Crowing Hills Farm & Gardens

Introduction

Bipolar disorder (also known as manic-depression) is a chronic brain disorder marked by bouts of extreme and impairing changes in mood, energy, thinking, and behavior. The most outwardly apparent symptoms are behavioral; however, the illness often has less visible, but serious, cognitive, cardiac, and metabolic effects. Symptoms may emerge gradually or suddenly during childhood, adolescence, or adulthood. Researchers have identified cases of bipolar disorder in every age group studied, including preschoolers.¹   
Here, CABF examines bipolar disorder that emerges in childhood or adolescence.

Bipolar disorder does not affect every child in the same way. The frequency, intensity, and duration of a child’s symptoms and the child’s response to treatment vary dramatically. As the child grows up, bipolar disorder may affect the size, shape, and function of brain regions and networks. Recent research suggests that pediatric bipolar disorder is a neurodevelopmental disorder. Parts of the brain mature (or come online) at different rates and times; brain maturation is not complete until an individual is 25 or so. Consequently, the symptoms and diagnosis of a psychiatric illness may change as the child grows.   

There is presently no cure for bipolar disorder. Yet, there are reasons for optimism. Research to help children and adults with this illness is ongoing. Genetic discoveries are expected to lead to more accurate diagnosing, better treatments, and perhaps a cure. As always, it is wise to expect the best but prepare for the worst. Learn where the road ahead may lead. Develop strategies and contingency plans while staying flexible and confident in the present. Network with other parents. Be involved in CABF. Most importantly, take care of yourself. 

Bipolar disorder is often accompanied by symptoms of other psychiatric disorders (those other disorders are said to be "comorbid" with the bipolar disorder). In some children, proper treatment for bipolar disorder clears up the symptoms thought to indicate another diagnosis. In other children, bipolar disorder may explain only part of a more complicated case that includes neurological, developmental, and other components. An accurate diagnosis of a child or teen presenting with severely troubled behavior is perhaps the most problematic issue facing families.

Diagnoses that mimic, mask, or co-occur with pediatric bipolar disorder include:  

• Attention-deficit hyperactivity disorder (ADHD)* 
• Depression** 
• Oppositional-defiant disorder (ODD) 
• Conduct disorder (CD) 
• Pervasive developmental disorder (PDD) 
• Generalized anxiety disorder (GAD) 
• Panic disorder 
• Obsessive-compulsive disorder (OCD) 
• Tourette's syndrome (TS) 
• Seizure disorders 
• Reactive attachment disorder (RAD)

* It is estimated that 85% of children with bipolar disorder also have ADHD and up to 22% of children with ADHD have bipolar disorder.³ 

**Depression in children and teens is often chronic and cyclical. A significant proportion of the millions of children and adolescents with depression may actually be experiencing the early onset of bipolar disorder, but have not yet experienced the manic phase of the illness.

Bipolar disorder is often misdiagnosed as:

• ADHD or ADHD with depression
• Depression
• Borderline personality disorder
• Post-traumatic stress disorder (PTSD)
• Substance abuse