Children and Bipolar Disease
Children and Bipolar Disease
For the past 11 years I have been working with children at my church, and I have found it disturbing that for the past several years, the number of students we have had with major learning disabilities has skyrocketed. We had a range of students with a wide range of problems, from obsessive-compulsive disorder (OCD) to attention-deficit disorder with hyperactivity (ADHD), from conduct disorder (CD) to oppositional-defiant disorder (ODD). Eventually, out of every five children that we had, one of them had some form of learning disability. Though almost all of these children were undergoing some form of treatment or therapy, there were a few that never seemed to get better. One student in particular, seemed to get worse as he received more treatment. At first he was diagnosed with ADHD because he could not concentrate on one particular task. However, when he started receiving treatment for ADHD (including a heavy dose of Ritalin), his behavior became more erratic and at times, violent. Then he was diagnosed with ODD, however the same problem occurred when he started his treatment. Finally, this spring, he was diagnosed as Bipolar, and now that he is receiving the right treatment, he can finally live a somewhat normal life.
It is now estimate that upwards of one million children in the United States are suffering from early onset bipolar disorder, and that more than half are not getting the proper help that they need (1). Though this statistic may be somewhat shocking, it is also evidence of a well needed change in the way we think about bipolar. Originally, it was thought that bipolar was strictly an adult disease. Children with bipolar were always labeled with learning disabilities and often as simply "bad kids," when in reality these children are suffering from serious and frightening disease. Bipolar in children is becoming more common in children, and is only being researched. As these researchers learn more about these children, they are realizing that this disorder is even more frightening in children.
"Typically adults with bipolar disorder have episodes of either mania or depression that last a few months and have relatively normal functioning between episodes, but in manic children we have found a more severe, chronic course of illness. Many children will be both maniac and depressed at the same time, will often stay ill for years without intervening well periods and will frequently have multiple daily cycles of highs and lows. These findings are counterintuitive to the common notion that children would be less ill than their adult counterparts," states Barbara Geller, MD, head researcher from Washington University School of Medicine in St. Louis (2).
This rapid cycling is what has made it hard for doctors to associate these children with bipolar disorder instead of typical hyperactive disorders.
Another major problem with bipolar disorder in children is that no clear treatment path has been established. While it is known that medicines used for hyperactive children does not work at all and can actually make the disorder work, it is not known how other medications affect the bipolar child. Lithium, traditionally used on most adult patients dealing with the disorder, has only been successful with a small number of bipolar children. Mood stabilizers are much more effective in children, but because there are so many varying types, it takes a long time to find the "right" drug for the child. These "stabilizers" are only half of the drug cocktail these children need though. There is also the need for an anti-depressant that will not send these kids flying into mania, and they also need a medication that calms their manic rampages with out sending them into a nasty depression (3).
Many people are now saying that these children simply need psychotherapy and that overmedicating the child is worse than the actual disease. However, it is shown that if the child is not medicated, most therapy is wasted and has no value in for that child in the long run because they are unable to process it due to the disorder itself. Also, if the child goes on completely un-medicated, he or she can develop much more serious symptoms later on such as delusions, hallucinations, borderline personality, narcissism or antisocial personality (3). With the threat of failing in school and even suicide, the need for medication is incredible.
I guess the question that follows this research is how we find the
right balance for our children between medication and therapy that
allows them to get the most out of their lives. As of now there is not
even a test to properly diagnose these children with bipolar because
the standard adult test often does not apply to them because of the
rapidness of their cycling. More research must be done to ensure these
children a more normal life because with the genetic nature of bipolar
disorder, this disease is only going to spread further and effect more
people who will need this help.
References1)Time Magazine Homepage, an article on children with bipolar disorder
2)"Child Psychiatry Researchers from Washington University School of Medicine in St. Louis Report Bipolar Disorder in Children Appears More Severe than in Most Adults."
3)Child and Adolescent Bipolar Foundation Homepage
3) Child and Adolescent Bipolar Foundation Homepage http://www.bpkids.org/printing/about.htm
It should be:
3)Child and Adolescent Bipolar Foundation Homepage http://www.bpkids.org ... Shira Raider, 20 March 2006
I enjoyed your article and it weighed heavily on my heart. My 11 year old daughter was recently diagnosed with biopolar disorder. She is severely disabled by this disease. She is so newly diagnosed they haven't been able to stabilze her yet. As her mother, I am dumb struck by all of this. The meds they have tried have sent her into a terrible manic state that it frightens me. Your article appears that you wrote about my daughter personally. I wish you knew her and could help her ... Karen Hurbrough, 5 October 2006