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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

Mental Disorder and Hope

The Whacko is BACK!

By Bruce Anderson (The Freak in the Corner)

Bipolar Whacko Says HelloHey there, you.  How ya been?  You’re looking a little rough, but you know what?  You’re still here.  And that’s a start.  And it could be the start of something wonderful.  You may not believe it now, but have I lied to you yet?  Well… not intentionally.

There was that first bit about Bipolar Disorder which turned out to not be true in my case.  I had been misdiagnosed.  If you have Borderline Personality Disorder, (BPD), chances are your doctor went through about half a dozen diagnoses before he finally arrived at the one you’re stuck with now.  It’s very easy to misdiagnose.  What isn’t easy is living with it.  But guess what?  YOU CAN.  And in most cases, with treatment and a conscious effort to change negative patterns, YOU DO get better.

Just like me!

Oh, come now.  Don’t go all crazy congratulating me.  Crazy is MY job, remember?
But seriously, if you work hard, listen to your doctor and your support network of friends, you too can be awesome again.

Boy, I tell ya… it was darkest before the dawn, though.  Remember how “Justine” had left me and I was still hopelessly in love, but at least I had the Hollywood deal working?  Well… in a fit of pique, I told the director exactly what I thought of the changes he was making to my script.  He didn’t like my choice of words much.  So the deal is a bust.  My movie may never be made, but I’m cool with that.  The movie he wanted to make wasn’t the movie I wanted to make.  And I’m OK with that.  And since I renewed the WGA registration, no one can take and make my movie without me.

But man, that sucked.  And I fell apart.  And drove Justine crazy some more.  And I continued to drive her crazy for several more months.  She had sworn to stop talking to me, remember?  But I’m sure you also remember I can be very manipulative.  I’m VERY good at it, but it’s nothing I’m proud of.

Anyway, rock bottom happened.  I got a beautiful luxury apartment on the fifth floor and all I saw from the window for a long time was the parking lot and how inviting the jump was.  But I didn’t jump.  I got back to work.

Mental WhackoAnd even though I was still all messed up over Justine, I put on a happy face and went to work, because the kids needed me.  And that started to feel good.  And then it started to feel GREAT.  And I still wanted to tell Justine all about it, and that would set me back, but then I’d move forward again. And at the end of the school year, not only was I happy, but the happiness spread.  I was everyone’s favorite teacher.

And though I “lost” my kids, many of them have come back to see me… and tell me again that I’m STILL their favorite teacher.  And that, my friends, is a wonderful feeling.

But alas, the worst has come to pass.  I must now move from my beautiful apartment, which is located in a center of art and culture and is honestly the only place I’ve ever felt was truly home.  And this scares me.

I just gotta keep telling myself it’s for the best.

Because it is.  My girlfriend bought a farm and we’re moving in.

And no… it’s not Justine.  She never took me back, and I’m very glad of that.

Remember how I once said that I have a tendency to romanticize my romantic partners? Well, after a good long time, I took off the rose-colored glasses and began to see things as they really were.  I’m not going to go into details about it.  That would just be rude.  But I finally realized that not only was she not “The One,” she really wasn’t even that good to me.  Is she a bad person?  No.  Does she know how to treat a boyfriend?  Also, a resounding NO.

But I found someone who does.  And she’s got her issues, too.  And we occasionally fight, but we are like-minded enough to get along on most issues, and on the things we don’t see eye to eye one, we respect each other’s opinions, because we respect EACH OTHER.  And this time, it actually goes both ways.

BPD-Whacko Horse FarmerIs it scary to be jumping into a relationship again? Yes, but I’m not exactly jumping.  We’ve been seeing each other for about a year now.  We’ve taken the time to get to know each other.  And importantly, we’ve both been honest about our issues.  Yes.  I told her I have a personality disorder.  And she’s OK with that, but doesn’t put up with my bullshit, which is something that makes me love her even more.

And we COMPROMISE.  She’s moving to my town, because I have a job that makes me happy like no other before it and she doesn’t want me to give it up.  But I gotta give up the city life, and I don’t want to.  But I will.  Because she’s a farm girl, and I’ve learned to appreciate “farmy” stuff.  Horses are cool.  Like REALLY cool, and I would’ve never known that if I hadn’t stepped outside of my comfort zone.

So, your faithful whacko is going to learn to do “farmy” things.  I can already put up fence posts.  Next thing you know, she’ll have me milking the chickens and stuff.

And you thought I had gone all serious on you.

Well, I am a bit more serious now.  Or more to the point, I don’t feel the NEED to be funny.  The funniest people are often the saddest.  Because they can’t feel joy themselves, they spread it in others, if only just to see it so they remember it exists.

Poor Robin Williams is proof of that.  May he rest in peace!

If only he had known that you DON’T have to die to get it.  You just have to make a few changes, face your demons, take your doctor’s advice seriously, maintain your support network, stay busy, and maybe milk a few chickens.

You’re gonna make it, amigos.  I am.  And if this freak can manage it, so can you.

Until next we meet… KEEP FIGHTING!

Bruce