Bipolar disorder is a condition that sees sufferers ‘cycle’ through phases of mania (hyperactivity, creativity, euphoria, unusual thought patterns, rapid speech, irritability, delusions of grandeur, recklessness, lack of sleep, aggression and racing thoughts) and depression (sadness, hopelessness, crying, fixation on death and suicide, suicide attempts, lack of energy, tiredness, lack of interest and appetite). This can take many forms, with patients experiencing varying degrees of mania and depression and with cycles conforming to different patterns. Cases of mild depression are known as dysthymia, while mild mania is called ‘hypomania’. Often patients will also go through long periods of relative ‘normality’. Any of these episodes can last as briefly as a week or for as long as two years. To be diagnosed with bipolar disorder a patient must suffer at least one bout of depression and one instance of mania.
In type one bipolar disorder, individuals will suffer equal amounts of depression and mania. In the more common type two, patients experience longer bouts of depression when compared to mania. In cyclothymia they rapidly alternate between dysthymia and hypomania, with more mild symptoms and no ‘normal’ periods. In ‘rapid cycle’ bipolar disorder the same occurs but with more pronounced symptoms, where the patient experiences full blown mania and major depression with no respite.
A serious condition, it is now recognised that it is also fairly common to find cases of bipolar disorder in children. In a study dating back to the 1920s, it was found that of 900 bipolar adults, 0.4% had the onset of their symptoms prior to the age of ten. Another study showed that 0.5% of 200 patients had symptoms from as early as five. Modern studies of the population suggest that 1% of children suffer from bipolar disorder. 20% of youths admitted to psychiatric clinics suffer from bipolar disorder, which leads to many of them requiring hospitalisation. While this is still fairly rare, it is prevalent enough to be worthy of investigation, and diagnosis of the condition is becoming more common.
Bipolar disorder in children is a difficult and controversial diagnosis. Bouts of mania can easily be mistaken for ADHD or common childhood hyperactivity. Similarly, children suffering with depression may find it harder to vocalise their feelings and ‘delusion’ could easily be mistaken for childhood roleplaying. Nevertheless, parents might look out for abnormal mood swings, restlessness, separation anxiety, racing thoughts, grandiosity and periods of energetic behaviour and lethargy; all of which are signs of bipolar disorder in children. If more disturbing and concerning behaviour, such as the destruction of property, aggression, suicidal thoughts, compulsive behaviour or motor or vocal tics develop then parents may wish to turn to a health professional for help and advice.
The use of drugs in a developing brain can be risky, and misdiagnosis of bipolar disorder in children can be serious. If antidepressants are prescribed (which would be used for unipolar depression) it could increase the frequency and severity of episode cycles. Parents need to weigh the potential risks and benefits of medication along with the medical expert to decide the correct course of action. Meanwhile, providing emotional support for the child and a calm home environment can help to lessen symptoms. Stress, criticism and low self esteem can all contribute to bipolar disorder, so by giving children a secure environment they will stand a better chance of recovery and a healthy emotional life in adulthood.