Bipolar Disorder in children and adolescents
Marvin S. Kalachman, PA-C, M.S., DPAAPA
What is Bipolar Disorder?
Bipolar Disorder was previously called “manic depression” and is a treatable mood disorder. It includes variations in mood from depression (”low”) to mania (high”) or a less severe form of mania called hypomania. It may also reveal itself as a “mixed” mood disorder or shifts in mood. Both (highs and lows) can occur at the same time.
Cycling rapidly from high to low and back can especially in children. Changes can last hours to months.
The symptoms of the “Highs” or Mania may include:
1. Grandiose or an unrealistic character of self-importance.
2. Decreased need or desire for sleep.
3. Poor judgment.
4. Impulsivity (example: reacting or speaking before thinking about the implications).
5. Distractibility.
6. Reckless behavior.
7. Risky behaviors.
8. Racing thoughts.
9. Excessive talking.
10. Inappropriately optimistic.
11. Excessive spending or activities to access.
12. Can include delusions and hallucinations.
13. Hyper sexuality.
Symptom of the “lows” or mania:
1. Frequent crying.
2. Persistent sadness.
3. Feelings of worthlessness
4. Feelings of hopelessness.
5. Feelings of helplessness.
6. Over-sleeping.
7. Over-eating.
8. Physical Complaints such as frequent headaches.
9. Increase in level of sensitivity.
10. Low energy and motivation.
11. Social withdrawal.
12. Suicidal thoughts or behaviors.
Children's Uniqueness
In young children, bipolar disorder may first appear as depression or irritability.
Distractibility and hyperactivity may look like other disorders. The disorder may present as tantrums. Mania vs. depression may be difficult to distinguish in children.
It is important for a mental health professional with experience working with child and adolescence to evaluate for this diagnosis as this disorder can mimic other disorders in children. For example:
1. Attention-deficit hyperactivity disorder
2. Panic disorder
3. Hyperthyroidism
4. Tourette’s syndrome
5. Depression
6. Obsessive-compulsive disorder
7. Other anxiety disorders
Academic needs
Children and Adolescence with Bipolar Disorder may can benefit from a decreased workload during acute episodes. They should avoid caffeine or stimulating beverages. An environment of decrease stress can also be beneficial. Teachers and administrators can assist in assuring a safe and pleasant environment. Bullying or ridiculing of children especially with active bipolar disorder can have a disastrous effect.
Early identification is important. Early identification of bipolar disorder can help a child get early treatment, improve their academic potential, decrease the degree of future resources and prevent potential injury to the student and others.
Some pearls about Bipolar Disorder:
Stanford University researchers reported that children with the diagnosis or high risk of diagnosis of bipolar disorder score higher on creativity indexes than non-bipolar children. The study shows that bipolar children scored 120% higher score than the non-bipolar group.
Think of some famous artists and writers. A population which is alleged to have 2-3x the incidence of psychotic events than those in less creative roles.
Further research will determine the accuracy of this report.
Marvin S. Kalachman, PA-C, M.S., DPAAPA has been working with children, adolescents and adults for 30 years and has lectured to state and professional organizations. He has published works in clinical and administrative health care and has been involved in direction and teaching in psychiatry. He currently works in clinical psychiatry and research.
| How To Grow Your Brain!!!
Email: Judy Park, PhD
There is increasing evidence to support good lifestyle changes can enhance our memory. Memory loss can be a result of aging, depression, dementia, or Alzheimer's. It can appear confusing to the individual who is coping with memory loss as to what is happening to them. It is noteworthy to mention that good memory is not necessarily a gift. It is a skill you can develop. Let's look at 10 effective ways to grow and build your brain!!!
1. POSITIVE THOUGHTS---regardless of negative life events, which happen to all of us, it is important to be future-oriented. Looking forward thought the windshield is a more effective way to drive than focusing on the rear view mirror. No matter what keep your thoughts constructive. Why? Constructive thoughts are creative and rewire your brain to expand its neural pathways. Negative thoughts create stress and anxiety, which actually kill neurons and prevents the creation of new thoughts. Be constructive!!!
2. LEARN, LEARN, LEARN---Your brain is a living organ and is constantly at work. Be careful with its development and be selective with what you want to learn and retain.
3. KEEP LEARNING---Even though you maybe experiencing the aging process the brain is still changing and developing areas no matter what your age. Don't rely on solely on crossword puzzles. Focus on learning something new that will increase neural associations like learning a new language.
4. THRIVE ON LEARNING---Your brain is designed to learn and to adapt to challenging and new environments. Once new neurons appear in your brain, how long they survive depends on how you use information. Continue to challenge your brain often with new activities.
5. TRAVEL---Exploring new locations forces you to pay more attention to your environment.
6. BRAIN POWER---Use your brain to make your own mistakes and decisions. Do not rely on other people's opinions. Make your own mistakes. It's okay! You will learn from them and continue to grow your brain.
7. FRIENDSHIPS---Maintain friends who will stimulate your brain. Enjoy good conversation. Debate with your fellowmen and share ideas. Join a book club.
8. NUTRITION---The brain consumes 20% of the nutrients and oxygen we take in a day. Be careful what you feed it! Focus on keeping away the harmful ingredients, especially drugs and excessive alcohol consumption.
9. EXERCISE---When you exercise your body you are also working your brain. Physical exercise enhances neurogenesis and helps your brain remain sharp and focused.
10. LAUGH---Laughter is the best medicine. The complexity of a joke is full of twists and turns. Enjoy humor. A deep laugh exercises the whole body including the brain!
Practice these and make them a habit you will begin to see a difference.
| Forty Million Americans with Anxiety Disorders
Email: David L. Barnhart, EdD
Most everybody feels anxiety from time to time. A screening test, the Beck Anxiety Inventory, administered to an adult would likely hit a cut score high enough to suggest “mild anxiety” for anybody in the midst of stressful events. However, six months of mild anxiety suggests the presence of an anxiety disorder. Without treatment anxiety disorders can get worse.
While “mild anxiety” doesn’t seem that bad, after all, it’s just mild, people with mild anxiety that meet the clinical criteria are in a constant state of hypervigilance. After a while, some become depressed. Attention and concentration can be affected. Sleep may not be restful. Headaches, stomach aches, restlessness, fear of the worst happening, even panic attacks may ensue.
Some resort to drugs and alcohol in an attempt to find some relief. These substances ultimately make the symptoms worse even though they provide immediate relief. Alcohol interferes with deep sleep and often results in early awakening.
Primary care physicians and psychiatrists often prescribe certain antidepressants or anti-anxiety medications to reduce anxiety. However, research indicates cognitive behavior therapy can help those with anxiety disorders learn to reduce their stress, problem solve, and face their anxiety-producing stresses.
It isn’t necessary to wait until you have six consecutive months of mild, moderate, or severe anxiety to seek help. Add exercise to your daily routine, eliminate caffeine after noon (it also interferes with deep sleep), see your physician or contact a licensed professional counselor, psychologist, or social worker who will take a thorough history and design a program to help you lower your stress and anxiety response.
For more information on the diagnosis and treatment of anxiety disorders take a look at the National Institude of Mental Health website at the following link: http://www.nimh.nih.gov/health/publications/anxiety-disorders/introduction.shtml
~David
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