The Bipolar Adolescent
Bipolar disorder, formerly known as manic-depressive illness, is a mood disorder that affects many more children and adolescents than formerly known. Mania, hypomania, and depression are the general categories of symptoms involved in bipolar disorder. Mania often begins with a sense of heightened energy, an exaggerated optimism, and self-confidence. People in this state of mind can be very impulsive and use poor judgment. They can be excessively irritable and show aggressive behavior. They may have an inflated sense of self-importance and a decreased need for sleep. (Fawcett 38)
There are many subforms of bipolar disorder, and one of the most disabling is mixed or dysphoric mania, in which symptoms of both mania and depression occur simultaneously, or alternate frequently during the same day. The person becomes excitable and agitated as in mania, but also irritable and depressed, feeling great anxiety. The mood swings can last for days, weeks, months, or in some cases, moods may change rapidly alternating with normal periods. Depression is characterized by loss of energy and motivation, feelings of worthlessness, inability to concentrate, and loss of enjoyment in usual activities. The variation in symptoms and in the severity of bipolar disorder in different individuals is one reason for the difficulty in obtaining a proper diagnosis.
Bipolar illness can manifest itself at extremely young ages. Young children with bipolar disorder often develop very early language skills. They sometimes hold imaginary conversations with another person and often experience night terrors. They are often restless and have difficulty falling asleep. Some show severe separation anxiety and are very affected by temperature. Very young children may show constant irritability and extreme sensitivity to touch, odors, and noises, as well as an inability to handle changes in routine. (Papolos chapter 1) The child may have tantrums for hours on end, be aggressive to himself or others, and show an inability to focus. Parents sometimes feel a sense of helplessness and frustration not knowing how to deal with the child. Neighbors sometimes tell their children not to associate with these out-of-control kids, and an untreated bipolar child can be the cause of many problems with siblings. Many young children have tantrums that last 20-30 minutes, and some engage in tantrums for hours without showing signs of reduced intensity. (Fawcett 239)
Frequently bipolar disorder is manifested for the first time during adolescence, which is a time of "normal" turmoil. Since moodiness and various crises around school and relationships often occur during the teen years, it is easy to understand how the early symptoms of bipolar disorder might first be incorrectly attributed to "normal" adolescent problems. All too often, doctors fail to arrive at an early diagnosis. (Fawcett 34-35) Clinical scientists have found that the...