Early onset Bipolar Disorder.
By David Joel Miller.
Bipolar diagnoses in children have increased 40 fold in the ten-year period from 2000 to 2010.
What is behind the increasing number of children and teens who are being diagnosed with Bipolar Disorder?
We are learning more about the risk factors for early onset all the time. Still as we learn about what may be causing this increase in the number of cases of early onset Bipolar Disorder, the picture of how to treat or prevent early life Bipolar Disorder is getting less clear.
If we could detect symptoms of Bipolar Disorder early, presumably we should be able to treat those symptoms and reduce the incidence of Bipolar Disorder or at least reduce the severity of the disorder.
Unfortunately there is often a lag of ten years or more from the first symptoms until the child has a manic or hypomanic episode that qualifies them for a diagnosis of Bipolar.
I have written in past blog posts about how many of the things that cause people to think of someone as Bipolar are in fact not necessarily symptoms of the disorder. Being moody does not make you Bipolar.
What does help define the Bipolar condition are the ability to sleep only a few or no hours per night and still have plenty of energy. That along with excessive energy, being driven to do things and being impulsive are the hallmark features of Bipolar Disorder.
Here are some of the possible causes for the increasing number of Bipolar diagnoses in children.
1. Taking Stimulant ADHD meds or antidepressants can set off a manic or hypomanic episode.
One huge risk factor for developing a Manic or hypomanic episode, the key factor in a Bipolar Disorder diagnosis is having taken either a stimulant or antidepressant medication.
Having been treated with a stimulant ADHD med seems to correlate with developing mania. Not all children treated for ADHD develop Bipolar and not all people with a Bipolar Disorder diagnosis were first diagnosed with ADHD but the overlap is disturbing.
In one study of adolescents with Bipolar Disorder 98% had been diagnosed with ADHD and treated with stimulant meds first.
This points to the need for psychiatric diagnosis to be reviewed by psychiatrists and in children by a child psychiatrist.
2. Abusing substances increases the risk of developing Bipolar disorder.
Over 40 % of children who receive the Bipolar Disorder diagnosis have been abusing substances. In their life time 60% of all people with Bipolar Disorder will develop a substance use disorder.
This is not limited to just stimulant drugs. There is a high overlap between Bipolar Disorder and alcohol abuse as well as developing problems with excessive use of Marijuana.
3. Being the victim of physical or sexual abuse or neglect.
Abuse or neglect increases the risk of developing Bipolar disorder. This also accounts for the difficulty in many cases of distinguishing between Bipolar disorder and Borderline Personality Disorder. It is possible for people to have both illnesses.
There is also an overlap between trauma induced problems, stress disorders like PTSD, dissociation and the like and Bipolar Disorder. We would like to think the boundaries between genetic disorders and those that are the result of life experiences were easy to find. In practice those lines are blurry.
4. Poor diet and lack of exercise are risk factors for Bipolar Disorder.
Poor diet, particularly diets deficient in some vitamins and minerals can increase the risk of getting a Bipolar diagnosis. Hard here to tell which came first. People with depression or mania, both symptoms of Bipolar Disorder neglect their diet. Poor diet increases the risk and around the circle goes.
Lack of adequate exercise has resulted in an explosion in weight related problems. There is the thought that this lack of exercise and poor diet is also contributing to the increased prevalence of Bipolar Disorder.
5. Genetics is a Bipolar Disorder risk factor.
If you have one parent with Bipolar Disorder the risk you will develop Bipolar Disorder is 33%. Two parents with Bipolar Disorder and the risk goes up to 70%. Add to that the difficulty that parents who have an emotional problem have in parenting and you can see how the interplay of genetics and environment increase the risk dramatically of your grow up with a Bipolar, substance abusing parent.
6. A changing environment may make Bipolar Disorder more noticeable.
Some of the characteristics that we today call Bipolar Disorder would have had survival benefits in the past. Fast processing speed and jumping to conclusions might save your life in the woods but can get you into trouble in the class room.
People with milder varieties of bipolar disorder enjoy the hypomania – for a while. Even full on Mania can be fun, until those impulsive decisions get you into trouble. Bipolar Disorders are often associated with over spending, excessive sexual activity and substance abuse. All things that damage relationships and can cost you your job.
The increase in children receiving the diagnosis of Bipolar disorder will continue to result in more adults with those labels as these early life cases age. If your child is having problems consider family therapy to help everyone find simple solutions to these problems.
If you or someone you know has Bipolar Disorder or another emotional problem that might look like Bipolar Disorder consider getting help. Therapy can be effective in helping you to learn how to control your symptoms. Medication can also be useful in keeping you moods within bounds.
People can and do recover from the symptoms we call Bipolar Disorder.
For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended books.
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