Existence, Prevalence and Diagnosis of the Bipolar Disorder in Children and Adolescents

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Manic depression was the previous name for the severe mental illness known as bipolar disorder. The severe mood swings associated with this brain disease include emotional lows (depression) and highs (mania). (Renk et al. 1). These abrupt mood changes could make it difficult for someone to carry out daily chores. There are four different kinds of bipolar disorder, each characterized by changes in activity, vigor, and mood. Manic periods that may be so severe that a person needs hospital treatment are a feature of bipolar I disorder. At least seven days may pass between manic attacks. The episodes of depression also exist in this type of bipolar disorder (Renk et al. 2). There is also a probability of the existence of both the manic disorders and depression. The second type of this serious brain illness is the bipolar II disorder that is characterized by a pattern of hypomanic and depressive episodes (Birmaher 140). However, the manic episodes are not as severe as the ones in bipolar I disorder. Cyclothymia is also a type of bipolar disorder that is defined by a series of depressive and hypomanic symptoms that last for at least one year in adolescents and children and two years in adults (Birmaher 144). Unfortunately, the symptoms of this disorder do not meet the diagnostic requirements for depressive and hypomanic episodes. There also exist other unspecified and specified bipolar and related orders that have the symptoms that do not match the three categories (bipolar I, bipolar II, and cyclothymic disorders). The incidences and prevalence of this disorder in children are extremely high, but the criteria for diagnosing the illness are absent. As such, the condition has a potential of developing in children and teens without being noticed and having adverse outcomes in their adulthood thereby affecting their college education.

Bipolar disorder in children is prevalent in most parts of the globe. However, many scholars have conducted a myriad of studies that only focus on the adult population rather than children and teens or adolescents (Post et al. 207). It is estimated that Bipolar Disorder is manifest in 1-3% of the American youth (Birmaher 140). The prevalence of this disorder also varies with age. The individuals in their early adulthood or late teenage are more vulnerable to this brain illness than the children below thirteen. Various scholars attribute genetics as the primary cause of bipolar disorder. However, some researchers indicate that the causes of this lifetime illness are yet to be defined and that family genes might not be the actual cause of this disorder. Some pieces of research also indicate that poor brain structure or functionality might be a cause for the bipolar disorder in children. In a nutshell, the youth with a family history of BP and subsyndromal mania are at a heightened risk of developing either BP-I or BP-II.

The symptoms of BP can be characterized based on the nature of depression that an individual possesses. However, the primary sign that a child or an adolescent has BP is an unusual series of mood changes that are accompanied by the variations in sleeping habits (Renk et al. 3). These mood and activity changes vary from child to child. The children and youth with manic episodes act silly and might feel happier in a way that is unusual for the people of their age. The manic episodes are accompanied by short tempers and sexual thoughts and talks. The teen and children with manic episodes also have trouble with sleeping and staying focused and talk a lot of things within a short time duration. Lastly, a key symptom of manic episodes in children is that an individual begins to conduct risky activities that might endanger their lives and those of the persons around them (Renk et al. 3).

The teens and children with depressive episodes also have diverse symptoms. These individuals feel guilty, worthless, and very sad (Renk et al. 3). Depressive episodes are also characterized by variation in eating and sleeping patterns and death or suicidal thoughts. The children and adolescents with depressive episodes also complain about headaches and stomach aches and have little energy in the activities that the persons of their ages may deem as fun. Irritability is persistent among these individuals, and the persons have physical agitations and significant changes in body weight. The symptoms that children with BP have may at times be mistaken for ADHD and the patients must visit psychiatrists to conduct rule out a diagnosis of other illnesses with similar signs (Youngstrom et al. 113). The social symptoms that all teenagers and children with this illness possess is declining academic performance and difficulty to establish and maintain peer relationships.

BP is linked to other social and medical problems substance abuse, ADHD, psychosis, and anxiety disorders. The young adults and children with BP are prone to abusing drugs and taking alcohol due to depression. These persons also express psychosis symptoms such as delusions and hallucinations. These symptoms tend to match an individual’s mood (Youngstrom et al. 118). For instance, an individual with symptoms of psychosis during a manic episode believes that they have fame, special powers, and humongous amounts of financial resources while those with these symptoms during an episode of depression have thoughts and assumptions of being penniless, ruined, and unaccepted within the social spheres. Consequently, the children and adolescents a combination of bipolar disorders and psychotic symptoms are often misdiagnosed with schizophrenia. Anxiety disorders are also prevalent in persons with this illness.

The causes of the BP disorder are difficult to assess. As such, scientists established several factors that might increase a child’s risk of having this mental health condition. Brain structure and functionality is a primary risk factor (West et al 1169). Studies indicate that the brains of individuals with bipolar disorder have brain structures and functionalities that are different from those of healthy individuals or people with other types of mental health conditions (West et al 1169). Children are at higher risks of having mental development issues as their brains are still developing. As such, most children develop mental issues that translate into BP disorder in their teenage. Scientists have also had debates regarding the contribution of genetics to BP disorder. Some scholars indicate that persons with particular genes are at risk of having bipolar disorder. However, some researchers trash these findings by giving examples of identical twins. One twin might have this mental health issue, but the other would not have it indicating that genetics is not a risk factor for this disorder.

Experts in adolescent and child psychiatry find the conceptualization of the diagnosis of this illness extremely complex (Agrawal et al. 10). Despite the presence of numerous pieces of literature unearthing various treatment options and diagnostic tools for this illness, the applicability of the various diagnostic criteria for bipolar disorder in children remains unclear despite the numerous pieces of research that have been conducted in this field. Different scholars have emerged with diverse methodologies of diagnosing bipolar disorder. Uchida et al. examined different pieces of literature and determined that based on these previous works, the children who have high scores on the aggressive behavior, Attention problems, and Anxious-Depressed (AAA) subscales of the CBCL (Child Behavior Checklist) have a higher probability than other children of meeting the BP-I criteria (p.81). Basing on this information, the Child Behavior Checklist would be a suitable checklist for this disorder. The most appropriate diagnostic tool for BP disorder in children would be the DSM-V criteria. This tool has been utilized in the diagnosis of this brain illness only in adults. The incorporation of Child Behavior Checklist and DSM-V criteria would assist in diagnosing this illness in children.

Treatment assists several people in managing this mental health condition. One role of the various types of treatments is to assist the patients in stabilizing their mood swings (Geddes and Miklowitz 1672). Effective treatments for bipolar disorder include a combination of medications and psychotherapies. Bipolar disorder is a lifelong illness with episodes of mania and depression occurring after uneven periods over time. Most persons with this disorder are free of mood changes over time while others have lingering symptoms. However, continuous treatment assists in the long-term control of these symptoms.

Different forms of medication can be applied in the control of the various conditions that bipolar disorder patients face. However, an individual might be forced to try several drugs before determining the best option. The general medications utilized in the treatment of bipolar disorder include antidepressants, atypical antipsychotics, and mood stabilizers. The antidepressants are primarily used whenever an individual has depressive episodes while atypical antipsychotics are used to control psychotic symptoms (Geddes and Miklowitz 1676). Mood stabilizers, on the other hand, are utilized in both manic and depressive episodes to control the different moods of the children and teens with this disorder.

Psychotherapy is also a chief treatment methodology utilized in the treatment of BP. Psychotherapy, also referred to as talk therapy is beneficial in treating this mental health condition as it provides a platform whereby the patients are provided with support, guidance, and education regarding this illness. Parents of teens and children with BP also undergo psychotherapy with the aim of gathering knowledge that would assist them in taking care of the children with this disorder. Some of the psychotherapy treatments include family-based therapy, psychoeducation, family-focused therapy and cognitive behavioral therapy (Geddes and Miklowitz 1676). Other treatment options include sleep medications and electroconvulsive therapy (ECT). Most BP patients have sleep issues. As such, they require medications to assist them in gaining sleep. ECT, on the other hand, is only used to provide relief to patients with severe BP who have not been capable of successfully recovering or blending into other treatments (Geddes and Miklowitz 1675). However, ECT has several side effects including concussion, memory loss, and disorientation.

In summary, bipolar disorder in children and adolescents is a social issue affecting a huge population of the globe. Most college students have this mental health condition that hinders them from achieving their goals and aspirations. Students in most tertiary institutions are in their early adulthood thereby making them vulnerable to this condition. The social challenges that students with this disorder might have include overeating, sleeplessness, difficulty in establishing and maintaining relationships, irritability, and poor academic performance. This paper presents the existence of this disorder within the child and adolescent age bracket and describes its signs and symptoms. The presence and overlap of the other comorbid conditions such as conduct disorder and ADHD further make the diagnosis of the bipolar disorder in children difficult. In a nutshell, the incidences and prevalence of this disorder in children are extremely high, but the criteria for diagnosing the illness are absent. As such, the condition has a potential of developing in children and teens without being noticed and having adverse outcomes in their adulthood thereby affecting their college education.

Works Cited

Agrawal, Swapnil, Aftab Ahmed Khan, Gayatri Mittal, Rahila Quresh, and Ashish Sahoo "Bipolar Disorder, Mania, Children: First-episode mania in a 9-year-old child - A case report.." Journal Of Research In Psychiatry And Behavioral Science, vol 2, no. 2, 2016, pp. 10-11. http://www.jrpbs.com/latest-articles.php?at_id=19. Web

Birmaher, Boris. "Bipolar disorder in children and adolescents." Child and adolescent mental health vol,18, no.3 (2013): 140-148. Print

Geddes, John R., and David J. Miklowitz. "Treatment of bipolar disorder." The Lancet vol.381, no.9878 (2013): 1672-1682. Print

Post, Robert M., Lori L. Altshuler, Ralph Kupka, Susan L. McElroy, Mark A. Frye, Michael Rowe, Heinz Grunze et al. "More Childhood Onset Bipolar Disorder In The United States Than Canada Or Europe: Implications For Treatment And Prevention." Neuroscience & Biobehavioral Reviews, vol 74, 2017, pp. 204-213. Elsevier BV, doi:10.1016/j.neubiorev.2017.01.022. Print

Renk, Kimberly, Rachel White, Brea-Anne Lauer, Meagan McSwiggan, Jayme Puff, and Amanda Lowell. "Bipolar disorder in children. "Bipolar disorder in children." Psychiatry journal vol.2014, no.928685 (2014): 1-19. Print

Uchida, Mai, Stephen V. Faraone, MaryKate Martelon, Tara Kenworthy, K. Yvonne Woodworth, Thomas J. Spencer, Janet R. Wozniak, and Joseph Biederman. "Further evidence that severe scores in the aggression/anxiety-depression/attention subscales of child behavior checklist (severe dysregulation profile) can screen for bipolar disorder symptomatology: a conditional probability analysis." Journal of affective disorders vol.165 (2014): 81-86. Print

West, Amy E., Sally M. Weinstein, Amy T. Peters, Andrea C. Katz, David B. Henry, Rick A. Cruz, and Mani N. Pavuluri. "Child-and family-focused cognitive-behavioral therapy for pediatric bipolar disorder: a randomized clinical trial." Journal of the American Academy of Child & Adolescent Psychiatry vol.53, no.11 (2014): 1168-1178. Print

Youngstrom, Eric A., Jacquelynne E. Genzlinger, Gregory A. Egerton, and Anna R. Van Meter. "Multivariate meta-analysis of the discriminative validity of caregiver, youth, and teacher rating scales for pediatric bipolar disorder: Mother knows best about mania." (2015): 112. Print.

June 19, 2023
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