Monday, September 2, 2013

Bipolar Kids

While having or being a bipolar child is difficult and can be frightening, there are resources to help deal with the challenge that were not available until recently — resources, at least, for people who can afford them. Some health insurance does not cover childhood bipolar disorder because it isn't yet listed in the "Diagnostic and Statistic Manual of Mental Disorders" (DSM).

All four of the variations on bipolar disorder that appear in adults and are sanctified by the DSM may, some experts believe, also strike children: Bipolar I Disorder, Bipolar II Disorder, Bipolar Disorder Not Otherwise Specified (BP-NOS), and Cyclothymic Disorder (or Cyclothymia). Like an adult, a child may also have hypomania, which has symptoms that are similar to bipolar symptoms but are much less severe.

Complicating the situation further are two childhood disorders that may be confused with bipolar disorder: attention deficit hyperactivity disorder (ADHD) and severe mood dysregulation (SMD). This is one of several good reasons to consult an expert in bipolar disorder for a child who is having extreme and frequent mood swings.

Doctors and their bipolar patients, whatever the patients' ages, try various medications and doses that have been identified as possibly helpful. When something works, or at least works better than anything else, they settle on that. Treatments of childhood bipolar disorder include various medications, but no medication works for all bipolar children or, for that matter, for all bipolar adults. Furthermore, children and adults may react differently to the same medication.

Children typically have high energy and noticeable changes in mood that may be extreme. Unfortunately, experts do not agree on how to distinguish normal moods in children from bipolar mood swings. As a result, there is no way of knowing whether the rapidly increasing number of children being diagnosed with bipolar disorder are really bipolar. Not a comforting situation for parents living with an intensely moody child.

Shocking and sad as it is, young people with bipolar disorder are even more likely than bipolar adults to be suicidal. Parents, teachers, and doctors of bipolar kids should be familiar with signs of suicidal thoughts and fantasies. A failed attempt at suicide should never be dismissed as merely a plea for attention and not a serious attempt to die. Any signs of interest in suicide should be addressed immediately by an expert.

Because bipolar disorder runs in families, the pediatrician of a child with a bipolar parent should be alerted to the risk and sensitive to possible symptoms in the child.

When bipolar symptoms are extremely severe and unmanageable, a child may have to be hospitalized, and the hospital ideally should be one in which experts are experienced in dealing with childhood bipolar disorder. In less severe cases, outpatient talk therapy for child and parents may bring relief.

Whatever the details of the lives of bipolar children and their parents, an expert in the disorder should be able to suggest ways to improve their quality of life.

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