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what causes bipolar disorder

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

What Causes Bipolar Disorder?

So, what causes Bipolar disorder?

It appears to be an interplay of genetic and physiological factors, coupled with stressful triggers, that causes Bipolar disorder…

Bipolar doctor

Manic depression, also called bipolar disorder, causes severe mood swings that can last for weeks or even months.

Everyone feels happy or sad sometimes. For someone with manic depression, however, these mood swings are much more intense. Scientists have not identified a single factor what causes bipolar disorder. Instead, it may have one or more of several different causes. These may be broken down into genetic, environmental and physiological causes.

There are three types of manic depression.

Bipolar Type I is characterized by at least one manic episode. A manic episode is a feeling of intense elation, restlessness and loss of inhibitions and over-activity. Sufferers during a manic episode may sleep for only three or four hours a night if at all.

Bipolar Type II, where there may be frequent episodes of depression with only mild manic episodes (called hypomania). Rapid cycling involves four or more mood swings over the period of a year.

Finally, there is Cyclothymia, where the mood swings last longer but they are less severe.

Genes is considered to be a contributing factor.

If one of your relatives has manic depression, there is a reasonable chance that you will develop it, too. Chromosome numbers 6 and 8 appear to have been implicated. Children of bipolar parents have an eight percent chance of developing the condition, compared with one percent in the general population.

A chemical imbalance in the brain may cause the disorder. Nerve signals travel from one neuron to another by way of chemicals called neurotransmitters. These include norepinephrine, dopamine, and serotonin. It is possible that excess levels of norepinephrine may cause a manic episode.

During a depressive episode, levels of this neurotransmitter may be excessively low. The picture, however, is not that simple, as there are other neurotransmitters involved.

Mood swings can also be triggered by stress. Abuse; either physical, emotional or sexual, may trigger an episode. Bereavement or the breakdown of a close relationship may also be a trigger.

Not all stressful triggers are negative experiences. A positive change, such as a marriage or a birth can also make a contribution.

Once diagnosed, the condition can be treated or controlled, although certain risk factors may trigger a recurrence. Failure to comply with medication carries a high risk of recurrence, as do alcohol or drug abuse. Other risk factors include poor support systems. For example, the lack of caring friends or relatives or an erratic lifestyle.

Manic depression can lead to psychosocial disturbances.

For example, Bipolar Type I and Bipolar Type II are associated with a high absentee rate at work. There is also a higher rate of suicide attempts and hospital admissions with these conditions. While both conditions have high rates of attempted suicides, Type II sufferers seem to have fewer hospital admissions than Type I, and consequently miss fewer days at work.

So, what causes bipolar disorder? It appears to be an interplay of genetic and physiological factors, coupled with stressful triggers.

Complying with medication, adopting a stable lifestyle, and developing healthy coping strategies, may all keep the condition under control.

It is essential to consult a medical professional and not attempt self diagnosis.