Childhood Onset Bipolar Disorder Essay (COBPD) is one of the most debilitating mental disorders affecting children today. Bipolar Disorder is a mood disorder that usually affects adults and causes severe changes in mood. Childhood Onset Bipolar Disorder is just what it sounds like: a bipolar disorder that occurs during childhood. Persons suffering from bipolar disorder experience mood swings ranging from depression to mania.
During a depressive episode, patients can experience feelings of extreme hopelessness or sadness, inability to concentrate, and trouble sleeping. Symptoms of mania include rapidly changing ideas, exaggerated cheerfulness, and excessive physical activity. Hypomanic symptoms are the same as in mania; however, they are not so severe as to require hospitalization.
The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) outlines the diagnostic criteria for mood disorders. According to the DSM-IV, a person must have at least 5 of the following symptoms during the same 2-week period to qualify as a major depressive episode: a depressed mood lasting most of the day for several days; significant weight gain or weight loss; loss of interest in activities; difficulty sleeping (insomnia) or an increased need for sleep (hypersomnia); restlessness or slowed pace observable by others; daily fatigue; feelings of guilt or worthlessness; inability to concentrate; or recurrent thoughts of death. These symptoms can only be diagnosed as a depressive episode if they are not better explained by grief, effects of a drug, or a medical condition.
The person experiencing these symptoms must also report interference in their daily functioning. Additionally, the person’s symptoms do not meet the criteria for a mixed episode. To be categorized as manic, the patient’s mood must be irritable or abnormally elevated for at least 1 week. The person must also exhibit at least 3 of the following symptoms (4 if the mood is only irritable): extreme feelings of personal greatness, decreased need for sleep, marked talkativeness, distractibility, extreme focus on a goal-directed activity, reports of racing thoughts or a flight of ideas, or excessive involvement in pleasurable activities that have a high potential for painful consequences.
Sexual indiscretions or unintelligent business investments are not relevant to the topic at hand. The DSM-IV specifies that symptoms of a manic episode should not be better explained as a side effect of a drug or illness in order to qualify. These symptoms must also interfere with the person’s normal functioning and not meet the criteria for a mixed episode. Childhood-onset bipolar disorder, like adult bipolar disorder, can present in various ways.
Children with Bipolar I Disorder have episodes of mania and depression. Sometimes there are long periods of normal moods between episodes. Adults usually have more depressed episodes than manic episodes. However, some children will have chronic mania, which is characterized by symptoms of mania lasting for long periods of time or marked by frequent recurrence, and seldom experience a depressed episode. Bipolar II Disorder causes depressive episodes, sometimes lasting for long periods of time.
It can also cause hypomanic episodes, but manic episodes are not present. Unlike Bipolar I Disorder, for persons with Bipolar II Disorder, periods of normal moods are virtually nonexistent. Cyclothymia is characterized by frequent hypomanic episodes and occasional episodes of mild depression only. Some children have repeated hypomanic episodes a year. Persons showing signs of depression and mania at the same time are referred to as being in a mixed state. Bipolar I Disorder, Bipolar II Disorder, Cyclothymia, and Mixed State Bipolar Disorder are all very rare. For many years, it was assumed that children could not suffer the mood swings of mania or depression, but as more research has been done, we have realized that bipolar disorder can occur in children and it is much more common than previously thought.
Although the DSM-IV does touch on the subject of children with mood disorders, they are still diagnosed according to criteria meant for adults. In children, mania and hypomania appear as more of an irritable mood. These features come and go throughout the day and are not as persistent as in adults. When bipolar disorder is present in children, it is more severe and harder to treat. Children tend to experience extremely rapid mood swings, often cycling from mania to depression and back to mania several times a day.
The most typical pattern of cycling among those with COBPD, called ultra-ultra rapid or ultradian, is most often associated with low arousal states in the mornings followed by increases in energy towards late afternoon or evening. (Source: Facts about COBPD; http://www.mhsource.com/hy/) Difficulties with early onset bipolar disorder begin with…
