Bipolar Disorder

Bipolar Disorder or Manic Depression in Children

Manic depression (now commonly referred to as Bipolar disorder) is characterized by extreme changes in mood, energy, and behavior. Until recently, manic child depression was rarely diagnosed in adolescents, but recent research has improved the ability of child psychiatrists to diagnose and treat the condition in children and teens.

There is no laboratory or imaging test that can help determine the prevalence of depression, and parents concerned about their child’s behavior should look out for the following behavioral and emotional symptoms:

Manic Symptoms

• Misplaced self esteem - boastful of acquired or un-acquired skills.
• Extreme changes in mood - suddenly happy, irritable, silly, angry or agitated.
• Hyperactivity - usually going without sleep for days without showing signs of fatigue.
• Vociferous - speaking too fast and changing topics frequently.
• High risk - increased sexuality, reckless driving, and substance abuse.

Depressive symptoms

• Sadness - unrelenting depressive mood, crying spells, and pervasive sorrow.
• Lack of interest - inability to enjoy activities that were once highly favored, isolation, refusal to interact with people.
• Lethargy - low energy, lack of concentration, fatigue, and complaints of boredom.
• Major changes in sleep and eating patterns - oversleeping or overeating.
• Negative emotions - thoughts of death or suicide, frequent complaints of vague diseases.

Bipolar disorder is further classified as Bipolar I and II. Bipolar I is a condition where the child experiences severe mood changes bordering on psychotic (loss of or highly distorted contact with reality), mania, and depression.

Bipolar II is characterized by a marked increase in physical and mental activity with irritable mood that lasts for 3 to 4 days between recurrent episodes of depression. Bipolar II disorder is more common in adolescents than Bipolar I.

Cyclothymia is a form of mild Bipolar disorder that persists over a long period. Significant mood symptoms suggestive of Bipolar I, II, or cyclothymia that are not of sufficient duration or severity to meet criteria for either are classified as Bipolar disorder NOS (not otherwise specified).

Before seeking any teen depression help, it is imperative to first get an evaluation from a specialist. Bipolar disorder requires specialized treatment from a child psychiatrist. Depending upon the severity and frequency of mood changes, the psychiatrist may limit treatment to psychotherapeutic therapies like cognitive behavioral therapy, or suggest medication with antidepressants and mood-stabilizing drugs. Just as the symptoms of Bipolar disorder alternate, the medication also needs to be changed often, necessitating condition monitoring through frequent visits to the child psychiatrist.

The importance of a correct diagnosis of teen depression, especially Bipolar disorder, must be emphasized. It needs to be remembered that diagnosis should be based on the scientific learning and training of the doctor who arrives at a considered opinion after studying the child’s behavior, family history, and developmental stage.

At the same time, improper handling of Bipolar disorder can have serious consequences, including increased symptomatic behaviors and personality disorders like narcissism, antisocialism, and borderline personality. Incorrect medications may worsen the disorder and may necessitate hospitalization or incarceration under the juvenile justice system.