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Bipolar Disorder and Adolescents

Symptoms of bipolar disorder in children and adolescents may look like other disorders

Traditionally bipolar disorder has been thought to first show in early adulthood – and more often in females.  Bipolar disorder was considered to be quite rare as few as 20 years ago, to be more exact. The first emergence came in the early 20s, mainly in females. But, our knowledge about bipolar disorder has grown rapidly in the last 20 years.

Instead of the single manic-depressive diagnosis – which included diagnostic criteria of both depressive periods, alternating with manic periods – described as “euphoria”?

Those who did not have clearly rhythmic, alternating periods of a “happy” and frantic manic phase with a classic depression period were mishandled, misdiagnosed, mistreated, or dismissed.

Bipolar ChildrenIn addition, it wasn’t really known that bipolar disorder could start in adolescence or even childhood, or that there are different types of bipolar disorder.  Today, it still isn’t “officially” recognized in the “psychiatric bible” – the Diagnostic Statistical Manual of Mental Disorders (DSM), but at least more practitioners do know that it exists.

Today, we don’t exactly know what causes bipolar disorder (only that there is a genetic link of some kind, and often some past trauma). But, we can at least identify adolescent and childhood bipolar illness.  We also recognize a variety of different types of bipolar disorder (Such as mixed manic episodes, rapid cyclers, people without a depressive phase, hypomania, dysphoria rather than euphoria and cyclothymia). We also have a “catch-all” type – Bipolar NOS or “not-otherwise-specified”.

Adolescent or childhood bipolar disorder is official known as: “early onset bipolar disorder”.  In fact, childhood bipolar disorder can be more serious than a similar disease in adults and may have slightly different symptoms.

Symptoms of bipolar illness in children can often be more severe, and the cycling period may be more frequent.  Children also have more mixed episodes.  Children also have slightly different symptoms – so even the depression phase of the cycle may not be obvious.

Pediatric patients (children and adolescents) with bipolar disorder may have:

Bipolar Disorder in Children•    Abrupt mood swings
•    Periods of hyperactivity followed by lethargy
•    Intense temper tantrums
•    Frustration
•    Defiant behavior
•    Chronic irritability

These symptoms have to appear in more than one setting (school and home) and cause “distress”.

The problem is that many of these symptoms may look like other disorders.  They might be disorders such as ADHD, childhood depression, anxiety disorder, obsessive compulsive disorder, conduct disorder, premenstrual syndrome, oppositional defiant disorder and others. The danger might come from a misdiagnosis and improper treatment.

Bipolar disorder is treated with anti-manic agents (lithium), anti-convulsants (Depakote, lamotrigine) or atypical antipsychotics (Abilify, Risperdal).  In many cases, anti-depressant won’t be needed.  Treatment for other disorders like ADHD or depression may make bipolar disorder worse. Childhood bipolar disorder is something that desperately needs treatment as the distress caused to the patient, and the family can predispose the youngster to

•    Drug or alcohol abuse
•    Stealing
•    Involvement with law enforcement
•    Poor social integration
•    Poor academic performance
•    Suicidal tendencies
•    Premature sexual behavior

The Balanced Mind has a good self-check list of symptoms that can help a parent or a teen decide if bipolar disorder might be an issue.  Self-testing is not always accurate and should be discussed with a doctor, (preferably with test results in hand).  Not all doctors accept pediatric bipolar disorder. Parents may have to seek advice from more than one mental health professional and be aware that insurance may not cover the illness.

Melissa Lind

Is It Really Borderline Personality Disorder?

Borderline Personality Disorder is one of the hardest disorders to diagnose

Borderline Personality DisorderMy diagnosis is formal and was made by a professional.  Don’t use this to diagnose yourself.  We’re all people, we’re all different.  While I match many of the diagnostic criteria, I don’t match them all.  However, if you haven’t been formally diagnosed and you’re reading this and nodding your head, you may want to talk to a professional about it.

So here goes.  What makes Bruce Anderson suffer from Borderline Personalty Disorder (and what doesn’t).

Signs and Symptoms of Borderline Personality Disorder:

1.  Feels emotions more easily, deeply, and longer than others do—CHECK.

Is this a bad thing?  Sometimes.  But sometimes it’s good.  If I wasn’t able to keep those emotions running high, I could’ve never written my prizewinning screenplay, which is emotionally brutal and makes everyone who reads it cry.  But when I get hurt, it takes a long, long time to shut it off.  Something most people get over in a few hours can take me a few days or more.

2.  Exhibits signs of impulsive behavior, such as substance abuse, eating disorders, unprotected sex, and reckless spending or driving—CHECK.

I smoke.  I drink.  At one time, I did drugs.  I’ve fathered two children that I love, but never intended to have.  Casinos are very dangerous places for me.  But I drive like an old man, very slowly, most of the time.

3.  Self-Harm and Suicidal Behavior—CHECK.

The scars are mostly faded, but the razorblades and lit cigarette were once close friends of mine.  So are booze and pills.

4.  Unstable, intense personal relationships—CHECK.

Married twice.  More girlfriends than I can count.  Every relationship ends in tears, usually mine.

5.  Black and white thinking—NO.  Well, MAYBE in the moment.

But I’m pretty realistic when it comes to how I see others.  I realize that no one is all-bad or all-good, though I do have a tendency to idealize my romantic partners.

6.  Manipulative behavior to obtain nurturance—DOUBLE CHECK.

Maybe even triple.  I’ll do anything, things I’m terribly ashamed of later, to get that feeling of being loved and cared for.

7.  Poor sense of self—CHECK, but not so much anymore.

It took me to the age of almost forty to figure out what I wanted to do with my life.  I want to write and teach, and I’m doing just that.  And it feels good.  At the same time, it is sometimes hard for me to know what I value and enjoy.

Do I really write because I like to?  Do I really teach because I love it?  Maybe.  It could be just that I’ve found that I’m good at both, and being good at both gets me attention and admiration from others.  I’m not really sure that I enjoy anything.

8.  Dissociation, feeling empty, or zoning out—CHECK.

Now, everyone zones out from time to time, but probably not to the same level that I do, and probably not for the same reasons.  Periods of high emotions can make me shut down at a cognitive level.  I become so preoccupied by the wave of emotion crashing over me that I can think of nothing else.  Sometimes, this is nice.  Like that first feeling of new love where my heart goes all aflutter.  That’s AWESOME.  But most of the time, it’s a negative emotion that has
my attention.  And that pretty much sucks.

Well, those are pretty much my life in a nutshell.  Sucks to be me sometimes, but not all of the time.  I gotta try to remember that.  Until next time.

Your bother in arms,

-Bruce

Read more from Bruce Anderson here: How I Became the Freak in the Corner

(A page that tells his story from the beginning and has links to several of his articles)

Treating Borderline Personality Disorder

Skills Training Manual for Treating Borderline Personality Disorder

Signs and Symptoms of BPD