Bipolar disorder is a brain condition that causes unprecedented mood swings levels of activity, energy, and involvement in daily tasks. The National Institute of Mental Health (n.d), also refers to the condition as a manic and depressive condition that affects the normal brain functioning of an individual. The disease affects people of all ages and gender. Over the recent past, there have been growing concerns due to the prevalence of the disorder among children and adolescents in the United States. As such, this paper presents a detailed discussion of the current situation of the bipolar condition among the children and adolescent in the U.S.
Manic and Depressive Symptoms
The Mental Health America (n.d) has outlined various symptoms of the bipolar condition that may be observed among children and adolescents. According to the organization, the bipolar symptoms develop when one is still a child but only become visible during adolescent life or even in adulthood. Furthermore, according to the Mental Health America (n.d), the bipolar condition was initially not diagnosed in children and teenagers until very recently. As such, a significant population of children and teens in the U.S who had been earlier diagnosed with depression ended up being found to be bipolar. However, while the physicians have become aware of the prevalence of the disorder among the young persons, the disease still attracts minimal attention from the medical fraternity as reported by a magazine article by Egan (2017). The following have been outlined as some of the common manic and depressive symptoms among children.
Abrupt mood changes: For instance from very happy to highly aggressive.
Unrealistic self-esteem of feeling indestructible
Unusually high energy levels
Extra involvement in the various activities at once
Talking too much, fast, and inconsistently
Attempting risky stunts
Frequent crying or unhappiness
Feeling bored and lacking motivation
Unusual sensitivity to failing
Having suicidal thoughts and behaviors
Overdoing activities. For instance, oversleeping and overeating
Types of Bipolar Conditions
The National Institute of Mental Health (n.d) outlines several types of bipolar disorders that are all likely to affect children as well as adolescents. The four types of bipolar include:
Bipolar 1: This condition is manifested by manic episodes that can last up to a week and require immediate medical attention. Furthermore, the individual may exhibit both manic and depressive symptoms of the disorder at this point.
Bipolar II: In this type of bipolar condition, the patient experiences continuous episodes of depressive symptoms accompanied by hypomanic experiences. However, in this case, the manic episodes are premature and not as sophisticated as those of type 1.
Cyclothymic Disorder: In this type of disorder, the individual experiences multiple sessions of hypomanic periods that recur for at least two years. However, in children and teenagers, it may last for only a year.
Unspecified and Specified Bipolar: In these types of disorder, the symptoms fail to match the three types of conditions discussed. These conditions have been explicitly addressed by Mash & Barkley (2014).
Prevalence of Bipolar Disorder in U.S Children and Adolescents
As reported by Diler and Birmaher (2012) the rates of bipolar disorders among the children and adolescents are similar to those of adults. Therefore, this means that there is an equal distribution of the condition between the females and males. However, a previous study had found some differences in the rates of bipolar types between the female and male teenagers. The study, according to Diler and Birmaher (2012), reported that the bipolar I and II were higher in female adolescents than the males with a percentage of 3.3% and 2.6% respectively. However, from a general perspective, the high rate of the bipolar condition among the adolescents in the U.S has been linked to the late diagnoses in the condition despite numerous researchers refuting such claims. Kamahanf (2010) reports that a study conducted in the U.S indicated that 2.5% of the adolescents are affected by the lifetime bipolar condition while 1.7% were established only to be manic. Furthermore, Post et al. (2017) reported that in the U.S two-thirds of the cases of bipolar conditions begin before the teenagers are 19 years old. Additionally, the researchers also discovered that in the U.S, the treatment of the bipolar disease takes an extended period mainly due to the lateness in diagnoses.
Vulnerability Factors in the U.S
The study by Post et al. (2017) established that the U.S has several vulnerability factors that lead to the prevalence of childhood bipolar disorder. The first element is the familial inheritance. It has been determined that a fraction of the affected children in the United States has a high probability of inheriting the disorder from their parents. The study by Post et al. (2017) compared the familial risk factors between the U.S and European nations and found that the U.S had a higher coincidence. In fact, the condition in the U.S seems to be stabilizing given the results of the latter researchers who established that the parents of the affected children were more affected than the current generation. Other risk factors associated with the high prevalence of childhood bipolar disorder environmental stressors accompanied by childhood adversities. Example of these factors includes childhood abuse such as neglect, verbal, physical, and sexual abuse. The exposure to such kind of torture increases the likelihood of the children becoming bipolar.
Diagnoses of Bipolar Condition
The diagnoses of the bipolar condition are majorly similar in the U.S and the rest of the world. Furthermore, active diagnosis methods are intertwined between nations, and any improvements are also shared by the medical community and researchers of various countries. As such, the United States applies the similar approaches registered in other nations. Therefore, the American Psychiatric Association (2010) recommends that parents should start by seeking the help of a child and adolescent psychiatrist. The medic is then required to check the medical history of the child to establish whether their condition is inherited or triggered by other risk factors. The medical history is essential in forming a strong background for the psychiatrist. Afterward, the physician needs to engage the child or teenager in a conversation to comprehend what they think and feel. This conversation establishes the type of problem that the individual is experiencing.
Nonetheless, the diagnoses process necessitates frequent visits to the psychiatrists since it is difficult to establish that the child is bipolar through a single assessment. Furthermore, determining whether a child is bipolar is more difficult than an adult. Also, the psychiatrist is faced with the problem of misdiagnosis, and hence, the process has to be swift but extremely careful. Therefore, parents are encouraged to ensure that they find a reputable physician regardless of the costs involved to ensure that a misdiagnosis does not happen. However, in the case that parents cannot find a true child and adolescent psychiatrist, the American Psychiatric Association (2010) recommends that an adult physician can also be consulted as long as they have experience diagnosing children.
Treatment of Bipolar Disorder in Children
So far, there has not been a traditional treatment for bipolar disorder. However, there is the recommendation of combining both medicine and psychosocial therapy in addressing the disease. The combination of the two methods can be used in ensuring the stability and predictability of the child's behaviors. The medication works by controlling the moods of the child while the psychosocial approach guarantees the management of the diseases by engaging close family members of the child or teenager (Geller & DelBello, 2003). A significant purpose of the psychosocial treatment is the education of the family about the disorder. As such, this ensures that the child patient has the motivation and zeal to get better and be able to control their behavior. Rizvi, Ong, and Youngstrom (2014) report that a lot of the psychosocial treatments involve educating the parents on how to recognize the early signs of bipolar disorder and how to motivate their children on how to transform the negative energy into a positive one.
American Academy of Child and Adolescents Psychiatry. Bipolar Disorder. Parentsmedication guide for bipolar disorder in children and adolescents.
Diler, S, R. & Birnaher. (2012). Bipolar disorder in children and adolescents. IACAPAPTextbook of Child and Adolescent Mental Health
Egan, J. (September 2017). The Bipolar Puzzle. The New York Times. Retrieved from http://www.nytimes.com/2008/09/14/magazine/14bipolar-t.html
Geller, B. E., & DelBello, M. P. (2003). Bipolar disorder in childhood and earlyadolescence. Guilford Press.
Mash, E. J., & Barkley, R. A. (Eds.). (2014). Child psychopathology. Guilford Publications.
Mental Health America. (n.d). Bipolar disorder in children. Retrieved from http://www.mentalhealthamerica.net/conditions/bipolar-disorder-children
National Institute of Mental Health. (n.d). Bipolar disorder. Retrieved from https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml
Perou, R., Bitsko, R. H., Blumberg, S. J., Pastor, P., Ghandour, R. M., Gfroerer, J. C., ... &Parks, S. E. (2013). Mental health surveillance among childrenthe United States, 20052011. MMWR Surveill Summ, 62(Suppl 2), 1-35.
Post, R. M., Altshuler, L. L., Kupka, R., McElroy, S. L., Frye, M. A., Rowe, M., ... & Nolen,W. A. (2017). More childhood-onset bipolar disorder in the United States than Canadaor Europe: Implications for treatment and prevention. Neuroscience & BiobehavioralReviews.
Rizvi, S. H., Ong, M. L., & Youngstrom, E. A. (2014). Bipolar disorder in children andadolescents: an update on diagnosis. Clinical Practice, 11(6), 665.
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