Bipolar disorder in children is coming out from the shadows; here’s why:
Bipolar disorder was once thought to be an “adult” condition and that it could not express itself in children. Studies are now showing that half of the patients who suffer from bipolar disorder had their onset before the age of 18. The misconception about its prevalence in childhood led to long delays in treatment that resulted in decades of suffering for those affected, says Sheryl M. Hakala MD.
#2 Fourth leading cause
The World Health Organization in 2011 estimated that “pediatric bipolar disorder is the fourth leading cause of disability in adolescents aged 15 to 19, worldwide, accounting for a total of 5 percent of disability in this age range.” Up to one-third of the 3.4 million children and teens with depression in the United States may actually be experiencing the early onset of bipolar disorder.
#3 Still under-recognized
Symptoms can begin in early childhood but usually emerge in adolescence or adulthood, but even very young children can have bipolar symptoms, explains Francis Mark Mondimore MD. In one study that looked at such symptoms in the under 18 age range, nearly one-third of those in the study were younger than 12, with the average age of onset was 8 1/2 years old. Doctors now recognize and treat the disorder in young people, but it is still an under-recognized illness.
#4 Varied symptoms
Parents who have children with bipolar typically describe them as alternating rapidly between extremely high moods (mania) and low moods (depression). They can be unpredictable, going back and forth between aggressive or silly and withdrawn. It is common for children who have mania to have multiple mood cycles during the day that could range from silly, giddy highs to gloomy, morose lows. Experts say it’s important to recognize these depressed cycles because of the danger of suicide.
#5 Greater risk
Children with bipolar disorder are at a greater risk for ADHD and anxiety disorders. These “co-occurring” disorders complicate the diagnosis of bipolar disorder and contribute to the lack of recognition of the illness in children. Also, several studies indicate that 20 to 30 percent of young children with major depressions develop manic symptoms later in life.
#6 Differences in young and older onset
Bipolar disorder in young children can appear rather different to those of adults, Mondimore explains in his book, Bipolar Disorder – A guide for patients and families. For example, initial episode: major depression for pediatric and mania for adult; episode type: rapid cycling, mixed for pediatric and discrete for adult (symptoms go into remission for months or years at a time); duration: chronic, continuous for pediatric and weeks for adult; functioning between episodes: poor (continuous cycling) for pediatric and improved for adult.
#7 Genetic loading
Research shows that when bipolar occurs in children prior to puberty, it is a more severe form of the disorder. Mondimore says this could be because children who develop symptoms at so young an age may have a “heavier genetic loading” for mood disorders than do individuals whose symptoms begin later.
#8 All in the family
While the condition can affect anyone, if one or both parents have bipolar disorder, the chances are greater that their children may develop the disorder. There are typically more individuals with mood disorders in the families of children with bipolar disorder than adult-diagnosis patients and for many of these children, mood disorders exist on both sides of family, Mondimore writes.
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