We present the first of two parts of the article ‘Bipolar Disorder in Child and Adolescent Population‘ by Stephanie Vizuette and María Jesús Rojas. The first part will provide an introduction to bipolar disorder and its detection in childhood, while the second will offer a detailed description of the symptomatology of child and adolescent bipolar disorder.
Bipolar disorder with onset in childhood and adolescence is one of the pathologies for which it is difficult to find specialized bibliography. In the area of mental health care, there is a growing and large amount of relevant literature and research for clinical practice. The reading of different articles and manuals has fostered the exercise of compiling and synthesizing the most significant information on bipolar disorder in child and adolescent population.
Bipolar disorder
According to the Diagnostic and Statistical Manual of Mental Disorders DSM IV-TR, bipolar disorder is a serious brain illness also known as manic-depressive illness or manic depression. People with bipolar disorder have unusual mood changes. Sometimes they feel very happy and ‘up’ and are much more energetic and active than usual. This is called a manic episode. Other times, people with bipolar disorder feel very sad and ‘down’, have low energy, and are much less active than normal, which is known as depression or a depressive episode. Occasionally, manic and depressive symptoms appear at the same time (called a mixed episode), and finally, symptoms similar to manic ones but of shorter duration and severity, called hypomanic episodes, or symptoms that resemble hypomanic episodes that later change to symptoms that resemble depressive ones, but without being as intense as depressive ones (cyclothymia), may appear.
Bipolarity in children
The onset of bipolar disorder in children and pre-pubescents can be characterized by both manic and depressive episodes. But contrary to what happens in adults, mood swings fluctuate rapidly, potentially presenting symptoms of mania and depression, coupled with persistent irritability. Dr. Amy West and her collaborators (West A., 2008) conducted a retrospective study of the temperament of early-onset BPD when they were infants and young children, indicating that it was possible to differentiate these children from ADHD control groups and healthy ones, in terms of the severity of early temperamental characteristics: difficulty sleeping, care difficulties, excessive crying, difficulty being comforted, separation anxiety, and difficulty calming down after separation. As young children, before the age of four, these children were described as less adaptable, more emotionally intense, more negative, and less regulated. According to the findings of Luby J. and Belden A. (2008), although preschoolers with bipolar symptomatology and those with unipolar depressive disorder present similar clinical levels of sadness, in bipolar individuals, these periods of sadness are more prolonged and they are significantly more prone to present depressive symptoms such as: easy annoyance, sleep problems, self-hatred, death themes in games to the exclusion of other themes, self-harming behaviors, and clinically significant anhedonia, understood as the inability to enjoy recreational activities.
ISEP offers the Master’s in Child and Adolescent Clinical Psychology, which covers Child and Adolescent Bipolar Disorder. If you want more information about it, you can do so by clicking here.