|Childhood Mental Health: Bipolar Depression|
Although rare in young children, bipolar disorder ,
or manic-depressive illness , can appear in
both children and adolescents. Bipolar disorder, which involves unusual
shifts in mood, energy, and functioning, may begin with either manic,
depressive, or mixed manic and depressive symptoms. It is more likely
to affect the children of parents who have the disorder. 20 to 40% of
adolescents with major depression develop bipolar disorder within 5 years
Existing evidence indicates that bipolar disorder beginning in childhood
or early adolescence may be a different, possibly more severe form of
the illness than older adolescent- and adult-onset bipolar disorder. When
the illness begins before or soon after puberty, it is often characterised
by a continuous, rapid-cycling, irritable, and mixed symptom state that
may co-occur with disruptive behaviour disorders, particularly (ADHD) or , or may have features of these disorders as initial symptoms.
Symptoms and Signs
Symptoms are divided into manic and depressive symptoms.
1. Manic Symptoms
- Severe changes in mood: either extremely irritable or overly silly
- Overly-inflated self-esteem; grandiosity.
- Increased energy.
- Decreased need for sleep: ability to go with very little or no sleep
for days without tiring.
- Increased talking: talks too much, too fast; changes topics too quickly;
cannot be interrupted.
- Distractibility: attention moves constantly from one thing to the
- Hypersexuality: increased sexual thoughts, feelings, or behaviours;
use of explicit sexual language.
- Increased goal: directed activity or physical agitation.
- Disregard of risk: excessive involvement in risky behaviours or activities.
2. Depressive symptoms
- Persistent sad or irritable mood
- Loss of interest in activities once enjoyed
- Significant change in appetite or body weight
- Difficulty sleeping or oversleeping
- Physical agitation or slowing
- Loss of energy
- Feelings of worthlessness or inappropriate guilt
- Difficulty concentrating
- Recurrent thoughts of death or suicide
Symptoms of mania and depression in children and adolescents may manifest
themselves through a variety of different behaviours.
When manic, children and adolescents, in contrast to adults, are more
likely to be irritable and prone to destructive outbursts than to be elated
When depressed, there may be many physical complaints such as headaches,
muscle aches, stomach aches or tiredness, frequent absences from school
or poor performance in school, talk of or efforts to run away from home,
irritability, complaining, unexplained crying, social isolation, poor
communication, and extreme sensitivity to rejection or failure. Other
manifestations of manic and depressive states may include alcohol or substance
abuse and difficulty with relationships.
Diagnosis and Treatment
Once the diagnosis of bipolar disorder is made, the treatment of children
and adolescents is based mainly on experience with adults, since as yet
there is very limited data on the efficacy and safety of mood stabilising
medications in youth.
The essential treatment for this disorder in adults involves the use of
appropriate doses of mood stabilisers, most typically lithium
and/or valproate , which are often very effective
for controlling mania and preventing recurrences of manic and depressive
episodes. Research on the effectiveness of these and other medications
in children and adolescents with bipolar disorder is ongoing. In addition,
studies are investigating various forms of ,
including , to complement medication treatment for this illness in young
The information in this page is presented in summarised form and has been taken
from the following source(s):
National Institute of Mental Health: http://www.nimh.nih.gov
(def;articles & more)