Bipolar blogger Natasha Tracy offers exclusive insight into the world of bipolar disorder.See all posts »
Bipolar Disorder in Children: Part 1
Despite some wishful thinking to the contrary, Natasha Tracy brings some evidence about bipolar disorder in children.
OK, I admit it. I once didn’t believe that bipolar disorder existed in children. Maybe this was wishful thinking on my part. Maybe I just didn’t want to believe that the severe pain that I suffered should ever be visited on a child.
Regardless, I now have learned more and know better. I have spoken to doctors, parents of mentally ill children, and have even a met a person who was diagnosed with bipolar disorder as a child. I can now say that yes, bipolar disorder does exist in children.
Facts on Bipolar Disorder in Children
Unfortunately, we know little about bipolar disorder in children as not only is it rare but it has only recently been recognized. What is currently thought is that between 0.2-0.3 percent of children have bipolar disorder type 1 and it’s present in about 1 percent of adolescents (this is the same number as in the adult population). However, recent estimates are that between 20-30 percent of adults with bipolar type 1 began showing symptoms under the age of 20.
Those with childhood bipolar disorder also tend to have much more pronounced family histories of mental illness and thus are at greater genetic risk for the illness than people who experience bipolar disorder later in life.
Diagnosing and Treating Bipolar Disorder in Children
The Diagnostic and Statistical Manual of Mental Disorders (DSM) doesn’t differentiate between childhood and adult bipolar disorder. This is, honestly, because we don’t know how to accurately diagnose bipolar disorder in children. We really don’t know exactly how it presents, so psychiatrists who specialize in this area must use their own clinical judgement, experience and the diagnostic criteria seen in adults for diagnosis. Children often receive a diagnosis of bipolar disorder not otherwise specified (NOS).
It is recognized that moods are harder to diagnose in children with irritability, tantrums and other behaviours being normal in some degree for some children. It’s also known that the classic symptom cluster of mania (racing thoughts, pressured speech, hypersexuality, and grandiosity) is less likely to clearly occur in children. Children also vacillate more frequently between mood states than adults. In children and adolescents, it’s also known that a depressed mood can manifest as irritation.
Medication treatment of children with bipolar disorder is the same as adults: mood stabilizers, anticonvulsants, antipsychotics, and other medications. Most parents try many forms of therapy before resorting to medication of their children.
In part two, I will discuss the prognosis for those with childhood bipolar disorder and give real-life examples of what childhood bipolar disorder really looks like.