time.

Youth with a bipolar disorder can be effectively treated. However, the most effective treatment is holistic and usually includes psychosocial and biological interventions. Treatment interventions should include:

• Education of the youth and family about bipolar disorders.

• Proactive encouragement to maintain a healthy life style including a healthy diet; regular, vigorous exercise; appropriate amounts of rest and sleep; stress management; and avoidance of alcohol and drugs.

• Psychotherapy (Interpersonal and Social Rhythm Therapy, Systemic Family Therapy and Supportive Family Therapy).

• Medications -- usually mood stabilizers (Lithium, Valporic acid) and antipsychotics (Risperidone, Haloperidol).

Bipolar Disorder Bibliography 

Biographies of Theodore Roosevelt, Vincent Van Gogh, Ernest Hemingway, Abraham Lincoln, Winston Churchill Duke, P., Call Me Anna: The Autobiography of Patty Duke New York: Bantam Books 1987 

Fieve, Ronald, M.D., Moodswings New York: Morrow, 1975, 1989

Goodwin, F.K., Manic-Depressive Illness New York: Oxford University Press, 1990

Jefferson, James W., Lithium and. Manic Depression: A Guide Madison, WI: Lithium Information Center, 1992 

Othmer, Ekkehard, M.D., Life on a Roller Coaster PIA Press Winakur, George, M.D., Manic-Depressive Illness St. Louis: Mosby, 1969

References:

U.S. Department of Health and Human Services. (1999). Mental Health: A Report of the Surgeon General. Rockville, MD, U.S. Department of Health and Human Services, Substance Abuse and Mental Health Administration, Center for Mental Health Services, National Institutes of Mental Health.

"Facts for Families" (Topic No.37) American Academy of Child and Adolescent Psychiatry, Washington, D.C.